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Veganism and Eating Disorders: Facts and Fiction

Green vegetables

 

Veganism is a social justice movement which aims to eliminate animal exploitation and suffering as far as is possible and practicable. 

Because billions of animals are commodified and killed for food each year, boycotting animal agriculture is a core part of veganism. As an ethical stance that overlaps with food choices, veganism may be interpreted as dieting or disordered eating. While this usually isn’t the case, sometimes it is. 

You might be wondering…

Does veganism increase someone’s risk for an eating disorder? What happens when someone who is vegan suffers from an eating disorder – can they recover and still be vegan? 

Before we go any further (and don’t worry, we’ll get to those questions), it’s important to note that this post is not a replacement for individual medical or behavioral health care and is for informational purposes only. Please work with your health care team for personalized guidance and support.

I am not an eating disorders expert but luckily I was able to interview several Health At Every Size eating disorders practitioners with expertise in veganism to bring expert insights to this post!

First, let’s start with the basics…

Causes of Eating Disorders

There isn’t a single cause of eating disorders and the causes are not yet fully understood. We do know that there are biological, psychological and sociocultural variables at play when it comes to risk for eating disorders. There is a strong genetic component to eating disorders and they can run in families.

According to Tammy Beasley, RDN, CEDRD-S, CSSD, LD, vice president of clinical nutrition services at Alsana, “Eating disorders are not caused by one trigger or one choice or one traumatic life event or painful relationship. Yes, genetics and environment both play a role, and our choices can ‘feed’ genetics and environment and create the perfect storm through which an eating disorder enters. But no one ‘cause’ is to blame.”

Types of Eating Disorders

The most common eating disorders people hear about are anorexia nervosa and bulimia nervosa. But did you know that three times more people suffer from binge eating disorder than anorexia and bulimia combined? 

There’s also OSFED, or “other specified feeding or eating disorder,” previously known as EDNOS, or “eating disorder not otherwise specified.” Many people with this diagnosis do not meet the strict diagnostic criteria for anorexia or bulimia. That doesn’t mean they aren’t suffering, though. 

Orthorexia is not a formal eating disorder diagnosis, but it is a serious and dangerous form of disordered eating marked by an obsession with healthy eating. Orthorexia absolutely warrants attention and professional care, even if it is not a formal diagnosis.

Avoidant Restrictive Food Intake Disorder, or ARFID, previously referred to as “selective eating disorder” is similar to anorexia due to food restriction. But those who struggle with ARFID aren’t preoccupied with their body shape or size. This disorder is different from “picky eating” phases that many children go through.

For more details on types of eating disorders, check out the NEDA website.

Now, let’s get into more specifics about vegans and eating disorders…

variety of vegetables and vegan dips on a white board

Does Veganism Cause Eating Disorders?

No, being vegan does not cause eating disorders. Remember the section above about causes of eating disorders? There is no single cause of eating disorders.

Beasley clarifies, “Veganism does not ‘cause’ eating disorders any more than a social media post of thin models ‘causes’ eating disorders or going on the latest diet du jour ‘causes’ eating disorders, or having a poor relationship with a loved one ‘causes’ eating disorders, or having a family history of others in your family with eating disorders ‘causes’ your own.”

According to Jenny Weinar, LCSW, a vegan eating disorders therapist with a private practice based in Pennsylvania, “There is a relationship between veganism and eating disorders – that is to say, the percentage of people who report being vegan (or vegetarian) is higher among people with eating disorders compared to the general population. But as always, we have to be careful about confusing correlation with causation. There are many factors that contribute to eating disorders, and to say veganism in and of itself causes them would be a gross oversimplification.”

When Veganism is Used By the Eating Disorder

Sometimes people with eating disorders will cut out animal products and say they’re doing so because of veganism, when in reality it’s because of their eating disorder. As Rachael McBride, MCN, RD/LD, CEDRD, a vegan eating disorders dietitian, notes, “Most people with eating disorders have tried a ton of different ways of eating (low carb, keto, gluten- or sugar-free, etc). Veganism is often just another manifestation of the eating disorder, but that certainly doesn’t make it the cause.”

In these cases, the eating disorder precedes the vegan diet. So when we see folks who eat vegan and also have eating disorders, it’s worth considering what came first – the ED or the diet?

Veganism does not cause eating disorders.

Are Vegans at Increased Risk for Eating Disorders?

So we know veganism doesn’t cause eating disorders, but what about the correlation between people who don’t eat meat and eating disorders? What about when people who used to have an eating disorder go vegan? Let’s see what the experts have to say!

According to Caitlin Martin-Wagar, PhD, a postdoctoral associate at Yale University School of Medicine doing weight and eating clinical-research, “There is not sufficient evidence to say vegans are at any more risk for eating disorders than non-vegans. The biggest thing to monitor is why someone is ‘vegan’ – some people with eating disorders will call themselves vegan so they can restrict more easily. However, with the abundance of vegan options in many cities these days, it is getting harder to use veganism as a way to cover up an eating disorder.”

