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May 29, 2018

The Dark Side of “Clean Eating”

Written by: Erin Burke MS, RDN, LDN

Let me ask a few questions:

  1. How often do you think about your weight?
  2. Are your Instagram and Facebook Feeds overrun with healthy lifestyle gurus?
  3. Do you avoid certain food groups, such as carbohydrates, fats or sugars?
  4. Are you constantly checking food labels for offensive ingredients?

Finding someone who does these things in our society is not hard. In fact, many of these behaviors are actually praised. But here’s the thing: these behaviors, among others, are warning signs and symptoms for a type of disordered eating known as orthorexia. Though not a formally recognized eating disorder, the term orthorexia was developed to describe an obsession with healthy eating.

Wait a minute. An obsession with healthy eating? you may be thinking: isn’t that a good thing?

Let me explain.

Orthorexia starts with good intentions. You might start replacing some snacks foods with fruit, choosing foods with a bit more fiber, and starting your dinner off with a salad. No medical professional will argue that these are healthful behaviors. However, when the pursuit of “clean eating” begins interfering with your life, problems arise. For example, anxiety over food production can lead you to skip dinners out with friends. Parties and social situations become off-limits since “clean” food will not be provided. Physically, malnutrition sets in as major food groups are eliminated. This type of behavior can also lead to a full-blown eating disorder, such as anorexia or bulimia

May is Mental Health Awareness Month. Orthorexia and identified eating disorders, including anorexia-nervosa, bulimia-nervosa, and binge-eating disorder, are serious, potentially life-threatening conditions. As outlined above, they affect both physical and emotional well-being. It is estimated that 20 million women and 10 million men in America will suffer from an eating disorder at some point in their lives (1). Dieting is a major risk factor for the development of an eating disorder, especially among young boys and girls. The National Eating Disorders Association (NEDA) reports that teens to who diet are five times more likely to develop an eating disorder than those who do not (2). How prevalent is dieting? Over one-half of teen girls and over one-third of teenage boys practice unhealthy weight control behaviors. Young girls begin showing concern over their weight and shape by age six. What is contributing to this?

Environmental Triggers.

Eating disorders are caused by a complex interaction between genetics, the nervous system, personality characteristics, and environmental factors. However, disordered eating behaviors (eliminating foods or food groups, extreme exercise, laxative abuse, and following very low-calorie diets) are thought to be much more common. The idealization of thinness, bullying and weight stigma are all major societal triggers for dieting.

Eating disorder, and orthorexia, do not discriminate.

When you think of a person with an eating disorder, you may think of a thin, young white female. The truth is, eating disorders can affect both men and women of all ages, sizes, cultural backgrounds, sexual orientations, races, ethnicities and socioeconomic status.

What is a healthy approach?

Disordered eating behaviors are so common today that they may even feel “normal”. However, it is a slippery slope. Remember: Nutrition is not black and white. There are truly no “good” or “bad” foods. Food choices do not fulfil a moral obligation. If you find that you are anxious or distressed about eating a particular food, or feel guilty or ashamed after eating, seek help immediately. Remember that bodies come in all shapes and sizes, and consider taking a weight-neutral approach to health. Choose foods and exercises that make you feel good, rather than choosing those that feel like a punishment. Make health decisions from a place of self-compassion rather than self-hate.

The National Eating Disorder Association has developed a screening tool to help you assess whether your behaviors toward food, exercise, and your body are healthy or harmful. Check it out here (

If you are struggling to find a healthy balance to nutrition, exercise, and/or body image, reach out to schedule an appointment with an Avance Care Behavioral Wellness counselor and registered dietitian by calling (919) 237-1337, option 3.



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Erin Burke is an RD/N working at the North Raleigh and Central Raleigh offices. She enjoys running, yoga, working in her yard, and snuggling with her dog, Lottie. She is passionate about promoting a healthy lifestyle in a non-judgmental environment.

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