A new study out of Australia has linked social media to the rise of the eating disorder orthorexia, as people looking to stay healthy and tone up instead find themselves heading down a path of food restriction and guilt.
This article discusses eating disorders. A list of helplines can be found at the bottom of the page.
The researchers analysed 300 popular TikTok and Instagram posts tagged #healthylifestyle, #nutrition and #cleaneating. They found the messaging centred largely on restrictive food rules, moralising food as 'good' or 'bad', appearance-based definitions of health, and unrealistic dietary ideals.
Katie Porteous, lead author and psychology PhD student at Flinders University in Adelaide, said health-focused online content can easily shift from encouraging the adoption of healthy habits to promoting unhealthy perfectionism.
"Orthorexia nervosa goes beyond an interest in healthy eating. It involves a fixation on eating the 'right' foods and avoiding those perceived as unhealthy," Porteous says.
"Many of the posts we analysed promoted strict food rules, clean eating ideals and the belief that health can be achieved through perfect dietary choices. Those messages closely resemble attitudes associated with orthorexia nervosa."
Of the posts studied, 67% emphasised clean or healthy eating, almost one-third promoted food restrictions or rules, and one in five framed foods as 'good' or 'bad'. Nearly two-thirds featured body objectification, and many directly linked health to achieving a lean, toned appearance.
"We repeatedly saw messaging that suggested 'if you eat like me, you can look like me'," she says.
"That ignores the reality that health is influenced by many factors, including genetics, lifestyle, culture and personal circumstances. There is no single diet that works for everyone."
It also found unqualified influencers dominated the health content landscape, accounting for 78% of creators analysed.
More than two-thirds of health information was classified as misleading or deceptive, while qualified health professionals were significantly more likely to provide accurate, evidence-based advice.
Three-quarters of posts also promoted supplements or superfoods, often presenting them as essential to health despite limited scientific context.
What is orthorexia nervosa?
Coined in 1997 by American physician Steven Bratman, orthorexia nervosa is not yet formally recognised as a distinct diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the guide used by clinicians and researchers to diagnose and classify mental health disorders. There are calls for its inclusion in the DSM-VI.
According to Eating Disorders Victoria, signs and symptoms of the disorder include strong anxiety and an intense fixation with the quality of food, which can then progress to the elimination of entire food groups, and avoiding certain ingredients; social isolation to avoid social situations and people that do not align with their strict dietary regime; guilt around eating 'bad' food; heightened self-esteem when eating foods that are ‘healthy’; and mood swings, anxiety and depression.
While there are no official figures, the Eating Disorder Association of New Zealand says an estimated 103,000 people in Aotearoa struggle with some form of eating disorder.
Former Eating Disorder Association of NZ chairwoman Megan Tombs says while there are overlaps with anorexia nervosa – such as "exaggerated emotional distress" in relation to food – one point of difference is a "focus on eating as opposed to not eating".
"The desire to lose weight is absent. The idea is that I'm making this healthy and it's moralistic. So, it's not necessarily 'I want to lose weight'. It's more 'I want to be healthy' or maintain this health' but you're still cutting out whole food groups to do that or you're changing your social day, day in, day out. It affects your daily life," she says.
"It might be 'I'm just eating healthy yogurt' and then all of a sudden, it becomes one sort of yogurt, and then it becomes no yogurt."
Dr Meg Vardy is the founder of JourneyED, New Zealand's first peer support provider for individuals with eating disorders. She says the restrictions "can lead to severe physical consequences" as people cut out entire food groups, carbs, or processed foods.
"It can mean that people don’t get the energy and the nutrients they need, thus leading to physical consequences."
It can also lead to social isolation as they avoid interactions – most of which tend to centre around food.
"Their mind becomes so preoccupied with the healthfulness of food that they’re unable to engage in other talks in life, in relationships, in work."
A lonely and isolating experience
Vardy says she has lived with depression and anorexia for "much of her adult life".
It served as a way of "dampening" her emotions and punishing herself, she says, "because I didn’t feel like I could control my emotions".
"I didn’t feel like I was worthy of taking up space. I didn’t feel like I was worthy of food."
She went into treatment after it became "unsustainable" in her early 30s.
"That was an opportunity for me to reassess my relationship with my eating disorder. And now I hold my eating disorder at a distance.
"Through that experience, I learned how important it is to have people around you who can be compassionate and can love and accept you for who you are and not be driven by your diagnosis."
Vardy says living with an eating disorder can be a lonely and isolating experience – especially for adults due to the pervasive myth that it only affects "teenage girls wanting to be skinny".
"When people think about eating disorders, they often think about teenagers rather than adults. I hear all the time people saying that nobody really sees their eating disorder because they think, 'Oh, well that's a teenage problem – you're an adult. You can't have an eating disorder."
A 'socially accepted' eating disorder
As society has shifted from the diet culture of the 1980s and 1990s to the wellness industry of today, orthorexia has affected men as well as women.
