Are Juice Cleanses and Gluten-Free Diets Eating Disorders In Disguise?

Doormen are the ultimate yentas. They know everything. Who’s shacking up with whom. Who’s Airbnb-ing. Who would rather give up her first born than Diet Coke (that would be me), and who’s been blowing off her cello lessons to hang with her new beau (also me).My doorman, Jose, can also detail every apartment dweller’s eating habits. He knows who’s doing juice cleanses; who’s gone Paleo; and who’s ordering plant-based, gluten-free food from places like Jay Z and Beyonce’s 22 Days Nutrition (home of the vegan challenge kit!), Provenance Meals (“Make your friends rave about your shiny hair, bright eyes and glowing skin”) or Sakara Life (“We’re food as medicine”).

It was Jose, in fact, who introduced me to Sakara. One afternoon, he handed an eight-foot-tall model a Sakara tote bag and I watched her sling it over her shoulder and slip into the elevator.

“What’s Sakara?” I asked.

“A diet delivery service,” Jose said. “All the skinny girls do it.”

Sakara, it turns out, is not a mere diet delivery service—its founders, Whitney Tingle and Danielle DuBoise, both 29, avoid the “D word” as if it were white flour. Their company’s website describes it as a “weight loss and healthy living program”; their motto is “Eat Clean Eat Whole” (sans comma), the mantra of any number of healthy lifestyle regimes. (The word “clean,” addiction treatment jargon, has been co-opted by wellness marketers.)

Sakara fans include models, actresses, doctors, Lena Dunham, and, apparently, half the women in my building. Bobby Flay serves on the advisory board. The product has also been given the Paltrovian Seal of Approval: On her lifestyle e-commerce site, Goop, Lady Gwyneth honored the company as the city’s top meal delivery program.

‘Most of the “healthy” cleansing, fasting and “detox diets look like calorie-restriction based on fear to me.’ Nina Planck, author of The Real Food Cookbook

Sakara, Sanskrit for “with form, or, the manifestation of thoughts to things,” operates in New York, New Jersey, Connecticut, the Hamptons, Philadelphia, Boston and Los Angeles. “We are …  here to remind our clients that their thoughts play as much of a role in their overall diet and lifestyle as does their food,” its website proclaims.

I’m not sure if my thoughts play as much of a role in my diet as my taste buds do, but as a proud non-cook, I like the idea of others preparing my meals. And though I haven’t stepped on a scale since the Bush (41) administration—my clothes serve as my gauge—I was also interested in losing a few pounds.

The company promised that I’d shed weight and purge toxins, that my skin would shine like Kate Middleton’s sapphire and that I’d have so much energy I’d practically skip down Fifth Avenue. So I signed up for four weeks (a week being five days) of lunch and dinner, for about $300 a week including delivery.

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That companies such as Sakara exist is not surprising; they’re the logical extension of the yoga-, SoulCycle-, detox- and organi-fication of our culture. They point to the sanctimony with which we infuse our eating habits: I cleanse, therefore I am (better than you). And, of course, they also speak to our willingness to listen to the self-appointed guru du jour.
Case in point: A recent study conducted by the nonprofit Institute of Diet and Health found that dark chocolate accelerates weight loss. Magazines from Shape to Prevention bit, except—oops!—both the Institute and the study were fakes. The hoax, perpetrated by biologist and journalist John Bohannon (who masqueraded as “Johannes Bohannon, Ph.D.”), showed how susceptible the media—and the public—is to miracle cures, especially when related to weight loss.

Talk about drinking the agave-sweetened Kool Aid.

Graduates of the Institute of Integrative Nutrition (IIN) started many high-end food-delivery businesses (Americans spend nearly 800 million dollars annually on such services). Students pay $5,995 tuition for the one-year, online pass/fail course and learn about 100 different dietary theories from an array of “experts.” To date, there are over 68,000 health coaches in 107 countries; much of the 23-year-old school’s growth occurred since 2011, when it went fully digital. Alumnae include Organic Avenue founder Denise Mari (who sold a controlling stake in her business to VC Weld North in 2013), Urban Detox Club partners Jen Morris and Rebecca Sadek, and Sakara co-owner Danielle DuBoise.

