Are Cleansing and Detox Diets Just Fancy Anorexia?

Posted on 25 Jul 2016 18:54

By Eric Troy

I've seen a quote about cleanse diets and detoxing being shared on Facebook quite a lot lately. Each time it shows up, it gets hundreds to thousands of likes and hundreds of shares. Amazing the power of a superficially logical statement that is actually based on a fallacy. This is one I would call a false analogy. I decided I'd like to write a few things about it.

First, the quote. It is by someone named Jessica Goldstein. I didn't know who she was or where the quote originated, but I tracked it down to a website called ThinkProgress, for which Jessica Goldstein is the culture editor and, obviously, a writer. Let's start with the quote, and then I'll get to the context of the quote:

I have this theory that the reason cleansing and detoxing have taken off is because it’s this socially acceptable way to have an eating disorder, basically, for a finite period of time. No one would ever say, “Oh, you should definitely just not eat for the entire month before your wedding.” But you can say, “You should do this lemon and cayenne pepper cleanse, you’ll feel amazing,” and somehow that’s okay. But it’s just fancy anorexia.

This quote is actually from an interview that ThinkProgress did with Timothy Caulfied, author of Is Gwyneth Paltrow Wrong About Everything?: How the Famous Sell Us Elixirs of Health, Beauty & Happiness and Canada Research Chair in Health Law and Policy, and professor at University of Alberta School of Public Health, where he is the long-time research director of the Health Law Institute.

There are many other quotes that could have been mined from this article/interview, but it is not surprising that this one quote comparing cleanse diets and detoxing to anorexia got singled out. It seems to make such a powerful point. People are engaging in unscientific and extremely unhealthful dietary practices. They are on their way to dire straits! People are killing themselves. Oh, my. Why, this cleansing stuff is one step away from a full-on eating disorder!

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The quote is actually a statement posed to Caufield. Does he agree? Well, he says he does, but then his actual response says nothing of cleanse diets being a fancy and acceptable cover-up of anorexia or anorexia-like behaviors. But again, it's not odd that people chose to take the question/statement and leave the interviewee's actual response behind. His response was less succinct and provocative:

You’re right. It has this sort of veil of healthiness to it, this idea that, as you know from the book, people really encouraged me. They said, “Good for you! Keep it up! Don’t give in!” It was seen as a very noble thing, and how it’s portrayed in celebrity culture helps that. I did a Google Trends search recently, comparing the word “dieting” to “detox” and “cleanse,” and it’s incredible, confirming just what you said, the idea of detoxing and cleansing has overwhelmed the idea of dieting. Dieting is vain and superficial, but detoxes and cleanses are all about health. When in fact, even an executive of Clean Cleanse, the one that I did, he admitted that most people go on it for dieting reasons. And you do lose weight, because you’re basically extreme dieting for a short period of time.

So, does he agree that it's fancy anorexia, or does he not? His response has little to do with the actual content of the quote, accept for the idea that it is socially acceptable and encouraged behavior. He compares detoxing and cleansing to dieting, not to anorexia.

Now I'll repeat my opinion of the statement. It's ridiculous. It is quite popular right now, among health advocates, to invoke a slippery slope regarding eating disorders. All the trendy and sometimes extreme dietary practices currently being promoted by various charlatans and celebrities are seen as a road to orthorexia or anorexia.

The answer mentioned Google trends. Well, anorexia is trending even more heavily than cleanse diets or detoxing. Do you think this is a coincidence? People in all walks of life who have probably never given a thought to anorexia are now suddenly concerned with it. Many of them probably have never heard of it and know absolutely nothing about it. The same thing goes for the many, many people who absolutely agree with this statement when it is shared on social media. Most of them have probably never given it a second thought but suddenly, as such trends go, everybody is an expert on cleanse diets, detoxing, and eating disorders!

So what is anorexia? Well, anorexia, technically, is just the medical term for loss of appetite. This loss of appetite can be from any cause so the term taken alone does not necessarily refer to an eating disorder. However, anorexia is almost always used as a shorthand for anorexia nervosa. This is a very serious mental health condition.

Just because someone skips some meals, fasts, or does a cleansing detox diet, we can not pronounce them anorexic! In order for anorexia nervosa to be diagnosed, many clinical criteria must be met. I've already provided an overview of anorexia nervosa, with signs and symptoms. Take some time to go over it, and you should see that superficially comparing a cleanse diet to this disorder is more than just simplistic and silly. You can also learn more from this article which compares the effects of anorexia nervosa and bulimia.

Most of the comments by Caulfield are pointing out that cleanse diets are mostly undertaken for weight loss reasons. They are not about cleansing, but are simply a very extreme and now socially acceptable diet. If so, these diets are not the only trendy diets in history that feature extreme deprivation. But as these trends have come and gone, the health industry has never declared a full-scale anorexia epidemic.

