When “Healthy” Eating Stops Being Healthy

Source: Irina Novkova / Pexels.

By Emmanuelle Awad, a Ph.D. student under the supervision of Dr. Jessica M. Alleva.

Many of us use social media for information, inspiration, and connection, among other things. Whether we are looking for advice, entertainment, practical tips on what to cook for dinner, or information on the newest wellness trends, social media can provide what seems like unlimited content that appeals to our interests. Social media has become the go-to for many people; seconds after we sign on, an algorithm is able to gauge our interests and offer exactly what we’re looking for.

Imagine you came across a video about “super foods” and watched it until the end. Soon enough, your main page could be filled with content promising to optimize your health.

What could possibly go wrong with wanting to be “healthier”? The answer is more complicated than we might think.

What Is Orthorexia Nervosa?

In recent years, researchers have become increasingly interested in “Orthorexia Nervosa,” a fixation on eating only self-perceived “clean” or “pure” foods. Importantly, while Orthorexia Nervosa might seem similar to eating disorders like anorexia nervosa, the main focus in Orthorexia Nervosa is on the quality of foods and perfectionist standards about one’s diet, rather than necessarily losing weight or changing one’s appearance. Like other eating disorders, however, Orthorexia Nervosa can significantly interfere with people’s daily lives and lead to worsened physical and mental health (e.g., anxiety, social isolation).

Investigating Orthorexia Nervosa in the Context of Social Media

Given that rigid "clean eating" practices and perfectionist dietary standards are increasingly promoted online, researchers have begun to explore how Orthorexia Nervosa may be linked to social media use. In our recently published research, my colleagues and I at Maastricht University and the Lebanese American University conducted a review of the existing research on social media and its relationship to Orthorexia Nervosa.

To do so, we searched the literature for all existing studies that have been published on the topics of Orthorexia Nervosa and social media. Our search identified 31 studies. Then, we extracted the data from these studies to identify common patterns across the findings. Below, we describe the key findings from our analyses.

Eating With Your Eyes First?

One of the main findings was that the use of visual platforms such as TikTok, Instagram, and YouTube was more strongly linked with levels of Orthorexia Nervosa than the use of primarily text-based platforms like X and Reddit. Images and videos can be particularly powerful in communicating content that a user seems to be interested in. For example, carefully curated visuals like “What I Eat in a Day” videos and photos of perfectly prepared meals can present a pretty convincing ideal of what “living well” is supposed to look like.

The More You Scroll

Another result involved the time spent using social media: People who spent more time on social media tended to show more signs of Orthorexia Nervosa. This could be related to the frequency of seeking out clean/pure eating content. People interested in this subject matter are more likely to search for it. A platform's algorithm will pick up on this interest and recommend similar content. As a result, social media users might spend more time interacting with content that interests them on different platforms.

The Power of Content

We also found that seeing health and fitness content on social media was related to higher Orthorexia Nervosa. For example, posts that promote “clean eating,” self-discipline, and thinness were linked to higher Orthorexia Nervosa.

Findings derived from interviews and focus groups included in our review also provided insight into users' experiences with recovery-oriented content. Strikingly, recovery-oriented content, such as content labelled with “#orthorexiarecovery” hashtags, had mixed effects. Some users from this community felt supported and encouraged by similar people who were trying to recover from Orthorexia Nervosa, while other users felt that this content made them feel “disordered” and marginalized.

Are the Findings Similar for Everyone?

Importantly, our review also showed that the relationship between Orthorexia Nervosa and social media was stronger among certain groups of people. Specifically, women who reported higher social media use exhibited more Orthorexia Nervosa than men. This could be due to higher appearance-related pressures among women.

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In addition, adolescenst and young adults showed higher risk in contrast with older age groups, potentially because they are more likely to compare themselves to others at that age.

Also, the relationship between Orthorexia Nervosa and social media was stronger among people who reported higher concern about their health, had higher perfectionist tendencies, or grew up with strict dieting rules. Additionally, this relationship was more prominent among individuals who exercise frequently.

What Does This Mean?

Our review suggests that more time spent on social media, especially on visual platforms and when engaging with health and fitness-related content, is associated with higher levels of Orthorexia Nervosa. The findings also suggest particular groups may be more vulnerable to this content compared to other groups.

These findings highlight the importance of being mindful of how much health-related content we consume and how it might guide our perceptions of “clean” eating. Users may benefit from approaching this kind of content more critically and recognizing that what is presented online is often curated rather than representative of a realistic lifestyle for all. At the same time, social media platforms also have a responsibility to consider how algorithms may spread potentially harmful messages and rather to promote more balanced representations well-being.