Clean Eating: The Dirt on a Popular Fad


Clean Eating DisorderBy Robert P. Montenegro, M.D. ABOM, Family Medicine and Bariatrics

Setting impossible goals for ourselves can make us reach for any shortcut, even if it hurts our bodies. Motivated by health, some people are cutting out entire food groups and depriving themselves of important nutrients in the process. Clean eating is a trend with very good intentions — wellness, choosing whole, unprocessed foods — that can be beneficial for you or become deeply restrictive.

Eating clean doesn’t necessarily make it easier to eat nutritiously, so you could still be missing out. Clean eaters may skip out on necessary foods while trying desperately to be healthy.

Eating well certainly can mean fewer processed foods and ingredients. That’s what many nutritionists recommend anyway. A diet rich in vegetables, fruits, dairy, whole grains and heart-healthy oils, fats, and protein is excellent for many people. The social media stars of the clean eating movement correctly advocate for eating better.

Clean EatingBut it’s not without downsides. The diet often asks adherents to ditch milk entirely, for instance, which may lead to higher risks of osteoporosis later on unless you’re eating enough calcium-rich leafy green veggies or taking supplements. Cutting out too many foods can hurt your body and still leave you hungry for nutrients.

In some cases, restrictive diets are a way to publically hide more serious problems. Some people even claim restrictive diets so no one questions what they eat (or don’t eat, in some cases). Disordered diet patterns where someone obsessively manages their food intake may actually be evidence of an eating disorder.

Disordered eating may be indicated by:

  • Declaring food universally “bad” or “good” – In moderation, most people can enjoy their favorite foods occasionally and shouldn’t feel guilty about indulging now and then. If you constantly berate yourself for your food decisions, that may be a sign of something more serious.
  • Interfering with your life – Going to work, attending classes or living your life may become more challenging because it takes you forever to plan a healthy diet.
  • Harming your social life – You never eat out with friends and family because restaurants never serve food that’s healthy enough.
  • Making you obsessed with food prep – If it’s not prepared a certain way you believe you can never eat food. So, you carry snacks or avoid situations where food prep is outside your control.

Clean Eating: Unhealthy Fixation or Eating Disorder?

So, are you taking clean eating too far? Right now, there’s discussion in the medical community about how to classify obsessive healthy eating.

The American Psychiatric Association (APA) 2017 Annual Meeting featured two presentations on orthorexia nervosa, “which is characterized by a restrictive diet and ritualized eating patterns” and may be associated with the “eating clean” movement, according to a recent Medscape article.

Orthorexia nervosa isn’t recognized by the entire medical community yet and so it’s not in the DSM-5 (a handbook of diagnoses used by doctors). Seeing some patients cross over into extreme healthy eating is still worrying many physicians and nutritionists.

Just Another Healthy Eater

Genuine healthy eating is good for you. If your diet restricts some foods, requires a moderate amount of prep that doesn’t interfere with your life and is well-balanced, you’re probably okay. There’s a line between healthy and disordered eating, and as long as your body gets the nutrition and calories you need, your diet is likely safe and good for you. If you’re not sure, ask your doctor or see a nutritionist to learn more about healthy meal planning and eating.


  1. Maria Johnson says:

    I do agree with you Dr. Montenegro! No that I have lost 50+ pounds I intend to keep it off permanently. Thank you for your services, advice, and honest opinion.

  2. Our systems are dependant on the food we consume so eating well should be a top priority for us. Foods rich in vitamins and minerals are critical for proper functioning and without these, your body and mind will start to deteriorate much faster. Knowing what to consume is based on so many individual factors and I can help figure those factors out. I am a nutritional therapist in Cape Town, love your thoughts.

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