How a Culture of Dieting Can Perpetuate Eating Disorders

Brain and Eating Disorders Young Woman Eating A Salad

Contributor: Staff at Treatment Placement Specialists

In a society where it’s impossible to pass a bus stop without being reminded of the culture of dieting and the cultural significance we place on dieting and body image, there are two connections that nearly everyone regards as gospel.

Gaining weight is bad. Losing weight is good.

Flip through your Instagram feed or pick up a magazine at the supermarket checkout and, odds are, you’ll find someone talking about fad diets like clean eating or intermittent fasting.

“I cut out red meat and lost 15 pounds in two weeks!”

“I’m like a new person after my eight-day juice cleanse!”

“Fasting for two days a week has made me feel 10-years younger!”

But like most diet programs, these are short-term solutions to long-term problems. Decades’ worth of studies shows that 95% of all dieters will regain any lost weight within five years [1].

Fad diets – think Whole30, paleo, Atkins – eliminate foods that contain necessary nutrients; sometimes, they shelve an entire food group. At its core, clean eating focuses on eating whole, natural foods that are minimally processed.

It can also be extremely restrictive, pinpointing the many things you shouldn’t eat rather than zeroing in on what you should eat. Intermittent fasting is what it sounds like: cycling through a predetermined period of not eating after a period of eating.

In the proper nutritional hands, certain diets and elements of clean eating might yield positive, sustained results. In the wrong hands, however, there can be far more serious consequences.

American culture has normalized the diets mentioned above over the past 20 years, but these methods have something else in common: They mimic and, in some ways, glorify disordered eating behavior.

How Culture of Dieting Is Linked to Eating Disorders

Americans spend an estimated $66 billion annually on dieting, and one of the most common demographics trying to lose weight is young women [2].

The Culture of Dieting with image of Lady making one of her many meals for her Grazing dietOne study, from the National Center on Addiction and Substance Abuse, found that 62.3% of teenage girls surveyed reported that they were trying to lose weight and 58.6% were actively dieting.

What’s particularly alarming is that only 15% of teenagers actually classify as being overweight.

In a separate study of 14- and 15-year-olds, dieting was determined to be the most important predictor of an eating disorder compared to those who didn’t diet.

Those who dieted moderately were five times more likely to develop an eating disorder, while those who restricted food intake extremely were 18 times more likely [3].

The more extreme or restrictive a diet is, the more likely it is to lead to orthorexia, a term coined by Dr. Steven Bratman in 1998 that refers to an individual having an unhealthy obsession with healthy food. Much in the same way a person who struggles with anorexia nervosa or bulimia nervosa obsesses over calorie count and weight, someone with orthorexia fixates on clean eating.

Nutritional therapist Dr. Karin Kratina, who authored a paper on orthorexia for, told VICE: “There is nothing wrong with eating local or being a vegetarian or vegan,” she says.

“I think a lot of those diets are inherently valuable. The problem is that we have moralized eating, weight, food, and exercise. Food has become presented – more and more – as the answer” [4].

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t officially recognize orthorexia in the way it does more widely accepted eating disorders like anorexia, bulimia, and binge-eating disorder.

Because doctors can’t diagnose orthorexia as a mental health condition due to its omission in the DSM-5, those who are suffering from the symptoms often go years without medically having their eating disorder identified.

How Culture of Dieting Can Exacerbate Eating Disorders

The linking of supermodels and societal pressures with being thin has had a negative consequence on young women with diagnosed eating disorders for years, and it’s just as easy to draw the connection between social media and orthorexia.

Open Instagram, and within minutes, it’s easy to follow hundreds of accounts that post multiple pictures per day of beautiful, presentable, “clean” foods.

A recent study from the Netherlands found that cultural phenomena are linked to the development of orthorexia – specifically Western culture and the influence of the internet and media [5]. As the study states:

“In 2017, during an investigation on the link between the use of Instagram and (orthorexia), it was discovered that a more frequent use of Instagram is significantly linked to a higher risk of developing ON symptoms [6].