Despite the proliferation of health coaches—yoga instructors are so passé!—critics question how much scientific knowledge an online program with no admission requirements can actually impart.

Even some graduates aren’t sure about it. Waller McInnes, 33, is a yoga therapist who studied at IIN and actually worked in the school’s education department in 2008. “I don’t think that a person who just goes through an online certification, without being mentored, without doing a real internship, is truly equipped to be a professional nutrition counselor,” she said.

Aside from questioning why we are so eager to let others do the thinking (and advising) for us when it comes to what we eat, is the obsession with all things raw/organic/detoxifying, and all the talk of gluten-free and food “allergies,” just culturally sanctioned eating disorders in disguise?

“Most of the ‘healthy’ cleansing, fasting and ‘detox’ diets,” noted Nina Planck, author of The Real Food Cookbook, “look like calorie-restriction based on fear to me.”

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Every morning my Sakara meals arrived in plastic recyclable packages affixed with a blurb on a featured “superfood” (itself a buzzword with ambiguous meaning). Through the label on the kale Caesar with hemp protein dressing, for instance, clients learn that there are two types of yeast: The “harmful kind that grows in your body and causes all sorts of mayhem, and the cultured, deactivated kind that grows outside only to provide seriously rejuvenating LOVE once ingested.” The latter, consumers are told, “fights fatigue, irritability and insomnia and boost nails, hair and memory.”My meals included four-ounce bottles of “Morning Beauty Water” and “Night Water.” Purchased alone, Beauty Water runs $24 for 16 ounces and “combines the highest quality alkaline water with pure rose oil and beautifying trace minerals, including silica.” Silica, incidentally, makes “water wetter and provides deep cellular hydration,” which recalls a line from Zoolander: “Moisture is the essence of wetness and wetness is the essence of beauty.”Sakara fan Jessica Katz, a registered dietician, on Park Avenue, offered a positive review of the “delicious” food and added that she recommends the delivery service to her patients. Yet she acknowledged that “there’s no science to support the notion of eating an alkaline diet.” As for the Beauty Water? “Maybe someone might derive some minerals from them, but I don’t think water with rosehips is going to be miraculous and make one beautiful.”

The Night Water ($18 for an eight-ounce bottle) is made with chlorella, a micro-algae that supposedly “helps increase the ‘good’ bacteria in the intestine in order to improve digestion and immunity.” For optimum results, I was told to pair the cleansing waters with “loving thoughts” (not included).

Each meal featured the richest (albeit yummy) salad dressings I have ever tasted, which were drenched with oil and, I’m sure, calories. I wouldn’t know, though, since Sakara is rabidly anti-calorie. They refuse to share nutritional information with clients. “We want to help the client focus on wellness, and calories are not a proven metric for weight loss,” Ms. Duboise told the Observer.

There is no doubt that counting calories (or points, in Weight Watchers parlance) can be crazy-making, which is one reason eating disorder specialists try to steer patients away from the strategy and to eat in tune with their bodies instead.

While all calories are not created equal—a 350-calorie Ding Dong is not the same as a 350-calorie chicken sandwich—I still wanted to know the proteins, carbs, fats, sodium, and yes, calories in Sakara’s meals. Was I ingesting 500 a day? 2,500? And what was up with those greasy dressings?

After a number of back-and-forths with Sarah, a registered nurse who works for Sakara, I was told to only use half the salad dressings if I wanted to lose weight. She was happy to provide me with the ingredients for meals, but she remained mum on nutritional specifics. (The FDA only requires nutritional labels for packaged foods). As she wrote by email, “At Sakara, we want you to focus on how our food makes you feel … All of the meals are nutritionally designed to give your body the exact amount of macronutrients, vitamins and minerals that it needs to function optimally.”

