From Biohacking to Orthorexia: The Dark Side of Clean Eating
- Evgeniya Zhukovskaya
- Jan 27
- 16 min read
Research shows that 75% of certain populations risk developing orthorexia 3.
Your desire to eat healthier can turn into an unhealthy obsession with food purity and "clean eating." Studies show different results - some groups show rates as high as 90.6% 16, while others indicate orthorexic tendencies in 19% of the participants 47.
Steve Bratman, a holistic medical practitioner, first introduced the term orthorexia in his 1997 article 'Health Food Junkie' 48.
The condition starts with a simple wish to improve health. But this mindset can evolve into an obsession that affects your mental health. People with orthorexia often struggle with high anxiety and low self-esteem 47. These symptoms make the condition hard to spot in yourself or others.
Understanding Clean Eating and Biohacking
Clean eating and biohacking have emerged as powerful dietary movements. These trends have captured widespread attention and gained nearly 100,000 hits on TikTok alone through a social-first approach 50.
What is clean eating?
Clean eating describes various diets based on whole foods instead of processed alternatives. This concept promotes eating foods closest to their natural state 52. People following this approach choose fresh produce, lean proteins, whole grains, and healthy fats. They limit processed snacks and packaged foods with added sugar and salt 53.
Bodybuilders coined the term "clean eating" during the 1990s. The original meaning focused on high protein, low carbohydrate consumption while avoiding sugar, fat, and junk food to build lean muscle 51. Tosca Reno's popular "Eat-Clean" books helped expand this concept beyond fitness circles throughout the 2000s.
Clean eating has become a goal for about 90% of surveyed people, much like the previous decades' obsession with maintaining a slim body 54. While this movement promotes nutritious choices, experts debate its potential to create rigid eating patterns, unrealistic standards, and food stigmatisation 16.
The rise of biohacking culture
Biohacking takes health optimisation to new levels. This movement applies tech-hacking principles to human biology, treating bodies as complex systems that need fine-tuning like advanced technology. Biohackers believe optimising their bodies, diet, and lifestyle can enhance mental and physical health and extend their lifespan.
Scientists and wealthy elites started exploring this concept since the mid-2000s, calling it "DIY biology" or "garage biology". Biologist Rob Carlson discussed "the advent of garage biology" in 2005, followed by computer scientist Attila Chsordash's writings about "the coming world of personal biotech" in 2006 50.
Twitter co-founder Jack Dorsey brought biohacking into mainstream consciousness in 2019 by promoting intermittent fasting 50. The trend has grown into a projected £41.30 billion market by 2026. Modern biohacking ranges from basic sleep optimisation to extreme measures like DIY gene editing 56.
Common biohacking practices include:
Intermittent fasting and extreme dietary protocols
Wearable technology monitoring bodily functions
Hyperbaric oxygen therapy
Infrared light treatments
Young blood transfusions claiming anti-ageing benefits
Health, technology, and personal development trends intersect to drive biohacking's popularity. People want proactive ways to optimise their performance as health consciousness grows.
When health becomes obsession
Clean eating and biohacking can quickly shift from healthy choices to problematic fixations. Unscientific health claims and the constant pursuit of "clean eating" have amplified orthorexic behaviours 16.
Many people start with good intentions to improve their health. This mindset can transform into an unhealthy obsession with food purity. The fixation on "pure" and "clean" foods has sparked conversations about personal illness fears and extreme dietary habits 16.
Orthorexia sufferers often feel overwhelming anxiety about consuming anything they consider unhealthy, which damages their physical and mental wellbeing 16.
Society's praise of restrictive behaviours has normalised "clean eating."
This normalisation makes it harder to recognise eating disorder symptoms.
Biohacking culture runs on extreme behaviours marketed as life-changing solutions 56. A newer study, published in 2019 by The Lancet, identified biohacking as a trend leading to eating disorders among men and adolescent boys 56. Extreme fasting and restrictive diets, often labelled as "health optimisations," can hide underlying mental health issues.
Recognising the line between healthy interest and harmful obsession is crucial. Clean eating and strict dietary rules can shape identity and purpose within health-conscious communities 16. This pursuit, taken to extremes, creates the foundation for orthorexia—ironically undermining the health it aimed to improve.
What is Orthorexia Nervosa?
Most people know about common eating disorders, but orthorexia nervosa stands out. It's not about how much food someone eats. The focus shifts to an obsessive fixation with food quality and purity. This newer concept has caught more attention as our society's health consciousness sometimes ventures into harmful territory.
