Is It Possible to Cleanse Responsibly?

There's something undeniably alluring about a fresh start — and in the end, that's what a dietary "cleanse" is promising: the clearing out of any unwanted muck and a brand-new starting line that signifies another chance to reach your goals.

But really, cleanses are usually just hyper-restrictive diets wrapped in the aura of ~wellness~.

That's what former Goop exec Elise Loehnen says she finally came to realize when she left the company about two years ago. In an Instagram video, Loehnen detailed the cleanse culture that permeated the wellness brand — which is known for its focus on holistic health fixes, including plenty of detox dieting — and just how damaging it was for her relationship with her body and eating.

"I decided to foreswear all cleansing," she says in the video. "To me, it had become synonymous with dieting and restriction, and I felt like I was not in a healthy relationship with my body. I was always trying to punish it, bring it under control."

But (plot twist!) after two years of "eating whatever", Loehnen swung back in the other direction again. "I'm clearly being called back to a place somewhere in the middle because my stomach often hurts," she wrote. And then, she went on to plug Kroma, a five-day cleanse that includes smoothies, drinks, and broths. (A rep from the brand confirmed that the post was not paid or sponsored.)

"I thought I would hate the whole thing, but I decided to do it differently," she wrote in the post caption. "I didn't weigh myself, before, during, after, and I chose the version that lets you eat extra veggies and proteins as you want. ([It also includes] extra lattes, a delicious almond butter concoction, and additional mixes if you need more food.) It didn't feel restrictive, at all, I wasn't hungry, and I felt much better after. What's more exciting is that I didn't retaliate by eating badly immediately. It just released me into a new, slightly healthier lane."

Even for the cleanse-averse, it admittedly doesn't sound that bad. The ability to add food when you want and snack on something called "cookie butter" (even if it is mostly made out of almond butter) doesn't read like punishment or starvation at all.

But, no matter how flexible or nutritious a cleanse might be (or claim to be), is it ever really a good idea? How does it impact your body physically and the relationship you have with your body and food? In the end, is the idea of a cleanse in itself actually the most harmful thing of all?

The "cleanse" label is most commonly associated with juices, but the idea behind commercial cleanses actually originated from the practice of medical nutrition therapy (MNT), a treatment given by registered dietitians that includes a prescribed diet, counseling, follow-up, and education designed for the management of conditions such as liver or kidney disease, explains clinical psychologist and dietitian Supatra Tovar, PsyD, RD. It's meant to help diseased organs heal and return to properly clearing the body of toxin build-up. "Somewhere along the line, an ambitious entrepreneur decided to commercialize the idea behind MNT as a 'cleanse' — which eventually grew into a marketplace worth over $50 billion, as of 2021," she says.

But for those not dealing with conditions like liver or kidney disease, your bodily processes naturally do the "cleansing" work. "We have kidneys, and we have a liver. Their purpose in our body is to 'detox.' We have our own built-in cleansing system," says former registered dietitian Laura Cohen, certified intuitive eating practitioner and eating disorder recovery coach.

So "cleansing" your body isn't really effective. And because the Food and Drug Administration doesn't regulate supplements or the use of words like "detox" or "cleanse" — you can slap that language onto any suavely marketed product or plan and, ta-da! a cleanse exists, regardless of whether it does anything beneficial or remotely cleansing for your body.

Understanding the answer to this question involves looking at the physical impacts of cleansing as well as the mental impacts.

"To me, and based on what research suggests, there's no world in which cleanses are responsible, effective, or in any way a necessary part of maintaining health and wellness as a human being," says Mallory Frayn, PhD, a clinical psychologist who specializes in disorder eating. "They've been popularized by diet culture, and the notion that there's a quick-fix solution to concerns related to weight and body image, and that simply does not exist. We know extreme forms of restriction (e.g., cleanses, fasting, calorie counting) are actually linked with overeating in the long run. When you try to deny your body what it needs, your physiology wins out, and when you do eat, you're way more likely to 'overdo' it than if you had just eaten regularly to begin with," she explains.

There's some research on "detox" programs that shows results in terms of weight and fat loss, insulin resistance, and blood pressure. But dig a little deeper, and you'll find that these studies have been low quality: they had design problems, too few participants, or a lack of peer review (meaning, they weren't evaluated by other experts to ensure quality), according to the National Institutes of Health (NIH). And even if a cleanse did lead to initial weight loss because of low calorie intake, they tended to lead to weight gain once someone resumed their normal diet. As Tovar puts it: "Unfortunately, research has shown that cleanses are more empty promise than proven science."

What's more, any initial weight loss is often masking nutrition deprivation, even if the cleanse in question contains seemingly "healthy" ingredients, Tovar says. That could mean you're not getting enough calories to fuel your body, or you're not getting the adequate amount of macro- and micro-nutrients necessary for your body to function properly. Not to mention, cleansing or detox diets can also disrupt your blood sugar levels and metabolic rate, and cause low energy and gastrointestinal distress, according to the Cleveland Clinic.

Ultimately, when evaluating whether a cleanse is "healthy" for you individually, it's just as — if not more — important to look at your emotional response as it is to consider the physical health implications, says Samantha Cassetty, MS, RD, nutrition expert with a focus on mental wellness and coauthor of "Sugar Shock."