How Sakara knew what my body needed to function optimally was beyond me—it’s not as if the company analyzed my blood. People digest and metabolize calories differently; a 5’2” ballerina has different nutritional needs than, say, a 6’2” logger.

“I’d have a hard time recommending a home delivery meal to my patients where I didn’t know the entire breakdown of calories, carbs, protein, what kind of fat,” said Keri Gans, a registered dietitian and author of The Small Change Diet. “I want to see the big picture.”

And here is the other point. No matter how you slice, dice and julienne it, no matter how much you claim your healthy eating plan is about health, “the majority of these programs are for weight loss,” said Ms. Gans. “They can call it what they want. But my male and female patients who have ordered home delivery meals say it’s because they want to lose weight.”

Marjorie Nolan Cohn, national spokesperson for the Academy of Nutrition and Dietetics and author of The Belly Fat Fix, said that people who already have an eating disorder, or who have a high propensity for one, “definitely can use these ‘healthy/organic’ food trends as a way to support eating disorder behaviors without being obvious.” In her analysis, it’s not intentional, but a by-product of an attempt to be healthier gone too far. This is common among her clients. “It starts off innocently enough as a fear of non-organic based on erroneous food information in the media, and can spiral,” she warned.

She tells clients that if their fervor doesn’t also include actual lifestyle changes beyond food (i.e., using cleaning products that are safe for both them and the environment) it’s not a truly holistic lifestyle change. “If they are overly focused on food/weight, and not other products that may affect health, it’s probably an eating disorder,” she said.

The name for “it” is “orthorexia,” an unofficial diagnosis coined in 1996 by physician and author Steven Bratman, who defined it as an obsession with “healthy or righteous eating.” In their desire to lead a virtuous life, orthorexics rid “impure” foods from their diet. Before long, they’re cutting out almost everything except for a few select items.

While orthorexia is not in the DSM-5, the psychiatric bible, those in the trenches take it seriously.

“Orthorexia exists, and I think these lifestyle delivery systems are for many people a form of it,” said Dr. Margo Maine, Ph.D., a clinical psychologist who specializes in eating disorders. “For many people, it’s an entry into an eating disorder. You start thinking you’re going to eat better, with more control—‘clean’—and before you know it you’ve excluded pretty much every food except raw, and limited your fat intake, your carbs, your protein sources and your calories and you have changed your life in a major way.”

Jenni Schaefer, co-author of Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem?, recalled the plaudits she received at the height of her anorexia, when she was 22 and a walking cadaver. “I was complimented daily, not only on my weight, but also on my dietary restraint,” said Ms. Schaefer, now 39. “It’s difficult to know that you desperately need help when you continuously receive positive feedback.”

Ms. Schaefer worries about the explosion of “plant-based” diets, the increasingly common euphemism for “vegetarian” or “vegan.” Clearly, many people avoid animal products out of deeply held personal or political reasons or to lower cholesterol. These beliefs are close to their hearts, and with them I have no, uh, beef.

But an August 2012 study in the Journal of the Academy of Nutrition and Dietetics found that 52 percent of those with a history of eating disorders were more likely to have been vegetarian. Of these, 42 percent said they were primarily motivated by weight management, compared to 0 percent of those with no eating disorder history.

The war on gluten is another issue. Only 4 percent of the adult population actually suffers from celiac disease, an autoimmune disorder where ingesting gluten—a protein found in wheat, barley and rye—produces inflammation that can damage the small intestine’s lining and prevents absorption of some nutrients. And a 2010 report in the Journal of the American Medical Association noted that only 1 to 2 percent of adults have legitimate food allergies.

“I see the gluten-free trend in many of my eating disorder clients, but more so than eating disorder I think gluten-free is misinterpreted as something healthier,” said Ms. Nolan Cohn, of the Academy of Nutrition & Dietetics. “There’s a lot of media about the effects of inflammation on weight. If someone goes from eating refined/processed foods to gluten-free, they may naturally eat more whole foods, which can help with weight loss in some cases, but not unless that person is watching calories.”