Definition and origin of the term
American physician Dr. Steven Bratman first coined in 1997 the term "orthorexia nervosa." He started to notice a pattern among his patients who were too preoccupied with healthy eating 57.
The name comes from Greek words: "orthos" means "correct" and "orexis" means "appetite" - together they mean "correct diet"9.
Dr. Bratman used the term with a touch of humour to show a patient she was going too far in cutting foods from her diet 58.
Someone with orthorexia nervosa shows a pathological obsession with proper nutrition. They follow strict eating patterns, prepare food in ritualistic ways, and strictly avoid foods they think are unhealthy or impure 59. Orthorexia has been studied for over two decades, but it isn't recognised as a separate eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) yet. This makes its measurement and clinical value debatable 57.
The public started to pay attention in 2014. Jordan Younger, who ran a successful blog as "The Blonde Vegan" with 70,000 Instagram followers, opened up about her eating disorder. She revealed it wasn't about food quantity but quality 61. Her story prompted more clinicians and researchers to look into this condition.
Signs of orthorexia
People who have orthorexia show specific patterns in how they think about and handle food. These key signs include:
Obsessive focus on food quality, nutritional content and "purity" 62
Strict dietary habits centred on "clean" eating
Strong emotional distress when faced with foods they see as unhealthy 63
Staying away from social events where others prepare food
Too much time spent on researching, planning, and preparing meals 64
Cutting out more and more food groups they label as "unhealthy"40
Constant worry about food "cleanliness"
Self-worth tied to following their diet rules
Feeling superior about their eating habits
Guilt, shame, or self-hatred after eating foods they see as "impure" 59
These behaviours can lead to physical and mental health problems. The most severe cases show signs of malnutrition, dramatic weight loss, medical issues, and major problems in social life, work, and school 62.
How it differs from other eating disorders
Orthorexia stands out from other eating disorders in its core motivation and focus. People with anorexia nervosa restrict food because they deeply fear weight gain and have body image issues 16. Those with orthorexia care more about food quality than quantity. Any weight loss happens as a side effect, not the main goal 57.
Dr. Bratman explains: "People are ashamed of their anorexia, but they actively evangelise their orthorexia. People with anorexia skip meals; people with orthorexia do not (unless they are fasting)" 65. People with anorexia mainly avoid foods, while those with orthorexia both avoid "bad" foods and embrace what they see as extremely healthy options 65.
Studies show orthorexia equally affects men and women 66.
This makes it unique among eating disorders, which usually affect more women than men.
Orthorexia looks different from obsessive-compulsive disorder (OCD) too. People with orthorexia see their beliefs as part of who they are (ego-syntonic) rather than as unwanted thoughts (ego-dystonic) 59. They view their behaviour as rational and positive, not intrusive or unwanted.
The lines between orthorexia and other conditions blur sometimes. Some researchers suggest it might be part of restrictive eating disorder patterns rather than its own condition 57.
From Healthy Habits to Harmful Fixation
People begin with honest health goals but end up trapped in a web of strict food rules and anxiety-filled restrictions. This change shows a central paradox of orthorexia—efforts to improve health that damage it instead.
The slippery slope of dietary control
Good intentions mark the beginning of orthorexia if you have certain tendencies. Your original plan might be to cut out processed foods or eat less sugar to boost your health.
The change happens little by little—you might start by reducing certain ingredients before you cut out whole food groups from your diet 9. Research shows that up to 55% of regular exercisers show signs of orthorexia, indicating how this pattern has become common in fitness communities.
This pattern becomes dangerous because society celebrates and rewards extreme dietary discipline. One study participant said: "I felt 'proud' to eat certain organically grown fruits, vegetables, nuts, beans, and drink only fruit or vegetable juice" 65. Such positive feedback makes it hard to spot when healthy habits become harmful.
When clean eating becomes restrictive
The difference between dedicated healthy eating and orthorexia comes down to flexibility and emotional response.
"The line between a commitment to healthy eating and orthorexia lies in knowing how to—or not being able to—practise moderation, and whether the drive to eat healthily creates distress"12.
Clean eating becomes orthorexia when it turns into an obsession that disrupts everyday life. People demonstrate extreme fear of eating certain foods or refuse to eat socially 9. These restrictive patterns usually get worse over time and may include:
Cutting out whole food groups deemed "unclean"
Adding dangerous cleanses or fasts
Creating complex rules about food combinations
Setting up timing rituals for meals 9
Physical effects can be severe. Malnutrition, extreme weight loss, and nutritional deficiencies often follow. A case study showed decreased sodium levels of 130 meq/L and bradycardia in a patient with orthorexic tendencies. "Clean eating" ironically guides people toward poor health outcomes.