"Whether you're talking about diet culture or the wellness industry, you're talking about a societal and institutional pressure on people to eat and look a certain way. And with the rise of wellness and the wellness industry has come a rise in people experiencing orthorexia," Vardy says.
It's also a risk factor for people in recovery from an eating disorder, with Vardy adding that her eating disorder "strayed into orthorexia" during a phase of what she calls "pseudo-recovery”.
"I was saying I was recovered to the outside world, and I was doing the things I needed to do but my mindset was very much one that was driven by my eating disorder."
The danger, Vardy says, is orthorexia is a "very socially accepted form of an eating disorder because you have the wellness industry to lean upon for the reasons why you’re bringing in all of these very rigid food rules".
"I was cutting out entire food groups, and it was not doing good things to my insides, I can tell you that. It meant that because it didn’t have the same sort of physical consequences as anorexia, it was seen as OK. I was doing OK, but I was still not OK in my mind.
"It became a way that I could hold on to my eating disorder mindset without triggering external people to tell me I couldn’t, because it was seen as OK and socially acceptable."
'Beneath the iceberg'
Social media doesn't "cause" eating disorders, Vardy says, but it can be a "slippery slope" that exacerbates a person's low self-esteem or their desire for "something that they can control in their life”.
"They’re looking for a way that they can hopefully feel better about themselves because society’s telling them to look and eat a certain way. If someone has low self-esteem or is feeling down or is experiencing depression, that’s a way that they can meet societal expectations, but I wouldn’t say eating disorders in general – and orthorexia is included here – aren’t caused by social media. Social media is an exacerbating factor.
"Eating disorders are not about food. There is always something beneath the iceberg for someone."
Tombs agrees and adds: "Eating disorders were around long before social media came in, even before magazines."
Vardy says that for people with eating disorders, it isn't "actually about food and bodies" but, rather, the outward expression of pain and distress.
"We can’t see emotional pain, but you can see if someone is restricting their food and so it’s a way of concretising or making emotional pain more visible to the outside world.”
A guilt-free treat?
The moralisation of food as 'good' and 'bad' goes beyond social media to permeate every aspect of daily life, experts say.
"We are surrounded all the time by the moralisation of food in every way that we talk about food and experience food," Vardy says.
One prime example is health star ratings on products at the supermarket.
"You’re instantly moralising food by putting stars on the front of it. Stars go back to when we’re children and we’re at school and we get a star sticker when we’ve done something well," she says.
"When we look at food and you get a certain number of stars for how ‘healthier’ food is, that’s instantly moralising, and it can be really damaging for people.
"It’s in the same way that we talk about having treat food and ‘do I deserve this?’, ‘am I worthy of this?’, ‘I’ve been good’, ‘I’ve been bad’. We talk about food in a very moralising way and that again can feed into orthorexia as well as other eating disorders."
Tombs agrees, adding that "food is food".
"You go to the supermarket, and it says something like 'guilt-free chocolate'... I don't think the more we moralise that you can be a good person because you eat broccoli and a bad person because you eat hamburgers, but that's what we're being sold."
The Ministry for Primary Industries says on its website: "Health Star Ratings reflect the overall nutrition content and healthiness of packaged foods."
It adds: "They are an independent rating. When developing Health Star Ratings, the New Zealand and Australian governments worked with public health experts, the food industry, and consumer groups."
'Old-fashioned snake oil'
Vardy and Tombs say it's important to turn to qualified experts when seeking health advice, as social media feeds can quickly become clogged by people looking to make a quick buck.
While some people sharing their positive experiences of a food trend or diet online are coming from a good place, Vardy says it's not a one-size-fits-all approach.
"Everybody’s body is different. Everybody’s needs are different. Everybody’s energy needs are different and everybody’s relationship with food is going to be in a different place. What works for one doesn’t necessarily work for another," she says.
"I would definitely be encouraging people to turn to reputable sources and turn to organisations that are well-known and can point people in the right direction."
Tombs warns the average influencer espousing the 'secret' to becoming the perfect picture of health and wellness is "trying to sell you something".
"Who's benefiting from this advice is what I would question. They're just trying to make money out of us. They're trying to tell you what's wrong with you and then give you a cure for it – old-fashioned snake oil," she says.
"And what a good way to do it. Make somebody feel so inadequate just for being and then sell them something to cure when they aren't broken in the first place."
Tombs adds that recovery "is 100% possible. You can live free of those symptoms".
However, it's important to have a prevention plan in place to avoid relapsing as disordered thinking and behaviours can "creep back into life".
Where to get help
Eating Disorder Association of New Zealand – 0800 2 EDANZ / 0800 2 33269 or (09) 5222 679
JourneyED – info@journeyed.org.nz
Lifeline – 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP)
Youthline – 0800 376 633, free text 234, email talk@youthline.co.nz
Samaritans – 0800 726 666
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