As for the catchphrase of the millennium—“organic”—studies have shown few nutritional differences between organic and non-organic. A 2012 review in the Annals of Internal Medicine found limited evidence that organic foods are significantly more nutritious than conventional fare.

“If you want to choose organic food, fine. But organic candy is still candy,” said Bonnie Taub-Dix, a registered dietitian and author of Read it Before you Eat it! “Organic says nothing about calories.”

But the piece de resistance, the cherry on the soy-free, vegan chocolate tiramisu, is the celebrated juice cleanse. According to 2015 research from IBISWorld, the juice and smoothie industry is worth $2.3 billion, with an estimated 4,289 juice and smoothie bars in the U.S. Starbucks even got in on it, shelling out $30 million for Evolution Fresh, a cold-pressed green juice outfit. At $10 to $12 per bottle of pulpy liquid, there’s big bucks to be made. The idea behind the fad is that existing on liquefied fruit and vegetables for a few days (or longer), will eradicate pesky toxins, eliminate gastrointestinal troubles, cure skin ailments, brighten your eyes and generally make you more euphoric.

Would that it were so. “The whole notion of cleansing is a little bogus and really not necessary because our liver, lungs and kidneys do that for us,” said Despina Hyde, a registered dietitian at the Weight Management Program at NYU Langone Medical Center.

Not that it’s bad to give your body a break every so often. Sondra Kronberg, a registered dietician and a spokesperson for The National Eating Disorders Association, likens it to an oil change. “From a logical standpoint—if I’m a [car engine], would a day of cleaning me out do me well? Yeah,” she said. “Do I think chemicals in my body are a problem? Yes. But the degree to which I do that for long periods of time or reach a level of holiness or eating organic or farm-to-table—there’s a lack of scientific evidence that they’re doing much of anything.”

‘The whole notion of cleansing is a little bogus and really not necessary because our liver, lungs and kidneys do that for us.’— registered dietitian Despina Hyde

In fact, fasting—essentially what these cleanses are—is recognized in the DSM-5 as a symptom of bulimia nervosa. And, as Ms. Schaefer and her co-author, Dr. Jennifer J. Thomas of Massachusetts General Hospital, note, there are no proven detoxification benefits to fasting “and no evidence that our bodies are even ‘toxic’ to begin with.”

A large part of the popularity of the juice cleanse can be attributed to companies like Organic Avenue, which was founded in 2000 and opened its first retail store in New York in 2006 as a juice and raw food cleanse service. Today, OA has 10 stores in the city and offers an extensive plant-based menu.

In July 2014, the company began delivering its juice cleanses nationally, among them “Go Green,” a three-day extravaganza “packed with phytonutrients, minerals and enzymes” that sells for $210. To make it less isolating (let’s face it, nothing’s lonelier than pulverizing beets solo), the company also offers group juice cleanses. Forget about building trust by falling backwards into your co-workers’ arms; now you have to chug spinach-and-celery slurpies in unison.

Katie Campisano, 26, who works in public relations in the city, has done five juice cleanses through Liquiteria, each lasting three to five days. Her goal was not to lose weight, but to “clean my body out,” and wean herself of sugar.

And while she managed to do that—temporarily, anyway—she calls the cleanses “utter bullshit.” She cheerily admitted that she “hates” them: “There’s no protein. It’s all sugar. They trick you by saying it’s natural sugar, but it triggers the same thing in your brain. The mood swings with juicing are just as bad as with eating processed sugar.” She paused and then said dead serious, “I can’t do another one unless I start smoking cigarettes again.”

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Sakara’s co-owners have thought long and hard about all of this. In fact, they became gastronomic warriors precisely because of their own food battles.

The two women, childhood friends from Sedona, Ariz.—they’re so tall and blonde they’re practically different species—have suffered in their lives. Ms. Tingle wrestled with cystic acne, and nothing, not Accutane nor antibiotics nor lasers, helped.