The role of food rules and rituals
Food rituals are must-do behaviours with food preparation, eating, or other food-related situations 14. These rituals grow more complex and non-negotiable for people with orthorexia.
Specific rules dictate which foods can mix in a meal or what times of day certain foods are allowed 9. Some people spend 3 to 5 hours daily to prepare food or talk about "correct foods to eat" with others 65. These rituals create an addictive sense of safety and control.
Bournemouth University research found that people with orthorexic tendencies struggled to identify and manage their emotions. This suggests that obsessive food habits help increase perceived control to handle difficult feelings 67. Food rules become their way to cope with emotions.
Breaking these rituals—during travel, social events, or when food choices are limited—brings intense anxiety, shame, and guilt 9. One patient felt "most important guilt and shame whenever he 'slips up' on his dietary regimen," which he "fixed" through a day of fasting 65.
These strict eating patterns make it nearly impossible to enjoy social activities around food. The patient "refused to go to restaurants and started declining offers from friends to eat dinner at their homes unless he could bring his prepared food" 65. People withdraw from social connections and become isolated and lonely 12. This creates a cycle that makes their focus on food control even stronger.
Psychological Drivers Behind Orthorexia
Complex psychological mechanisms drive and maintain orthorexic behaviours beneath the surface of obsessive healthy eating. Understanding why it happens is vital for prevention and treatment.
Anxiety and fear of illness
A deep anxiety about health and illness lies at the heart of orthorexia. People who deal with this condition feel overwhelming distress about their food choices. This leads to a complete focus on dietary purity 16. Their health-related anxiety shows up as intense fear about eating anything they see as unhealthy or impure.
This anxiety goes beyond normal nutrition concerns for many people with orthorexia. Research shows that higher scores on anxiety measures link to stronger orthorexic behaviours.
Some people develop orthorexia as a way to cope with health anxiety. They believe strict dietary control can heal their current symptoms 18.
The anxiety gets worse over time. People with orthorexia often feel guilty, depressed, and extremely anxious when they can't follow their food rules. This can create more serious mental health problems 19. A cycle forms where the behaviour meant to reduce health anxiety ended up increasing overall psychological distress.
Perfectionism and control
Perfectionism drives and maintains orthorexic behaviours at its core. This personality trait centres on extreme self-pressure to meet ever-higher standards20. Perfectionism has been identified as a most important risk factor in developing eating disorders, including orthorexia.
Research shows several key aspects of perfectionism that contribute to orthorexic tendencies:
Perfectionistic strivings involve setting high personal standards and pursuing unrealistic goals 2
Perfectionistic concerns cover fear of negative evaluation, worry about mistakes, and never feeling satisfied with achievements
Clinical perfectionism refers to self-worth based on striving despite negative psychological effects 4
All dimensions of perfectionism (self-oriented, others-oriented, and socially prescribed) link positively to following strict eating rules 21. This perfectionist mindset creates rigid thinking where failing to meet high personal standards leads to negative self-judgement and criticism 4.
The need for control and order shows up as strict adherence to self-imposed dietary rules and extreme focus on food purity 16. Perfectionism combined with obsessive-compulsive tendencies creates perfect conditions for developing orthorexia. This highlights the need to address these personality traits during treatment.
Low self-esteem and identity issues
Low self-esteem plays a key role in how orthorexia develops and continues. Research suggests people with low self-esteem use unhealthy coping methods, including disordered eating patterns 21. Studies found that self-esteem predicts orthorexia - higher orthorexic tendencies link to lower self-esteem scores 22.
There's another reason - people with orthorexia often tie their self-worth directly to following dietary rules 21. As Bratman hypothesised, "an orthorexic person's self-esteem is often tied to their adherence to the diet. They would feel a sense of superiority over others based on their eating practices which are the primary focus of their lives"22.
This link between identity and eating practices explains why orthorexia resists change.
Many people with orthorexia find their sense of identity and purpose in their dietary practices 8. Seeking spiritual purity through dieting becomes a way to gain control and handle difficult feelings, especially for those who don't deal very well with emotional regulation.