"If an eating behavior feels stressful or punitive, then it's negatively impacting your mental and physical health — and, obviously, that isn't good," Cassetty says. More significantly, cleanses have the potential to lead you down a path of harmful eating habits, says Cohen. "At the very least, it's perpetuating disordered eating, which could lead to an eating disorder in someone predisposed. It's a slippery slope," she says.

Disordered eating is not the same as an eating disorder, but they exist on the same spectrum, says Cohen. It's not a diagnosis, but rather refers to problematic eating patterns, such as frequent dieting, anxiety associated with specific foods or meal skipping, rigid rituals and routines surrounding food and exercise, and feelings of guilt and shame associated with eating. (For a full description, head to the Academy of Nutrition and Dietetics.) What it boils down to, according to Cohen, is "rules around eating."

So, if the best possible outcome is that a cleanse doesn't lead to disordered eating and actually does redirect you into a "healthier lane," as Loehnen says, it's worth asking yourself: is there anything else I could do that would give me the same result? Would focusing on eating more fruit and vegetables or drinking more water leave me with the same renewed motivation and positive feeling?

"I have so many clients who say to me, 'I just want to reset,'" says Cohen. "But what does a reset even mean? It's not like our bodies have a switch . . . I would ask them: 'what does that mean to you? What are you going to accomplish from that?'"

If it's not possible to cleanse your body — and if these eating programs generally aren't even that healthy for you — then why do they still seem so alluring?

It's likely partly because they promise that a better you is just days away, whether that's via weight loss, nutritional health, or a perspective shift. It's implied that you'll come out on the other side shinier in some way, shape, or form. Cleanses aren't just selling you food products or a plan; they're also selling you a lifestyle: "this is who you'll be if you do this program."

Having someone take the guesswork out of eating is also a huge factor, Cohen says, because we've been conditioned to think that "everyone [else] knows how to feed our bodies better than ourselves." For so many years, so many of us haven't listened to our bodies because we eat what we're told — by parents, friends, societal norms, diet culture — to eat and not what our body wants, says Cohen. Overriding that isn't easy. "Unlearning that is a process; it doesn't happen overnight."

And so the cleanse sweeps in, taking all that internal struggle away, at least for a few days. "People gravitate toward simple, immediate solutions for long-term problems," Tovar says. "It's more appealing than having to make longer-term, more difficult changes to their diets."

Sure, a cleanse may result in you feeling better for a short time, but it doesn't leave you with any long-term skills to continue feeling better for life. Tovar says the goal should be to move away from extreme approaches to eating and instead embrace the idea that "there are no off-limits foods (because that eventually leads to bingeing) and to learn how to listen to your body for hunger and fullness," she says. It's also key to "address your mental health needs separate from your food consumption to minimize emotional and mindless eating, and learn how to adopt mindful eating to better your self-awareness and self-regulation."

All physiology aside, the rhetoric around cleanses is quite damaging in itself. Calling something a cleanse implies the body is dirty and must (and can) be cleaned — and this suggests that the way you've been living your life or treating your body is inherently dirty, feeding into the idea that there are "good" and "bad" foods, and that your body is something that needs fixing.

"The biggest problem with cleanses is their intention focuses on restriction," says Amanda Sauceda, MS, RDN. "A responsible cleanse is about setting an intention to support your body and then ultimately means adding foods to your diet." What Sauceda is talking about isn't really a cleanse in the traditional sense, but simply eating with health in mind. The key is, "to let your organs do their jobs," Tovar says. If you want to make a change, "start by avoiding processed foods and instead eat a diet rich with nutrient-dense, high-fiber, and anti-inflammatory foods," she says. "You'll notice that adopting a well-balanced diet will keep your body free of toxins without increased anxiety or sacrificing mood stability."

No matter what, if you have a history of disordered eating, currently have an eating disorder, have type 1 or 2 diabetes, or are pregnant or breastfeeding, you should avoid cleansing or dieting in general, says Cassetty. If you don't fall into any of those categories and genuinely think that your intentions going into a cleanse are clear, try asking yourself these questions, she suggests. They'll help you determine whether you might be able to tackle something like a cleanse responsibly.

How important is exercise to you and your mental health? It's not appropriate to exercise when you're cleansing, since your body will generally be low on fuel from food, so if you're someone who needs it to manage stress, anxiety, and your mental wellness, you may want to re-think the cleanse, she says.

How will you manage hunger? Can you be flexible with yourself and allow yourself to eat something, even if it's not on plan? "If not, you're overriding your body's signals, which is a form of disrespecting your body," she says.

Does your life involve socializing around food? What will you do in these instances? "Avoiding social situations is a red flag that you're participating in something unhealthy," she says.

Do you have kids at home? And are you removing yourself from the family dinner table?
"If so, you may be normalizing body dissatisfaction and unnecessarily restrictive eating behaviors in front of kids, who will pick up on this," she says. "Remember that you're their health role model!"

Have you had a turbulent history with dieting? "If you're a yo-yo dieter, then it's a sign that you're not building sustainable habits. There may be an opportunity to focus on small, but impactful healthy habits rather than a cleanse," she says.