After moving to N.Y., she worked on Wall Street (“I wanted to be Suze Orman”) and gained 15 pounds.

Ms. DuBoise studied anthropology and chemistry at Hunter College, and tried her hand at acting and modeling (she resembles Sally Draper, all grown up). She never had an eating disorder, per se, but she struggled with body image. “I never felt pretty enough or sexy in my body,” she said. She and Ms. Tingle were roommates in the city; together, they did 10-day Master Cleanses, guzzling gallons of lemon, maple syrup and cayenne pepper to rid their bodies of impurities and help Ms. Tingle’s acne. They ate raw garlic. And they felt like shit: “I was cold, I couldn’t work out, and couldn’t function,” said Ms. Tingle. And she still broke out.

In 2010, Ms. DuBoise embarked on a 21-day retreat in Arizona, which included a seven-day water fast and 14 days of raw food. She ended up in the hospital with pneumonia.

And then one day, in a burst of spiritual light-headedness or a message from Beyond, it hit them that is was no way to live. Counting calories “made it worse,” Ms. DuBoise recalled. She enrolled in IIN; a year later, they came up with the kind of program they wished had been available to them, a nutritious meal delivery service. Ms. Tingle’s skin cleared up. Ms. DuBoise finally felt at home in hers.

Like all good evangelists, they wanted to share their findings, hoping to “empower women in their bodies and have a good relationship to food,” said Ms. DuBoise. “We’re trying to help people feel good in their body. That might mean weight loss for you, and something else for someone else.”

The pair gained momentum; earlier this year, The New York Post dubbed Sakara the “Victoria’s Secret” diet, since so many models use the service. Not surprisingly, their 20 staffers are entirely female, as are the bulk of their 8,000 clients, including Kelly Kimball, the owner of an acting school in Manhattan. “They’re coming from this place of abundance, rather than ‘starve yourself and you’ll fit into a bathing suit,’ ” said Ms. Kimball, who spent three months on Sakara. It cost $2,750, but she felt it was worth it. Within a week she said she had more energy and a better outlook.

The company’s founders also wanted a community feel, so they host yoga, meditation, dance classes and movie nights in Sakara’s sleekly-designed 3,250-square-foot Soho mothership.

Business has boomed—for the first time, this year Ms. DuBoise and Ms. Tingle paid themselves a salary—but the Post article made them uncomfortable. “We’re not the sexy diet!” Ms. DuBoise insisted. “That’s not our mission. We’re a wellness delivery program. It’s supposed to fit into your life. You can eat this food every single day and have a beautiful relationship to food.”

If you can afford it, anyway. As for whether Sakara and similar meal delivery services are creating or abetting eating disorders, the women insist they are doing the opposite. They point to the fact that they don’t promote juice fasts and that they encourage indulgence (on weekends, Sakara counsels customers to eat whatever they want, to live life—to retox). A few clients have even said Sakara helped them overcome eating disorders, since it removed the pressure of having to go to the store and shop for themselves.“While some people may use words like ‘cleanse’ or ‘detox’ as a way to feed into their eating disorder, to say that ‘all people who do cleanses or detoxes have an eating disorder’ is absolutely incorrect,” said Sakara’s co-owners by email. “There are millions of people in America and around the world who desperately need to cleanse their bodies from an unhealthy diet. And there are also thousands of doctors who prescribe cleanses or detoxes as part of a patient’s treatment plan.”

Clearly, the culture needs to re-think its relationship to food, weight, and well-being. It’s almost impossible to know what to put in our mouths, especially when we’re being force fed so many conflicting messages.

But here’s a simple guide: Eating whole foods and avoiding processed is smart. Imbuing specific foods and beverages with magical, curative powers is not.

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Abby Ellin is the author of Teenage Waistland: A Former Fat-Kid Weighs in on Living Large, Losing Weight, And How Parents Can (And Can’t) Help.