It is possible that the ability to follow the lives of others, including celebrities, can contribute to the engraining of the beliefs regarding the importance of certain diets.”

When Intuitive Eating Can Help

Bowls of food for a balanced diet.One plan that’s been around for a few decades but has recently gained more notoriety is intuitive eating.

The brainchild of dietitians Evelyn Tribole and Elyse Resch in the mid-90s in California, intuitive eating is not a diet but a method of eating mindfully without guilt and without cutting off specific food groups.

Past research has indicated that American women internalize the importance of food restriction as young as age 5, making it difficult to test how young girls would react toward eating outside of a culture of dieting [7].

Intuitive eating doesn’t mean you should eat anything at any time, but it removes a level of attainment necessity and discourages bingeing altogether. If a piece of pizza is always on the proverbial table, a person shouldn’t go through the mental anguish of needing to finish the whole pie once they get a taste.

We still need more research on the improved physical effects of intuitive eating – it is not a weight-loss tool, as many nutritionists point out – but early returns are good.

They’re specifically positive on the behavioral and psychological side, which makes it a favorite of those assisting young women through the emotionally taxing stage of recovery from an eating disorder [8].

That’s where Acadia Healthcare’s national team of Treatment Placement Specialists® (TPS) can help. Trained to specifically offer services to eating disorder professionals, TPS assists in placing individuals who suffer from:

  • Anorexia nervosa
  • Bulimia nervosa
  • Binge-eating disorder
  • Avoidant/restrictive food intake disorder (ARFID)
  • Orthorexia
  • Diabulimia

Diets aren’t going to fade from American culture, and, under the proper supervision, they don’t need to. Eating disorders aren’t going to disappear, either.

But, with more effective research on what leads young women down the slippery slope toward eating disorders, and better methods to prevent that descent, we can all begin to have a better relationship with both the physical and psychological effects of food.

If you or someone you know might be struggling with orthorexia or a similar eating disorder, please contact Acadia Healthcare’s national team of TPS as soon as possible.


1. Neumark-Sztainer D., Haines, J., Wall, M., & Eisenberg, M. (2007). Why does dieting predict weight gain in adolescents? Findings from project EAT-II: a 5-year longitudinal study. Journal of the American Dietetic Association, 107(3), 448-55
2. Marketdata LLC. (2017). The U.S. Weight Loss & Diet Control Market. Retrieved from
3. Golden, N. H., Schneider, M., & Wood, C. (2016). Preventing Obesity and Eating Disorders in Adolescents. Pediatrics, 138(3)
4. Kratina, K. (2012). Orthorexia Nervosa. National Eating Disorders Association. Retrieved from:
5. Syurina E.V., Bood Z.M., Ryman F.V.M., Muftugil-Yalcin S. (2018). Cultural phenomena believed to be associated with orthorexia nervosa – Opinion study in Dutch health professionals.
6. Turner P. G., Lefevre C. E. (2017). Instagram use is linked to increased symptoms of orthorexia nervosa. Eat. Weight Disord. 22 277–284.
7. Abramovitz B.A., Birch L.L. (2000). Five-year-old girls’ ideas about dieting are predicted by their mothers’ dieting. J Am Diet Assoc. 100(10):1157–1163.
8. Mensinger, J., Calogero, R., Stranges, S., & Tylka, T. (2016). A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial. Appetite. 105. 364.

About Our Sponsor:

Treatment Placement Specialists Banner - 300x250As an initiative of Acadia Healthcare, the Treatment Placement Specialists® (TPS) team is comprised of behavioral healthcare professionals who are dedicated to supporting individuals in need of personalized mental health and addiction programming.

With access to a broad spectrum of clinically-driven programs across the country, TPS offers comprehensive treatment options for eating disorders, mood disorders, substance use disorders, chronic pain, process addictions, co-occurring disorders, and trauma-related diagnoses. TPS referral services are provided at no cost.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published September 1, 2019, on
Reviewed & Approved on September 1, 2019, by Jacquelyn Ekern MS, LPC