Clean Eating & The Rise Of Orthorexia

Enthusiasm for nutrition and health has gone well beyond your 5 a day. Bored of the accepted advice to eat a balanced diet and get some exercise, a growing number of people are creating a dangerous lifestyle for themselves, leading to the rise of Orthorexia. Sure you want to be healthy and cut out refined sugar but you want people to see you do it. If you didn’t take a picture of your chia seed smoothie, did you even really drink it?

On Instagram, you’ll find culinary inspirations from quinoa brownies to spiralised courgetti. #EatClean is big business and many of us foodies are providing content which is interpreted by some, whether you want it to or not. Waking up, you are guaranteed to scroll endlessly through healthy ingredients accompanied by inspirational messages. Eating healthy should be encouraged but religiously documenting it can be harmful. Balance is important in all aspects of life, and too much of anything, even a good thing, can be bad.

Eating clean does not make the food you reject dirty, and no regime no matter how healthy it proclaims to be, should make others feel like they can’t keep up. The majority of devotees to clean eating diets and rigorous exercise regimes are teenagers and young women. The obsession with healthy eating can become addictive and lead to Orthorexia - when healthy eating turns against you. It’s a condition that is becoming worryingly prevalent amongst new clients in my Harley Street clinic.


Orthorexia is a term coined in 1996 by American physician Steven Bratman. He began to use it with patients who were overly health-obsessed. While Orthorexia is not currently recognised as a clinical diagnosis, it is term that can be used to suggest that healthy eating may not be as beneficial as you presume. Recent research has suggested an average prevalence rate for Orthorexia is nearly 7% for the general population.

Categorised by a pathological obsession for biologically pure food, this preoccupation leads to dietary restrictions. It is often a stage linked to Anorexia with those recovering often naturally falling into Orthorexia. Orthorexia always involves an intense compulsion to stick to any single way of eating, thinking and behaving around pure food. For example, sufferers may become so fixated over their macros they cut out vegetables such as red peppers and tomatoes, which are relatively high in sugar and carbohydrates. Before you know it, you have a diet that is basically just protein and very, very restricted. Many are so obsessed with short-term goals that they don’t think about the damage a restricted diet will do in the long term.

Orthorexia is a form of maladaptive eating that can begin with good intentions. There is a suggestion that Orthorexia is related to pathological eating attitude and obsessive-compulsive symptoms. Sufferers typically cut out entire food groups, often in the mistaken belief they are unhealthy, their bodies are intolerant to them or curing an ailment. This restriction deprives them of essential nutrition and vitamins. Accompanied with over-exercise, you are left weak or often emaciated. Amongst other symptoms, low energy levels and nutritional deficiencies can lead to depression and anxiety.


Dr Steven Bratman has developed a 10-point test, which can be used to determine whether Orthorexia is a prognosis. The test allows family and friends can ask similar questions of loved ones if they are concerned about them.

Do you spend more than 3 hours a day thinking about your diet? • Do you plan your meals several days ahead? • Is the nutritional value of your meal more important than the pleasure of eating it? Has the quality of your life decreased as the quality of your diet has increased? • Have you become stricter with yourself lately? • Does your self-esteem get a boost from eating healthily? • Have you given up foods you used to enjoy in order to eat the ‘right’ foods • Does your diet make it difficult for you to eat out, distancing you from family and friends? Do you feel guilty when you stray from your diet? • Do you feel at peace with yourself and in total control when you eat healthy?

Yes to 4 or 5 of the above questions suggests it is time to relax more about food. Yes to all of them means a complete obsession with eating healthy food.

Those who are suspicious of a loved one or friend is suffering from Orthorexia should ensure they seek help from a Registered Nutritionist and consult with a GP. Subsequently, help can be offered to structure an eating regime that that is more rounded. Assessing whether a person is being deprived of key nutrients is vital as it can lead to malnutrition, anaemia or an abnormally slow heart rate. Additional health consequences include digestion and fertility issues, hormonal imbalances and impaired bone health. Rigid eating patterns will also make it challenging to take part in social activities revolving around food, such as dinner parties or eating out.

A trigger is often at the root of any eating disorder and starting a diet, a trigger in itself will change your relationship with food. It can provide a powerful urge to eat little to nothing or conversely excessive quantities. Embarking on any diet will mean you are vulnerable to an eating disorder. Subjecting to yourself to believing you would be happier being slimmer or have less body fat along with believing weight should be managed expertly to the milligram are all dietary syndromes. Values and attitudes influence our behaviours and ultimately our relationship with food.

Body dismorphia is prevalent within our perfection-focused society. Just 8% of teenage girls in a poll suggested they were happy with their appearance. Of those who said they were unhappy, 90% thought their own mother had an insecure body image. 67% thought they needed to lose weight and 64% of those under 13 had already been on a diet. The research also disclosed some disturbing facts about the lengths young girls would go to in their quest for the body beautiful. More than a quarter of 14-year-olds said they had considered having plastic surgery or taking diet pills, rising to 42% among those who were overweight. Almost 19% said they were already suffering from an eating disorder.

While social media can be a positive space for peer support during recovery from eating disorders, when the overarching emphasis is placed on supposedly healthy diets with good and bad foods, it is obviously an example of where this kind of influence can have a negative effect. It is widely accepted that those who believe so vehemently in a cause tend to stick together as means to justify it. So, it’s no surprise to see scientific research demonstrating pro–eating disorder online movements supporting engagement with their lifestyles and associating them with negative health consequences.

The obsession with meals presented as art and so-called clean eating advice from self-appointed diet gurus is having a tremendous affect on people's relationship with food. There is no doubting now that the bombardment of unqualified diet advice and images of fashionable food can have an unhealthy influence on impressionable children and teenagers or those already struggling with an eating disorder.

Eating disorders are complex mental illnesses with no single cause. We can’t blame this clean eating trend of sharing images of food entirely for the development of an eating disorder, but for individuals already struggling with an one, it’s likely to only exacerbate the problem. Eating healthily and regular exercise are the pillars of a healthy lifestyle, but anything can be dangerous if taken to the extreme. We are just a click away from seeking advice on the internet about diets and lifestyle, but the information available is not always helpful or accurate. Deciphering the legitimate guidance of qualified Nutritionists from the bad advice of wannabe professionals can be risky.

All eating disorders are multifaceted with many sufferers requiring treatment from a number of professionals before being in a position to manage any condition safely. If you know someone or feel you are preoccupied with weight or susceptible to an eating disorder, there are countless ways to find expert help and advice. Speaking to your GP is a typical place to start to ensure there is no damage from any symptoms. Trusted nutritional guidance should only be considered if issued by a Registered Nutritionist or Registered Dietitian. More information on eating disorders can be found at The National Centre of Eating Disorders.

Rhiannon Lambert is a Registered Nutritionist specialising in weight management, eating disorders and sports nutrition. Founder of leading Harley Street clinic Rhitrition, bestselling author of Re-Nourish: A Simple Way To Eat Well and Food For Thought podcast host, Rhiannon’s qualified approach to nutrition and total dedication to her clients’ needs has seen Rhiannon work with some of the world’s most influential people


What Are The Side Effects of Dieting?


An Introduction to the Gut Microbiota