Let’s first establish some truths about Orthorexia:

  1. There is a growing body of research around Orthorexia Nervosa as a type of eating disorder. For a deeper understanding of Orthorexia Nervosa check out this blog.
  1. An eating disorder is a severe mental illness. So severe, in fact, that it has the highest mortality rate of all mental illnesses.

Now, why might this raise concerns about clean eating?

The clean eating lifestyle comes with all the bells and whistles of a diet. A quick google search reveals multiple sites explaining rules, grocery lists, ‘cleaner’ recipe versions, etc. Clean eating even makes an appearance on popular medical sites.

So, asking the difference between Orthorexia and Clean Eating is essentially asking the difference between a diet and a severe mental illness. Absolutely not one in the same—and yet the alarming reality is that this type of diet (and all diets) normalize and even promote disordered eating in our culture.

My clients know that participating in diet culture is dangerous for their health and they frequently ask me if this is only because they have an eating disorder. Certainly, those who have an eating disorder history may need to be more vigilant and aware of triggers to protect themselves from dangerous messages, but the diet industry can be harmful to all.

So the most important question then becomes, “why has clean eating become such an attractive alternative lifestyle?”

I have no qualms with the concept of clean eating—an opportunity to increase awareness of your food choices, the various ways in which our food supply is prepared and packaged and the overall impact of our choices on sustainability efforts. Sounds like steps towards mindfulness.

However, I do have some feelings about the phrase ‘clean eating.’ It implies that all food not cleared as ‘clean’ must be ‘unclean.’ And that sounds awful. As Harriet Brown writes in her book, Brave Girl Eating, ‘Language shapes the way in which we view the world.’

This phrasing now opens the door for diet culture to assign moral values to food choices in the context of ‘clean’ vs. unclean’ and promote various health claims—including claims about weight.

Clean eating advises eating food as close to its natural form as possible.  ‘As possible’ should not mean ‘all the time, every time,’ but instead, ‘when it is an appropriate choice for you when taking into consideration a host of factors including timing, finances, your body’s unique queues etc…’

So what are important factors to consider when making food choices?

Jessica Setnick MS, RD/LD, CSSD developed a great model to better understand positive nutrition vs pathological nutrition. I encourage you to check out the resources on her site.

The function of food choices is to support our overall wellbeing as human beings. Food choices should be free from shame and judgement. And I caution you to be wary of any system or trend that imposes these feelings onto participants.

Eating disorders allow no room for flexibility or fun in food choices. If you are experiencing feelings of guilt, judgement, or shame around your food choices just know that you are not alone and there is help available when you’re ready.


Danielle Sommers MS, RD, LDN is the program dietitian for Walden’s adult and adolescent PHP as well as the Free to Be program in Braintree, MA. She earned her bachelor’s degree in Human Biology, Health, and Society from Cornell University and completed her Dietetic Internship with a Master’s Degree in Clinical Nutrition at the University at Buffalo. She is passionate about eating disorders and helping others foster positive relationships with food through individual counseling, psychoeducation, group nutrition therapy, and meal planning. She implements Motivational Interviewing and Medical Nutrition Therapy in her work with patients and families. In her spare time, you can find her cake decorating or catching up on some reading.