“Clean Eating” Gone Too Far? Recognizing Orthorexia’s Grip and Finding Recovery

by | Jun 25, 2024

In our confusing food and body landscape, we often get the message that being strict or restrictive with our diet is always a good thing. We’re also often taught, either explicitly or subliminally, that eating “clean” (whatever that is) holds some kind of moral virtue. You may feel like a sense of pride if you’re able eat less, or cut foods out from your diet. But this can be a slippery slope and for some leads to disordered eating or even an eating disorder known as orthorexia. In this article, I’ll explain a couple of the major rabbit-holes that can lead people down this path so you can spot these tendencies in yourself and find recovery from orthorexia. Recovery from disordered eating isn’t easy, but it is SO WORTH IT.

It’s important not to blame or shame yourself if this resonates with you. This is not your fault or a sign that there is anything wrong with you. I sincerely hope you find this helpful and hopeful and you can begin to see that you deserve a big, full life without the narrowing that orthorexia and other disordered eating can cause.

What is Orthorexia?

Orthorexia nervosa is a serious eating disorder where you can become preoccupied and obsessed with eating “correct” or “clean” to a point where it is no longer helpful and has turned harmful. Although it’s not officially recognized in the DSM-5 yet, more and more eating disorder experts are recognizing orthorexia as a real condition that needs specialized treatment. This is especially true as wellness influencers (thinking Gwyneth and Jordan P.) continue to talk about their diets in a sort of never-ending stream of consciousness nonsense.

Typically this type of eating disorder starts with a genuine desire to improve one’s health and then builds gradually. You may become fixated on the quality and “purity” of your food. You may end up with a super rigid diet or LOTS of food rules, like cutting out entire food groups, only eating organic or unprocessed foods, or having strict meal rituals. 

If recovery is not being worked on, orthorexia can cause serious nutrient deficiencies, unintentional weight loss, social isolation, osteoporosis, and can seriously interfere with life. It can take over more and more of your time, mental space, energy, and frankly, life.  

While eating healthy is a nice way to live, orthorexia is different. It causes intense food anxiety, lots of guilt after eating anything not “perfect”, and self-punishment if you break food rules. 

There Is No Perfect Diet

Eating a healthy diet is no doubt a fantastic idea. Hell, I got a Master’s degree in nutrition. I’m invested in the power of good food for health and well-being. But as you’ll hear from most dietitians, eating “perfectly” is not a goal that anyone really should have. Here are the reasons I state this (and also tell this to every client I ever have).

  1. There are no lasting health benefits of being super strict with your diet. Meaning eating “no sugar” or “no processed food”. Those who have “high added sugar” would probably be well-served by lowering it some if they can, but eliminating it completely offers no clear health benefits, just like any other food group. You do not have to be a sugar detective in order to eat healthy food. It’s okay to have some sugar in your diet. The scientific consensus, based on decades of research is that limiting sugar to 10% of your total intake is the best case scenario.
  2. Personal preferences, cultural foods, access to food, time availability, and income all determine what kind of diet we have. Ignoring these things and trying to never eat x,y,z could be extremely difficult for you, to the point of impossible.
  3. Trying to eat perfectly can lead to disordered eating and eating disorders, such as orthorexia. While recovery is certainly possible, it’s a lot of work! Preventing an eating disorder is a much better goal for yourself.

When eating healthfully becomes the main focus in life, and interferes with relationships and emotional well-being, it needs to be considered a problem, not an impression expression of willpower, as diet and wellness culture would have you believe. 

What are the Warning Signs of Orthorexia?

Orthorexia develops gradually, making it hard to recognize. It’s kinda like that frog in the hot water metaphor. You know the one. In case you don’t, it goes like this: 

If you put a frog in boiling water it will jump out. But if you put a frog in regular water and slowly increase the temperature, it will be boiled to death. 

That’s often what’s it’s like with this disorder. Everything seems just fine, cutting out a thing or two here, being more careful about what you’re eating. Until all of a sudden things are out of control and you don’t really know how you got here. 

Some key warning signs of orthorexia to pay attention to in yourself or loved ones:

  • Obsessively worrying over the quality, purity, or “cleanliness” of food
  • Rigid food rules or elimination of entire food groups (grains, processed foods, anything “white”, etc)
  • Extreme anxiety or guilt when eating rules are broken
  • Avoiding many foods and using supplements to meet nutrition needs
  • Spending excessive time researching, planning, and preparing meals
  • Avoiding social situations involving food – this one is particularly important 
  • Judging others’ food choices harshly
  • Feeling virtuous or self-righteous about eating “correctly” 
  • Persistent fear of illness caused by “unhealthy” foods
  • Insisting on the healthfulness of one’s eating habits despite evidence to the contrary
  • Difficulty eating anything not prepared by yourself

As you can see, this isn’t just a desire to eat healthy. It is an extreme version of healthy eating, one that is no longer adding to your life, but is taking away from your life. It can be really hard to identify when this becomes a problem, which is why talking to a HAES-aligned dietitian trained in eating disorders, or with a therapist can be so helpful. If you want to find recovery from orthorexia, it’s totally possible.  