Society's pressures may also explain the connection between low self-esteem and orthorexia. Our culture sees disciplined and conscious attitudes toward diet as signs of health awareness 22. Publicly showing strict diet adherence becomes a potential way to boost self-esteem through social validation.
The Role of Impulsivity and Mental Health
Research points to impulsivity as another major factor in understanding disordered eating patterns, alongside perfectionism and anxiety. Impulsivity—defined as "a predisposition toward rapid unplanned reactions to internal or external stimuli without regard to negative consequences" 5—helps us learn about why some people develop problematic relationships with food.
How impulsivity traits influence eating behaviour
Impulsivity plays a complex role across various eating disorders, including orthorexia. People used to link impulsivity mainly with disorders that involved binge eating and purging. New evidence suggests it exists in restrictive patterns too 23.
This complex trait shows up through several dimensions that affect eating behaviours in different ways:
Negative urgency—the tendency to act rashly during negative emotions—stands out as the impulsivity facet most strongly related to eating disorder symptoms. People who score high in negative urgency often participate in impulsive behaviours to ease negative feelings 25. This might explain why some feel emotional relief through strict adherence to "clean" eating rules.
Lack of persistence varies among eating disorder profiles. People with anorexia nervosa usually show greater persistence 25. This could explain the steadfast dedication to restrictive eating patterns in orthorexia. Research shows higher perseverance has a strong connection with healthy orthorexic behaviours.
Depression, anxiety, and stress as mediators
Mental health conditions serve as vital mediators between impulsivity and disordered eating. Higher depression and anxiety scores link strongly to greater orthorexic tendencies 3. This creates a complex relationship between emotional state and eating behaviour.
The relationship works both ways. Impulsivity leads to disordered eating, which makes negative emotional states worse 24. Anxiety and stress might trigger impulsive food decisions if you have orthorexia. This reinforces the cycle of rigid eating patterns and emotional distress 16.
Studies reveal that depression and anxiety partially mediate between perseverance (an impulsivity dimension) and orthorexic nervosa symptoms 3. This suggests treatment of underlying mental health issues might help address orthorexic behaviours linked to impulsivity.
Gender differences in psychological impact
Impulsivity in eating disorders shows notable gender variations. A study about orthorexia and exercise addiction found interesting patterns. Women showed connections between orthorexia, anxiety, depression, and neuroticism. Men demonstrated links between orthorexia, conscientiousness, and extraversion 26.
Orthorexia affects both genders equally, unlike many eating disorders that mostly affect women 27.
Women report more orthorexic behaviours than men across cultures 3. This gender difference might reflect social pressures rather than basic psychological differences.
Gender's relationship with impulsivity in orthorexia matters significantly in treatment approaches. Women might benefit from emotion regulation focus, while men might need more attention on conscientiousness-related traits 26.
Social Media and the Clean Eating Ideal
Social media has revolutionised how health information spreads. It creates new ways to participate in food and wellness content. Nearly half of millennials now trust product recommendations from social media influencers. These digital spaces shape our eating habits and health views.
Instagram and the visual culture of health
Instagram leads the way in shaping health ideals through visual content. The platform rewards pretty pictures. Research shows that eye-catching posts get more likes and shares 1. Food becomes a performance on Instagram. Users capture, philtre, and share it with hashtags like #cleaneating (over 61 million posts) 29 and #foodporn.
Instagram's visual culture pushes perfect images that change how users see themselves and what they eat. Studies show that seeing too much of this perfect content links to poor mental health, especially about body image and eating disorders 1. Young users often feel pressure to meet impossible standards for looks and eating habits.
Influencers and the promotion of food purity
Health influencers have huge power despite lacking proper nutrition training.
Research shows that 90% of weight management advice from influencers has wrong or misleading information.
This bad info reaches young minds easily - 67-92% of teens look to social media for health tips 28.
Food purity promotion shows up in several concerning ways:
The numbers tell the story. Kids who watch influencers market unhealthy foods eat more overall (448.3 kilocalories) compared to those watching non-food content (357.1 kilocalories) 32. The wellness industry now runs on social media algorithms. It values influencer opinions more than real medical advice 28.
The echo chamber of wellness communities
Your social media feed changes once you start looking at health and fitness posts. Algorithms create a bubble that warps your idea of normal eating. Instagram users tend to see content that matches what they already believe. This makes them think certain behaviours are more common than they really are 33.
These algorithms create a dangerous loop. Pretty health-focused posts get more attention, which makes extreme behaviours seem normal 1.
The numbers are striking - 49% of Instagram users who follow health food accounts show signs of orthorexia.