As I pointed out on a Facebook comment, diets of any type can be socially isolating. One of the reasons for the success of diet programs like Weight Watchers is that friends often do them together. Some of the power of the cleanse and detox fad, driven by celerbrity endorsement, is that it is popular and socially acceptable, something that friends can undertake together. Now, is taking a negative and socially unacceptable behavior like anorexia and disguising it with a fancy "cleanse diet" label to make it socially acceptable the same thing as taking something that people do anyway but sometimes find isolating, and choosing a mode that is less isolating? Dieting is somewhat stymatized in our society, and many people compare yo-yo dieting to anorexia or an eating disorder. But dieting itself is nowhere near as stigmatizing as an eating disorder.

Others invoke a slippery slope, saying yoyo dieting inevitably leads to an eating disorder. Dieting behaviors can be a 'slippery slope' towards eating disorders, but to generally declare that anyone who engages in a particular diet trend is on their way to an eating disorder, or has one, is just as alarmist as food-fear mongers preaching about toxins in our food.

Fasting and Anorexia

Many cultures make it a regular practice to fast. For example, Ramadan is a month of fasting for Muslims, a time to remember the suffering of the poor and to appreciate what God has given you. This is but one example of cultural or religious fasting. Buddhist monks fast daily, from noon to dawn. And there is a long history of Christian fasting, which today varies from church to church. Examples are Advent and Lent in the Catholic church, which today means eating less food in general, and abstaining from meat and meat products.

When such fasting is a part of the culture, is it disordered eating behavior? Is it a behavior in which no mentally healthy person would engage? Will it morph into full on anorexia nervosa? I'll bet you're not ready to accept that. So, why should so many accept that a cleanse diet is nothing more than fancy anorexia? A cleanse diet is really just a fast. Regardless of the pseudo-scientific reasons, as opposed to religious reasons, its still a fast. And the idea that a fast cleanses us, both physically and spiritually, is nothing new.

I actually think that what upsets opponents of cleansing and detox diets more than the actual diets, is that so many people become steadfast promoters of them and encourage others to do it. The idea that you are more health-savvy and even more righteous and superior, while you are actually engaging in a ridiculous pseudoscientific fad, upsets some folks of a more scientific bent. But this is not about science itself, but a type of 'moral outrage' aimed at the proponents of such behavior. If a religious person fasts, the same folks may find it hard to understand, but since the faster isn't trying to convince the masses to join him, they don't give it much thought.

Sure, some folks are using these diets in an extreme fashion, and too often. Some with the right disposition may actually develop an eating disorder and there are those who are so obsessed with healthy eating that they eat in a way that is obsessive. Others may actually be using this behavior as an acceptable way to cover-up disordered eating behaviors, just as Goldstein said at the beginning of her statement. While all of this is possible, it is not probably that it applies to everyone using cleanse diets or detoxing. The last part of her statement is the real target here, because it compares cleansing and detoxing themselves to anorexia. In other words, it equates them.

Many people think that cleanse diets are healthy and will not only cleanse them. The desire to cleanse the body of toxins may be part of an obsession with healthy food has been named ortorexia nervosa. Instead of a focus on an ideal body appearance, there is a focus on a healthy life-style, food quality, etc. to the point that their diet becomes so limited they risk malnutrition. Many different dietary practices are used, such as macrobiotic diets, raw food, vegan, and fruitarian. However, many have taken to assume that with orthorexia comes extreme physical danger. This is not necessarily the case. It is the obsessive compulsive manifestation which is the real problem. The danger is psychological and emotional.

The question is, then, is fasting all that physically dangerous? Well, one thing to realize is that fasting does not always mean going completely without. For example, during Ramadan, the fasting only lasts through a specific period of the day, and it goes from 11 to 18 hours, depending on the season. Periodic fasting, in general, can mean a continuous absolute fast for days, or just to skipping meals regularly (which means I fast all the time).

Periodic fasting, intermittent fasting, or whatever you'd like to call it is to today one of the most popular weight loss strategies. And while many have expressed opinions about its efficacy and its danger, it seems worth nothing that fasting in general has never caused such outrage as cleanse and detox diets do now. Why? At its heart, its just a type of fast. Yet, intermittent fasting even at its height was never as popular and widespread as cleansing and detox diets. Is the outrage as much due to the the popularity as the content? Is it due to people's negative opinions of its chief endorser(s)? Is it due to the shoddy pseudo-scientific underpinnings, based on a complete misunderstanding of how the body works? I think is is all of these things.

