Popularity of clean diets has significantly increased in recent years. This approach to eating emphasizes the consumption of whole foods and the avoidance of processed foods as much as possible.

Given the importance of diet for health, it is often assumed that better nutrition will result in better health. However, as one influencer who promotes clean eating discovered, too restrictive a diet can have the opposite effect on health.

Instagram influencer Alice Liveing recently shared how becoming a clean eating influencer negatively impacted her health. In an interview with The Times, Liveing revealed that her restrictive diet, combined with extreme workouts, seriously affected her health – leading to poor sleep, low mood and energy, poor brain function, and even loss of menstruation.

Alice Liveing's story highlights how focusing on achieving an unrealistic health ideal – in this case, a perfect, healthy diet – can become all-encompassing and "addictive." For some, this obsession with healthy eating and the quest for the "perfect diet" can result in orthorexia – an unhealthy obsession with healthy eating.

Eating Disorders
Orthorexia is not yet officially recognized as an eating disorder. However, in 2022, experts in the field issued a statement agreeing that orthorexia is distinct from other eating disorders – such as anorexia.

They also proposed some diagnostic criteria for orthorexia. This includes compulsive eating behaviors (with the belief that they will promote optimal health), excessive fear of illness if the diet is discontinued (accompanied by emotional reactions such as fear and shame), and adherence to increasingly restrictive diets.

Orthorexia can impact many aspects of a person's life – including social, academic, and even work life. It also has many physical consequences – it can lead to anemia, severe weight loss, and malnutrition. It can also cause feelings of anxiety and guilt, especially if the person deviates from their strict diet.

Many factors are considered to be associated with the onset of orthorexia. Some examples include a history of eating disorders or mental disorders, lifestyle factors (such as frequent exercise), and social factors (including excessive media influence).

A person writes in a food journal. There are plates of healthy food on the nearby table. Perfectionism is associated with many eating disorders – including orthorexia. Rawpixel.com/ Shutterstock

Individuals with certain personality traits – such as perfectionism – may also be at greater risk of developing orthorexia, as our previous research has shown.

Perfectionism
Perfectionism is a personality trait characterized by an irrational need for perfection. It has two basic dimensions – striving for perfection and concern over imperfection.

Striving for perfection involves a personal commitment to being perfect. Concern over imperfection involves a fear of imperfection. Both of these dimensions of perfectionism have previously been associated with the development of anorexia and bulimia.

Perfectionism is also associated with orthorexia, as our meta-analysis (a study of studies) has shown. Looking at the available research, we found that both striving for perfection and concern over imperfection are associated with orthorexia.

However, striving for perfection has been shown to be the most important aspect when it comes to the likelihood of someone having orthorexia. This is different from other eating disorders – research shows that concern over imperfection is more strongly associated with the development of anorexia and bulimia.

This finding shows us that the factors contributing to orthorexia are different from other eating disorders – and that orthorexia is driven more by a desire for a "perfect" diet or "perfect" health, rather than a fear of imperfection.

Due to the lack of official diagnostic criteria, it is difficult to know how many people are affected by orthorexia. However, one recent study suggests that as many as 55% of regular exercisers have orthorexia. And given that so many young people now rely on social media for lifestyle and diet advice, there is a risk that orthorexia may become more common in the future.

Researchers and healthcare providers face a significant challenge in keeping up with this phenomenon. It is clear that more research is needed to better understand orthorexia, how we can prevent it, and how we can help those who struggle with it.

Original:
Verity B. Pratt
Doctoral Candidate, School of Science, Technology and Health, York St John University
Andrew P. Hill
Professor of Sport and Exercise Psychology at York St John University
Daniel Madigan
Professor of Sport and Health Psychology at York St John University