That's way higher than the general population's rate of less than 1% 34. The research is clear. More time on Instagram links directly to increased orthorexic behaviour. These digital bubbles make strict eating patterns seem okay while cutting users off from different views about healthy eating 7.
Challenges in Diagnosis and Recognition
Lack of DSM-5 classification
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and International Classification of Diseases (ICD-11) do not recognise orthorexia nervosa 6. This missing classification undermines consistent diagnosis and treatment methods.
Problems with current assessment tools
The ORTO-15, which doctors use most often, receives serious criticism about its measurement qualities. Research shows it lacks internal reliability and validity 38. The questionnaire's pooled reliability coefficients remain low11. Critics say it makes orthorexia seem more common than it is—with reported rates between 1% and an unrealistic 90%.
New assessment tools have emerged to fix these problems:
The Eating Habits Questionnaire (EHQ)
Düsseldorf Orthorexia Scale (DOS)
Teruel Orthorexia Scale (TOS)
Barcelona Orthorexia Scale (BOS)
These newer instruments show better internal consistency and validity. Experts recommend using multiple assessment methods instead of relying on just one tool 11.
Distinguishing orthorexia from healthy eating
Several behaviours might look like orthorexia but have valid explanations:
Religious or cultural dietary practices
Medical restrictions for allergies or diabetes
Ethical choices about animal rights or environmental concerns 39
Orthorexia differs from normal healthy eating through emotional distress, disrupted daily functioning, and obsessive ideas about food purity 6.
Treatment and Recovery
Recovery from orthorexia needs a complete approach that tackles both behavioural patterns and the mechanisms of psychological factors. Right now, no treatments have been developed specifically for orthorexia, but existing therapies show promising results.
Cognitive behavioural therapy (CBT)
CBT remains the most effective evidence-based treatment for eating disorders, including orthorexia 41. This well-laid-out therapy helps you spot unhelpful thought patterns about food and build healthier coping mechanisms. CBT sessions teach you to identify and challenge distorted beliefs about food "purity" while you slowly add previously avoided foods back into your diet 16.
Mindfulness and intuitive eating
Mindfulness-based treatments show how to observe anxious thoughts about food without acting on them right away 16. This pairs well with intuitive eating—created by dietitians Evelyn Tribole and Elyse Resch—which helps you reconnect with your body's natural hunger and fullness signals 43.
The importance of social and family support
Family support substantially reduces relapse rates during eating disorder recovery. Your support network makes tough moments like mealtimes easier to handle and helps you stay accountable to treatment goals 45.
Isolation makes orthorexic behaviours worse—connecting with others plays a vital role in lasting healing 46.
People who support someone with orthorexia should skip body talk and diet culture messages. They need to validate emotions without rushing to fix everything 44. Family therapy and support groups are a great way to get guidance for loved ones who want to help someone through recovery.
Key Takeaways
Understanding the fine line between healthy eating and harmful obsession is crucial for maintaining both physical and mental wellbeing in our wellness-obsessed culture.
Orthorexia affects up to 75% of certain populations, transforming well-intentioned healthy eating into an anxiety-driven fixation on food "purity".
Clean eating and biohacking can mask disordered eating patterns, as society celebrates extreme dietary discipline that may harm health.
Social media amplifies problematic wellness messages, with 49% of health food account followers showing orthorexic symptoms versus less than 1% generally.
Recovery requires addressing underlying psychological drivers like perfectionism, anxiety, and low self-esteem through CBT and mindfulness approaches.
True healthy eating prioritises flexibility over rigid rules—your relationship with food should enhance, not diminish, your quality of life.
The pursuit of optimal health becomes problematic when dietary choices cause significant distress, social isolation, or consume excessive mental energy. Remember: balance matters more than purity, and meaningful wellbeing encompasses far more than perfect nutrition alone.
References
[12] - https://health.clevelandclinic.org/orthorexia-when-a-commitment-to-healthy-eating-goes-too-far
[28] - https://www.tandfonline.com/doi/full/10.1080/13648470.2024.2386887?scroll=top&needAccess=true
[45] - https://www.nationaleatingdisorders.org/the-importance-of-support-during-eating-disorder-recovery/
[54] - https://www.telegraph.co.uk/news/2024/12/30/obsession-healthy-eating-can-lead-addiction-study-find/
[55] - https://www.wearetierone.com/blog/trend-analysis-biohacking-and-the-rise-of-holistic-healthcare
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