In the gospel according to Instagram, sugar is the source of all evil. Coconut sugar – although almost identical from a chemical and nutritional point of view – is good. Gluten, oil and grains are bad. Carbohydrates are scary. Dairy is positively terrifying.
Social media did not create fad dieting, which has been around for at least 200 years. One of the first celebrity yo-yo dieters was Lord Byron, whose preference for potatoes drenched in vinegar and biscuits with soda water might – it was feared – influence the impressionable youngsters of the 1820s, intent on mimicking his wan, romantic look.
But throughout most of history, these fads remained just that: passing phases adopted by small groups – the schoolgirls pooling pocket money to buy slimming shakes in the 1980s; their mothers temporarily subsisting on grapefruit or cabbage soup.
Over the past few years, however, disordered eating has become increasingly normalised. Last summer, the HSE released figures that showed the number of hospitalisations of teenage girls for anorexia and bulimia had almost doubled over the previous decade to 93 in 2015. Across all age groups, up to 200,000 people are estimated to be affected by eating disorders.
Last week, new figures from the UK showed similar patterns: a doubling in hospitalisations over a decade, and warnings that this might be the tip of the iceberg, since only the most ill end up in treatment.
Although no one is suggesting that Instagram is responsible for the rise in disordered eating, many experts agree that social media offers a platform on which unhealthy eating patterns can be extolled, celebrated and lionised.
In the murky, didactic world of #cleaneating, for instance, bloggers with no qualifications style themselves as nutritionists, dispensing advice about foods to be avoided or indulged. Restrictive and unrealistic eating patterns are given the veneer of pseudoscience.
Nutritionally ambiguous terms
Certain foods are arbitrarily deemed “clean” or “whole”: nutritionally ambiguous terms that have come to mean good, pure or healthy. Other foods are – often on just as shaky a foundation – dismissed as bad, impure, unhealthy.
Meals are assembled to be photographed, not eaten, and food is not so much a source of nutrition as an expression of their creator’s discipline, artistry and self-control.
To become a clean-eating guru, glossy hair, an agreeable manner, an airy kitchen and a taste for almond milk are more important than actual qualifications.
On Instagram alone, there are almost 50 million images hashtagged “#eatclean”. One day last week, a selection of the most popular posts with the hashtag included nutritionally dubious, but undeniably picturesque, bowls of porridge scattered with vegan chocolate chips; sweet potatoes stuffed with peanut butter; vegan donuts covered in a sugary pink icing and “almond coconut stove-top oats” with a squirt of medium-chain triglyceride oil for “an extra boost of clean energy”– whatever that means.
Alongside the rise of #cleaneating movement, a new type of eating disorder has emerged: orthorexia, or the extreme pursuit of a healthy diet.
“Enthusiasm for healthy eating doesn’t become ‘orthorexia’ until a tipping point is reached and enthusiasm transforms into obsession,” says Dr Steven Bratman who coined the term in 1996.
For people with orthorexia, “eating healthily has become an extreme, obsessive, psychologically limiting and sometimes physically dangerous disorder, related to but quite distinct from anorexia. It has an aspirational, idealistic, spiritual component.”
Orthorexia is "an obsession with eating correctly, eating pure", says Renee McGregor, a performance and clinical dietitian, and the author of Orthorexia: When Healthy Eating Goes Bad. "I don't for one minute say that social media has caused orthorexia. But what it has done is it made it more difficult to escape," she says.
Fitness and food blogging has become, “almost a cult. They’re all glamorous, beautiful people, and a lot of the better known ones are from wealthy backgrounds. They have good genes. And they’ve got this veneer of perfection. When you’re somebody who is susceptible or vulnerable to eating disorders, you will look to these people for validation.”
Much of what the bloggers preach is based on nonsense and pseudoscience – such as the cult of coconut sugar. “Sugar is sugar – whether it’s coconut, maple syrup or honey, it’s still sugar. It gives the same calorific value,” she says.