Two different meals, one of burgers and fries, one of a salad with fruit. Both meals say over them "your worth is not measured by your meal" indicating orthorexia recovery requires separating morality from food.

The Appeal to Nature Fallacy > Rabbit-hole > Orthorexia

The appeal to nature fallacy is the belief that anything “natural” is inherently good, healthy, or superior, while things that are “unnatural” or human-made are automatically bad or harmful. I just hate this misconception. It’s so elitist and ridiculous. 

This is also not true and not backed by science. But sadly, It’s a really common misconception, especially in our current culture where food morality gives many a sense of purpose (or perhaps self-righteousness?).

Just because something is natural doesn’t automatically make it better for us, and natural things can absolutely be dangerous (think poisonous plants, opium, or deadly diseases like COVID-19!). On the flip side, many human-made or “artificial” things have improved our health and quality of life (hello life-saving medicines, technology, refrigeration, and pasteurization – just to name a few).

On social media, you see the appeal to nature fallacy all the time – the push to avoid “chemicals,” the fear-mongering around processed foods, the romanticizing of a “simpler” way of life. Wellness influencers and bloggers often promote the idea that the more “natural” and “clean” your lifestyle is, the healthier you’ll be. But this just isn’t backed up by science. And, as I said, is extremely elitist and privileged. 

Adhering to the belief that all food should be perfectly “natural” is one of the reasons that folks develop orthorexia, so certainly can come with some pretty serious side effects. An important part of recovery from orthorexia, or any eating disorder, is learning why this information is pushed in the media and gaining some media literacy so you can judge for yourself which information is useful and which is click bait.

How “Clean Eating” Can Lead to Orthorexia

When you convince yourself that you can only eat foods that are “natural,” “clean,” or “pure,” it can quickly become super restrictive and dogmatic. Any food that doesn’t fit this narrow definition of healthy becomes off-limits, and the list of fear foods grows and grows. 

You start out with just trying to eat more “clean” by not allowing anything in a package, and before you know it, you’re in a full-blown eating disorder. You end up being afraid that eating a granola bar will actually put your health in jeopardy. 

Folks who orthorexia or other eating disorders often have to spend months, or even years, trying to recover. They have to hire someone like me (an eating disorder dietitian) and a therapist who can help them eat in peace again. It’s a lot of work. Not glamorous.

Elimination Diets and Functional Medicine, Despite Being Well-Intentioned, Can Lead to Orthorexia and Other Eating Disorders

I think functional medicine as a whole helps many people in times when conventional medicine cannot, especially those who feel un-listened to and left out by Western conventional medicine. This is often those with conditions that are not fully understood, who are often women. But in my professional opinion, there are many problems. 

Cutting out foods or whole food groups is far too often the first tool used, even when the evidence does not support it. And, from what I have read and have experienced myself, cutting out food groups seems to be used as a blunt instrument, rather than in subtle, gentle ways that “traditional” medicine is likely to have suggested. 

Functional medicine practitioners often recommend these diets as a way to “heal the gut” or “reduce inflammation” and improve various health conditions, even if there is no solid evidence that doing so is likely to help.

Many clients have come to me after having been instructed to cut out gluten, dairy, nightshades, beans, and eventually also all grains. They’re left with an extremely restricted diet, fear they’re messing up, and often their symptoms don’t improve anyway. 

While we’re on the subject, science shows only 1% of people have celiac disease and about 6% of the population is “gluten intolerant”. Not everyone with chronic fatigue, IBS, thyroid issues, or a litany of other conditions should be slapped on a gluten-free diet

On top of the fact they likely won’t “cure” you, elimination diets can easily become a slippery slope into overly restrictive eating patterns. The more foods you eliminate in an attempt to “improve your conditions,” the more foods that get added to the mental list of “bad” or “forbidden.” This can create a lot of fear and anxiety around food, leading to an increasingly narrow range of “safe” options. Now they don’t only have digestive issues, but they have to worry about recovering from orthorexia, anorexia, or a binge-restrict cycle.

Unfortunately, some functional medicine practitioners may not be well-versed in recognizing or treating eating disorders, and may even inadvertently encourage orthorexic tendencies in their clients. The language of “clean eating,” “detoxing,” and “healing” can make these restrictive diets seem like the virtuous choice, even when they’re causing more harm than good.

It’s not great. 

What’s It’s Like To Recover From Orthorexia

If you realize you’ve gotten caught up overly stressing about food, I want to say this again: it is not your fault. 

Eating disorders are not choices, but happen in those who are vulnerable for a number of reasons. Here are a list of things, explained briefly that can help you on the path toward more peace with food and recovery from orthorexia . 

Seek professional help 

If you feel really stressed and preoccupied with food rules, you probably need to work with a team including a therapist specializing in eating disorders and a registered dietitian familiar with HAES and intuitive eating principles. Full support can sometimes be costly. 