How does it affect health? How does any fasting affect health? Although fasting has actually been used clinically for various reasons, and with favorable results, such as fasting prior to chemotherapy to reduce side effect, there is not a lot of literature on its health effects. By far, the most literature exists on Ramadan fasting, because it is the most standardized type of fasting in the world. But its not standardized enough! Just like all of fasting. It is not just one practice. The practices and variables are quite wide and because of this it is hard to generalize its effects.

No one can really tell you that a periodic cleanse diet is dangerous to your health. Likely, no matter how silly it is, and no matter people's opinions of its practicioners, an occassional cleanse is most likely not going to harm you. As a weight-loss strategy, it is doomed to failure, but to say that its a poor way to lose weight is nowhere near the same as saying its a one-way ticket to an eating disoder and various ill health effects.

Before we start shouting about dietary practices causing eating disorders, or being eating disorders, we need to consider the impact on a person's life. A person could go on periodic cleanse diets and it could develop into something more. But such a person may well have developed an eating disorder regardless. Be careful with the difference between a manifestation and a cause. Obsessive use of cleanses or detox diets may be a manifestation of an underlying problem, but not the cause of it. On the other hand, a person could go on periodic cleanse diets and…that's all. No big negative effect on their life. I'd like to point out something to the more vocal folks on Facebook: Just because you find a person's attitude, moralizing, and advancing of ridiculous dietary fads to be annoying on FB, doesn't mean that person's life is in a shambles and they are couple of days away from a check-in at the eating disorder clinic.

I mentioned that two fallacies are associated with this thinking: Slippery slope and false analogy. Slippery Slope may well be the fallacy you come across most often. IT is used by everyone from lay-folks to health professionals and more, with few understanding it or even recognizing it. The basic fallacy is as follows:

A person argues that a certain act, or event will inevitably lead to a bad final result. What most people do not understand is by invoking this slippery slope they are actually stating that a chain of events will occur. One event will lead to the next, which will lead to the next, etc. and so on until the imagined disaster occurs at the end of the chain. You may have noticed the humorous television commercials by DirectTV, which use a slippery slope to describe the quite unlikely seeming results of using cable TV, like 'ending up in a roadside ditch.' Most slippery slope arguments, in contrast, seem superficially plausible and while some may actually list a chain of events, most simply describe the final result. What you must recognize, though, is that regardless if they are explicitly stated, the chain of events exists!

In order for this argument to succeed, a person must know the precise causal events that will lead to the described, and dramatic, outcome. Not only is it impossible to name a series of linked causal events that will take place solely as a result of a single action or event, but then each and every one of these events must occur, one after another, in a precise sequence. Any break in the chain and the result cannot occur. Once you understand just how unlikely this all is, you will start to see that these statements are not even superficially plausible.

The statement that diets, yo-yo dieting, or cleanse diets will end up in an eating disorder is just such a slippery slope argument. Many people reacting to the above quote seem to be invoking this same argument. They say, well, cleansing diets may not be the same thing as anorexia, but that's where they'll end up!

The original statement itself, however, is a false analogy. The problem with analogies in general is that people often see them as more powerful than they are. They seem to almost scream at us. Here's proof! This thing is just like this other thing! But an analogy is nothing more than a helpful explanatory tool. It is a way of illustrating a concept or thought process. It cannot prove anything. When we use comparisons to explain things, we are saying that two things are analogous. In order for our analogy to be valid, the items we compare must be alike in enough respects, and in proper context. If you've read through the articles I linked above, you already know why the statement in question is just such an invalid analogy: Cleanse dieting and anorexia nervosa are not sufficiently similar, and the comparison itself is misleading.

Unfortunately, given the culture of the internet, human tendencies in general, and the way all these subjects are trending, it is difficult to make people see that these expressions of anger about cleanse diets are not an expression of critical thought, but more of moral outrage. It is hard to make people see the errors in their thought process when they imagine themselves experts! Yet, as I said before, most of those expressing this outrage and this concern about potential eating disorders have probably never before given such problems a second thought, have no experience with such matters, and certainly would not be able to 'diagnose' such a disorder. Trust me, just as Gwyneth Paltrow got the whole cleanse craze started, someone else, or a group of people, got the current anorexia trend started as well! It may have well been he very quote in question here. How is one really different from another when they are based on the same lack of understanding, rush to understanding, or plain ignorance?

It may seem as if I am severely criticizing Jessica Goldstein and her statement. In fact, I am not. I am criticizing the spread of her quote and the subsequent misunderstanding, and the thought process this represents. When scientist say they have a theory, it means something completely different! When laypeople say "I have theory," what they usually mean is "I am blue-skying it here to make a point." Although I do understand the point she was trying to make, I do not think her theory holds water, nor do I think it should have spread like wildfire over social media. Cleanse diets are not just fancy anorexia. People do not choose to have eating disorders, and they certainly do not turn them on and off and have an eating disorder for a 'finite period of time' based on choice.



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