Last year, the American Heart Association suggested that the coconut oil beloved of the movement offered “no known offsetting favourable effects”.
Much of the rest of it is founded on fear – fear of toxins, of gluten, of dairy, of sugar, of carbohydrates, of meat, even when there is no nutritional evidence to support total avoidance.
Yet a recent survey of 2,000 people in the UK found that one in three prefers to take the advice of bloggers over dietitians. “It’s hard for regulated dietitians, because we’re trying to sell balance, and balance isn’t sexy. I’ve got years of education in biochemistry and nutrition, but they’ll believe a celebrity blogger over me.”
‘Anxiety responses’
McGregor cites one patient of hers who has a qualification in nutrition. “He has read all the scientific studies, and he understands intellectually that there is no evidence that eating a little bit of sugar on a daily basis will cause long-term harm.” But then he goes on Instagram and “all his anxiety responses come back. He’s swayed by it because it helps him to maintain his disordered behaviour.”
“You need [people with disorders] to change their narrative completely. They’ll describe themselves as living in a prison because they feel entrapped in their disordered eating. It’s a hideous and horrible illness.”
While McGregor makes a point of not sharing photographs of her own food, Dublin-based registered dietitian Orla Walsh takes the approach of trying to reach her target audience where they are. She has an Instagram account, with almost 5,000 followers, which she uses as a platform to dispense balanced recipes and a healthier approach to food. “There’s a lot of misinformation on Instagram and social media, and you just have to follow the #cleaneating hashtag to see it,” she says.
Like McGregor, she dislikes the labelling of food as “good” or “bad”. “We know that excess sugar is not healthy, and we should be having less than 12 teaspoons – or for some people six teaspoons – a day. But this doesn’t mean that sugar is toxic. Our body is capable of handling sugar; it just doesn’t want us delivering sugar to it all day every day.”
Walsh is seeing increasing numbers of male patients, and younger patients. “Some might want to change their body composition or lower their weight. Any qualified dietitian will tell you this is achieved by an energy balance that is negative. But social media implies that you cut out a food group to achieve it, which is compelling,” she says.
Some of her clients are children under 12, both boys and girls, “who have a genuine fear of sugar”. Frequently, they’ll come to her having seen a documentary on YouTube or on TV that “demonises sugar, and shows it as a toxin. These are not suitable for children and shouldn’t be seen by children.”
Of her younger patients, she says, “I wish children knew that if your relationship with food is healthy, you will have a healthy body, and when your relationship is less healthy, you won’t.
“I wish they knew the importance of a sustainable, balanced approach to food. I wish they knew the difference between a dietitian who is qualified and someone who has no qualifications. And I wish they knew that your body shape is genetic and you can’t change it.”
Warning signs
What are the warning signs of orthorexia parents should look out for? “Children saying “no” to treat foods when their siblings or friends are consuming them. Children actively avoiding certain foods and being very robust in their views. Suddenly deciding they want to be a vegetarian can be an excuse to cut something out of their diet. And don’t wait to see if it’s a phase and it will pass – because by then the disordered eating might have taken hold.”
For McGregor, the warning sign for children or adults is when food starts to cause them anxiety. “Food should not cause anybody anxiety. It’s a minefield for parents. I always create nutritious meals, but we have biscuits and cakes around the house too. My view is that as long as I’m eating well 80 per cent of the time, if I want to eat croissants or drink wine the other 20 per cent, that’s okay. Orthorexia is massively on the rise and it’s a societal thing.”
For McGregor, tackling the rise in disordered eating requires an approach that looks beyond food. “We need to be teaching our children emotional resilience from day one. We need to teach them to be happy with who they are. It’s very easy to compare and be hard on yourself when you’re looking at perfect snapshots of other people’s lives.
“But as I always say, you don’t even know if they’ve eaten that bowl of almond milk porridge – it could have gone in the bin. They might have had a bacon sandwich instead.”
