Lily Bloomberg has always had a complicated relationship with food. Now 39 years old, she was an anxious child and struggled with bulimia as a teenager. In her twenties, she began to work as a school counselor and had reached a good place, where she was comfortable with her body and self-image. 

In 2010, three years after giving birth to her first child, she took up CrossFit, a globally popular exercise regimen that also promoted the paleo diet, modeled on what hunter-gatherers are supposed to have eaten thousands of years ago. Based on lean meats, fish, fruit, vegetables, nuts and seeds, it restricts a wide range of modern-day staples. 

At first, Bloomberg, who lives in Los Angeles, did not follow the diet, mindful of her history of eating disorders. Others in her CrossFit community respected her decision, but she became curious and began reading books and listening to podcasts about the plan.

“I was like I’m in,” she said. “They all talked about how the cause of diseases like cancer or mental health issues, or anything was because of eating grains and dairy, and I’m like, ‘Oh my gosh, the cause of everything terrible is all these toxins in food.’” 

Bloomberg wasn’t just worried about herself. Soon, she began to believe that her three-year-old daughter should eat paleo. 

“That caused me so much stress. She was in preschool at the time and they’d serve crackers at lunch or snack, and she’d go to parties and it felt like she was going to die — ‘These things are going to cause cancer, they’re serving pizza and cake,’” she said. “I didn’t want her, or me, to become anorexic and have an eating disorder, but it also seemed like a real danger to be eating these foods.” 

Bloomberg abandoned clean eating in 2019. Looking back, she believes that she suffered from orthorexia nervosa, a proposed disorder characterized by an obsession with only consuming clean and pure food. 

Orthorexia was named in 1997 by the U.S. alternative medicine practitioner Dr. Steven Bratman. He described it as when “thinking about healthy food can become the central theme of almost every moment of the day, the sword and shield against every kind of anxiety, and the primary source of self-esteem, value and meaning.” 

Promoting “clean” ways of eating has long been a core part of wellness and diet culture. But, while a diet rich in fresh fruit and vegetables and low in processed foods is undoubtedly good for us, the merits of completely removing whole food groups, such as grains and dairy, are at best debatable. 

Along with a variety of other dubious trends, such as juice cleanses and unnecessary intermittent fasting, the clean eating movement has exploded on social media feeds in recent years. Impeccably curated feeds provide recipes and extol the purported health benefits of radically altering your diet, excluding many foods and only consuming whole, natural products. But, as colorful and wholesome as those images look, experts believe that fixating on the perceived purity of what we eat can be seriously detrimental to our physical and mental health.

While orthorexia is not an official diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, health experts are witnessing a growing fixation with food purity and some have come to see “clean eating” as a possible trigger for unhealthy relationships with food.

“Once it starts contributing to distress for the individual, with feelings of shame and guilt, and starts to really interfere with their lives, that’s when we start to think it’s starting to look more like a disorder rather than somebody making minor modifications to their diet,” Suman Ambwani, an associate professor of psychology at Dickinson College in Pennsylvania, told me.

In the course of her research on clean eating trends in the U.S., Ambwani has found that the vast majority of young adherents consider such dietary plans to be healthy and that most of them first become aware of them via social media. A 2017 study published in the peer-reviewed journal Eating and Weight Disorders also linked Instagram to symptoms of orthorexia.

Aside from a lack of formal diagnostic criteria, identifying orthorexia is tricky because — unlike other established eating disorders, such as anorexia and bulimia, which are based on calorie-counting and the quantity of food eaten — it is said to hinge solely around the quality and purity of a person’s diet. 

“We want people to make sure that they have a balanced diet and that they’re being thoughtful about what they’re eating. But, just as you can get carried away with not being fat, you can get carried away with healthy eating,” said Thom Dunn, a professor at School of psychological science at University of Northern Colorado.

Experts contend that even when they contain enough calories, highly restrictive diets can result in digestion problems, malnutrition, deficiencies or hormonal balances. They can also have a profound effect on people’s lives.

“It sometimes has consequences with your friends or family because you can’t participate in certain events because the wrong foods are going to be served, or you have to spend an hour fixing your lunch because it’s got to be perfectly or meticulously prepared,” Dunn explained. “It’s not dieting to be thin, but dieting to be healthy.”

That being healthy is not only socially accepted, but celebrated and praised makes tackling the problem trickier.

“The big issue is that, intuitively, clean eating seems like it should be a good idea,” said Suman Ambwani. “Think about the language that’s being used. The opposite of clean is dirty. Nobody wants to follow dirty eating.” 

As a result, hashtags like #eatclean #cleaneating and variations of them have millions of posts and followers on Instagram.

“That’s what I would really fuel myself with — so many podcasts and social media,” Bloomberg told me. “The whole reason I got on Instagram is because I was doing the ‘Whole 30’ challenge,” she said, referring to a routine in which participants would eat only whole foods for 30 days and post all their meals on the image-sharing platform. 

“I didn’t have social media but it was recommended that you have it to keep yourself accountable.” she added. “There’s so much support for eating ‘healthy,’ which some people can do, but for me, somebody more prone to disordered eating, I will read it and it is like dogma to me.”

Experts believe that, while social media cannot be blamed alone, the competitive and performative nature of online clean eating culture can lead people to adopt progressively stricter diets, which can eventually lead to health problems.

“It’s a lot easier to get to a really bad place if you’re comparing yourself with the world of Instagram and not just your peer group and your friends that are in your neighborhood,” said Dunn.

The pseudoscientific fear-mongering around certain types of food and ingredients by popular accounts — describing conventional, “non-organic” produce as dangerous or claiming that gluten should be avoided, even when there is no medical necessity — makes the trend even more hazardous. 

Debunking those is what Food Science Babe, a popular Instagram account, does. Erin, the woman behind it, who prefers not to give her last name, is a qualified food scientist. In her professional opinion, people who choose to eliminate certain foods from their diets need to have easy access to science-backed knowledge before doing so.

“I just think those decisions should be based on factual information, versus being scared into thinking you’re poisoning yourself if you’re eating these things, which you’re not,” she told me.

For all its problems, she also believes that social media has become an important medium for nutritionists and health experts to provide solid scientific facts to a global audience. In addition to her presence on Instagram, Facebook and Twitter, she recently embraced TikTok as a way to reach a younger demographic.

Bloomberg feels the same way. After nine years, she came to the realization that her fixation with clean eating was damaging her relationships and potentially putting the health of herself and her daughter at risk. Rather than abandoning the internet, she simply changed track, embracing the body positivity movement and curating her social media feeds around it. Now, she accepts the benefits of an inclusive and balanced diet.

As Erin told me, “Clean is a meaningless term, when it comes to food, unless you’re literally talking about dirt.”