So-called clean eating* is very trendy right now, inspiring people of all ages to pursue a “clean” diet. The clean eating movement includes avoiding processed foods and eating raw, unrefined produce. This often becomes a raw vegan diet, and it is raising red flags everywhere for eating disorder specialists who are reporting an alarming trend in eating disorders that started out as clean eating programs.
*“Clean” and “clean eating” refer to the trend, not the food itself. We do not ascribe nor give any credence to the idea that some foods are cleaner than others, or that there is any validity to the clean eating trend. It’s a dangerous sham. So please proceed with that in mind.
“At best, clean eating is nonsense dressed up as health advice,” wrote Max Pemberton, MD, in the Daily Mail. “At worst, it is embraced by those with underlying psychological difficulties and used to justify an increasingly restrictive diet — with potentially life-threatening results.”
Clean eating has taken off in large part due to bloggers and social media “influencers,” who have little to no nutrition training. Like most diet fads, these influencers promote a certain way of eating as if it were the single answer to a complex question. These influencers operate as preachers in the church of clean eating. Each has their own spin on the clean eating Bible, and is trying to gather as many followers as possible.
Despite the fact that there is absolutely no evidence supporting clean eating and its many claims, influencers have a serious impact on intelligent people who are vulnerable to this trend based on an unguarded belief in diet culture (i.e. “healthy” equals “thin,” and achieving a thin body should be a top priority).
The fact is that despite all the news media and social media telling us that diets work, nutrition science has been unable to prove that intentional weight loss is either possible or healthy. It has been impossible for researchers to demonstrate sustained weight loss or improved health on any diet for 95% of the population two years after weight loss. 
But powerful influencers promote clean eating diets that they promise will change your life, give you energy, detox* your body, make you lose weight effortlessly**, etc. etc. There is zero valid science behind clean eating claims, but the influencers are much sexier than science, and they sell clean eating like it’s candy (except, of course, they don’t eat candy).
*Detoxes are a scam. Unless you have a non-functional liver, your body does all the detoxing it needs automatically. There is absolutely zero scientific evidence showing any value of dietary detoxes, and quite a bit of evidence of dangerous side effects including dehydration, fatigue, and increased risk of infection and illness.
**Effortless weight loss typically occurs only when one is seriously ill – either mentally or physically. Otherwise, it’s freaking hard work and involves painstaking restriction and starvation.
Clean eating influencers all rely on a concept called “healthism,” which is the mistaken assumption that anyone can achieve “health” (defined as a slim body), relatively easily if they simply apply individual discipline and moral conduct. 
Healthism can be found in almost every diet book, blog and social media account, with celebrities and influencers screaming “I did it, this is how, and you can do it to!” and “If you follow my program, you can have a body just like mine!”
Healthism completely ignores the genetic and social determinants of health, which are well established in medical literature. In short, the largest predictors of health are genetics and zip code. Your genetics set 70% of your weight (just FYI: genetics account for 80% of your height, and you probably don’t think you can change that).  Meanwhile, social determinants of health, including socio-economic status and environment, have a much larger influence on your health than anything you can do as an individual.
But this concept does not sell books or get “likes” on Instagram. Healthism, on the other hand, is a consistent winner when it comes to “likes.” 
The result is that eating disorder specialists are reporting increasing numbers of people becoming sick via clean eating. It usually starts with cutting out processed foods. Soon they cut out sugar and then animal products, which are vilified on many clean eating blogs and social media accounts. For vulnerable populations, particularly pre-teens, teens, and young adults, something that starts out as an apparently positive move towards health snowballs into a very unhealthy obsession with controlling every bite of food.
“When new clients eat clean, they are elevating certain types of food (organic, locally-sourced) as ‘good,’ while demonizing all other food as ‘bad,’” says Brittany Markides, dietitian and founder of the Choose Food nutrition counseling service, in The Independent. “This way of thinking hurts our food relationship and leads to distorted eating patterns. Because the thought that the foods they are craving are ‘bad’ is deeply ingrained, eating these foods, which are perfectly fine, causes guilt and shame.”
Social media use has been directly tied to negative effects on body image, depression,  social comparison, and disordered eating.  A particular correlation has been noted between social media use and orthorexia nervosa, an obsession with eating healthily. One study linked Instagram use in particular to orthorexia nervosa. The study found that among almost 700 social media users who follow health food accounts, 49% showed symptoms of orthorexia, compared to less than 1% of the general population. 
Eating disorders are based on restriction, and clean eating is restriction. We have long defined an obsession with healthy eating as orthorexia, a disordered, unhealthy way of thinking about food, and clean eating is virtually indistinguishable from orthorexia. Clean eating is the perfect cover for disordered eating. It’s a trendy and acceptable cloak for eating disorders.
Sure, bring on the whole foods, try to choose locally-sourced foods when possible, come up with creative methods of serving whole grains, ancient grains, pulses and nuts, and serve raw veggies as crunchy snacks, but don’t cut out everything else!
Here’s the bottom line: to prevent eating disorders, parents should not support clean eating.
This doesn’t mean you force-feed your child Doritos and donuts all day. Parents should offer well-balanced meals that include fruits and veggies, pulses, nuts, grains, breads, animal products, butter and other fats, desserts, chips, and other treats. In other words, put a mix of highly nutritious foods on the table, but also offer fun foods. Not doing so leads to many unhealthy returns, including eating disorders.
If your child has already gone down the path of clean eating and seems very resistant and/or afraid to eat “non-clean” foods, then you may be encountering signs of orthorexia. Many of us will cry and show signs of anxiety when asked to eat foods that fall outside our boundaries of what we consider to be clean. Please seek a qualified eating disorder specialist for a consultation so that you can get help. To get started, you can call the National Eating Disorders Association (NEDA) hotline at 1-800-931-2237.
Early intervention can make a tremendous difference in a person’s likelihood of recovery from an eating disorder.
References Mann, Secrets from the Eating Lab, 2015  Sharma SS, De Choudhury M, Measuring and characterizing nutritional information of food and ingestion content in instagram, Proceedings of the 24th International Conference on World Wide Web, 2015  Lin LY, et al, Association between social media use and depression among U.S. Young Adults, Depress Anxiety, 2016  Carrotte ER, Vella AM, Lim MS, Predictors of “Liking” Three Types of Health and Fitness-Related Content on Social Media: A Cross-Sectional Study, J Med Internet Res. 2015  Turner, Lefevere, Instagram use is linked to increased symptoms of orthorexia nervosa, Eating and Weight Disorders, 2017  Crawford R, Healthism and the medicalization of everyday life, Int J Health Serv., 1980