If you need help, but cannot afford it, reach out to Project Heal. 

If you are reading this because you fear your food rules are starting to interfere with your life, perhaps you can do this work on your own. It’s never too soon to ditch dieting for good and explore a food freedom journey.

Challenge food rules

Sometimes, it’s smart to understand the truth about why these foods will not hurt you, but sometimes it’s just about exposing yourself to the things you’ve been avoiding – slowly and one at a time. Also work on increasing flexibility with timing of meals, where you eat and how you cook. Recovery from orthorexia must include liberating your diet and adding back fear foods at a pace that feels okay to you.

Practice body mindfulness 

Practice pausing during the day to tune into your body’s hunger, fullness, and satisfaction cues. Just the act of stopping to check in with yourself is a powerful tool in your toolkit. 

If you are neurodivergent and have trouble connecting with your body, you may need to put yourself on more of an eating schedule. 

Expand your definition of health

Health is so much more than food and exercise. In fact, our individual health behaviors only account for about ⅓ of our health. Social connection, access to good healthcare, and our living environment matter just as much. 

I like to get my clients to shift their definition of health from “the things I do” to “my overall sense of harmony and well-being”. 

Address underlying mental health issues

Explore and work through any anxiety, perfectionism, or trauma that may be fueling the orthorexia. Clearly, this is a big can of worms and could take months or years to work through. But that’s normal. 

You’ll also want to develop some better coping skills. Learn healthier ways to manage stress and emotions that don’t involve food restriction.

Work on body acceptance & respect

I can’t tell you how empowering and helpful it is to challenge mainstream societal beauty standards. And honestly I think that most women are so acutely aware of how oppressive this has been, even those who are very blessed genetically. Digging into this oppression is a main component of my group intuitive eating group, The Love Food Again Program.

Choose to stop objectifying yourself. 

Working on body image and accepting your body is certainly hard. It’s even hard work to get over the hump and accept this is where you are. But I promise you, this will change your life. You can learn to feel comfortable in your body, to take care of it, and to learn to take excellent care of it, without constantly scapegoating and blaming it.

Practice self-compassion

My clients can expect that I’ll tell them to give themselves grace and compassion about once every session. This isn’t because I say it automatically, it’s because I hear them blaming themselves for every little mistake, every way that they do not do things perfectly. 

Be kind to yourself throughout the recovery process and learn to quiet your inner critic. I know it can feel scary because you may think it’s protecting you, but it’s really just dragging you down. 

Broaden your interests and hobbies

I can’t stress enough how important it is to enjoy your life. Rediscover hobbies and passions outside of food and health. I took a painting class a couple years ago and surprisingly, now I have this entire new hobby that I can pick up whenever I want. 

It’s extremely pleasurably and makes me so happy. It feels good on a happy day, and really good on a sad day. 

Build friendships that are aligned with your healing 

Surround yourself with supportive people who model a healthy relationship with food. If all your friends are fixated on being a tiny size, or micromanaging their food and exercise, you might need to do the hard work of finding a new friend or two who definitely are not like this. 

If you don’t know anyone like this, I encourage you even more to find a dietitian or therapist who can be a bridge. If that’s not available, and even if it is, you can find support online.

Educate yourself

Checking out some Health at Every Size resources. Learn about Intuitive Eating and the toxicity of diet culture.

And last but very much not least, be patient: Recovery takes time and isn’t always linear. Celebrate small victories along the way and remember that it is SO worth it to get to full recovery. You’ll never regret it, no one ever does. 

Final Thoughts On Recovery from Orthorexia

Obsessing about the details of your diet, fearing about where your food comes from, and what ‘toxic’ ingredients that are in it is not normal, even though it’s incredibly common. You can definitely find recovery and healing from these thoughts, whether or not you technically have orthorexia.

If you realize you’re thinking way too much about food and want some support to get the hell over this, I’d love to support you. If you feel stressed about food, but you’re pretty sure you don’t have an eating disorder, consider joining The Love Food Again Program, my 6 month Intuitive Eating support group and coaching program. 

And if you feel that you need more individual support for whatever reason, check out my individual program, Heal & Nourish. You can always book a discovery call to get clear on which program would be best for you. 

If you’re not signed up for my newsletter, go ahead and do that! 

About Emily

Emily Van Eck, MS, RDN specializes in Intuitive Eating, eating disorders, body image, women’s reproductive health, and healing from years of weight-bias and disordered eating. She helps people find balance, consistency, and peace with their eating habits so they can feel confident to get outta their heads and into their bodies. Emily is a registered dietitian and certified Intuitive Eating counselor with a master’s degree in nutrition science. Read more about her practice, values, and experience here.

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Hey there, I´m Emily

A non-diet and weight-inclusive dietitian, intuitive eating coach, and body image healer. Here on the blog, I focuses on exploring intuitive eating, gentle nutrition, the complex arena of body image and feminism, anti-oppression, and all the ways these things intersect. I want us all to be free to own our appetites, and our desires, and eat really, really well. 

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