Beasley echoes the emphasis on the underlying motivation for veganism, saying, “Any time our food choices require limiting certain food groups creates the potential for a slippery slope if the motivation behind those choices is rooted in external factors related to our body size, society or peer pressure, a need to escape or numb or hide, or our self-worth.”

“If health is the primary motivation, veganism is arguably an extreme way of pursuing this and could progress to an eating disorder,” says Weinar. “Furthermore, anyone with a preexisting history of disordered eating might be triggered by the process of removing certain foods and experience this as restriction, which could contribute to a relapse or serve to maintain a diagnosis that was already there.”

Amy Taylor Grimm, RDN, LD, a vegan eating disorders dietitian with a private practice based in Maine says, says, “If someone loses weight for any reason, they could be at a higher risk for an eating disorder because starvation physiologically temporarily changes the brain. Vegans also tend to be more diligent and perfectionistic, which may increase their risk of eating disorders.”

According to McBride, “If a person who is already predisposed to disordered eating starts cutting out animal products, that may be the trigger just because it’s the first time that much attention has been paid to food and eating. This can be worsened by some of the less-than-helpful information online about veganism that conflates it with purity, cleanliness, and perfect health while vilifying certain types of foods. For someone who is vulnerable to disordered eating, this kind of misinformation is terribly harmful.”

Veganism, orthorexia, fat phobia, and eating disorders

How Does a Vegan Know if They Have an Eating Disorder?

You might be wondering about the warning signs of eating disorders. NEDA has great information on the signs and symptoms of eating disorders, and the experts I interviewed offered up some great insights specific to vegans.

“The signs of an eating disorder can be subtle, and I believe one of the first signs shows up in slow but consistent elimination of foods beyond animal rights or environmental ethics,” Beasley says. “If the list of unacceptable foods begins blending over into more and more food groups until you realize that your list of acceptable foods is so restrictive that your relationships, your thoughts, your emotions and your freedom have also become restrictive in order to maintain that list, an eating disorder is lurking.”

One of the most obvious (and common) disordered eating red flags I see is if vegans refuse to eat the vegan versions of what I like to call “fun foods.” This may include pizza, burgers, cheese, ice cream and baked goods. If there is no allergy or intolerance to the food, and the food meets the ethical stances of the individual, there may be some restriction going on. This is usually due to unwarranted fear over “processed foods,” sugar and dietary fat.

Weinar agrees: “If you identify as vegan but have a lot of other food rules beyond eschewing animal products, this might be an early warning sign that you are struggling with some degree of disordered eating. The other symptoms of eating disorders such as restriction, bingeing, purging, over-exercising, should also be taken seriously.”

“If a vegan starts to become obsessed with food and eating, loses a significant amount of weight, becomes ‘healthy’ to the point where it interferes with their social life, starts to think of foods as ‘clean’ or ‘dirty’, has guilt around eating certain ‘unhealthy’ foods, has any obvious ED behaviors like purging, or becomes overly rigid with nutrition or exercise, it would a good idea to get a professional’s opinion,” says Grimm.

McBride warns, “If food and eating are causing distress, secrecy, or worry, it might be worth talking to a professional to explore your relationship with food.” She clarifies, “many people think they can’t possibly have an eating disorder because their weight is stable/normal/higher or they still eat or they eat ‘too much’ or they don’t use certain behaviors. None of these are requirements of having an eating disorder. Again, if the relationship with food is causing distress, pain, or suffering, then that is enough to warrant attention and help.” 

You can also use NEDA’s free eating disorder screening tool.

When to get help for an eating disorder

Research on Eating Disorders among Vegans

The research on eating disorders in vegans is sparse and inconsistent. There are conflicting findings and it’s questionable if the tools used to measure disordered behavior are appropriate for vegans. For instance, if the tool throws up a red flag when someone responds that they don’t eat any meat, dairy or eggs, that may be falsely attributing risk to vegans. 

The biggest issue is that many studies combine vegetarians and vegans into one group. This is problematic because there often are huge differences in the dietary patterns and motivations of vegetarians versus vegans. Several studies have found that grouped together, vegetarians and vegans tend to display more orthorexic tendencies than meat-eaters; but this doesn’t tell us anything about vegans specifically or causation.

Another issue: Many of the study samples are thin, young, white and female, often using college students as participants. Studies using such a narrow demographic are not generalizable to the broader population.

As for studies that have looked at vegans in particular, some have found that vegans exhibit more problematic eating attitudes and behaviors than meat-eaters, while others have found that vegans exhibit fewer problematic eating attitudes and behaviors. 

Beasley has reviewed the literature on veganism and eating disorders and explains, “Up until just a few years ago, the majority of research was on vegetarianism and over 70% of that research used ‘semi-vegetarianism’ as one of variables studied; however, semi-vegetarianism has too broad of a definition to provide any evidence that can be translated to even a true vegetarian population, let alone a vegan population.”

Unfortunately, “The headlines from the most common research in the early 2000s stated that ‘college aged women who are vegetarian most likely have an eating disorder,’ which became so ingrained in the mindset of the professional community that we failed to dig deeper to see that the study size was small, limited and the research upon which it was based was primarily from the mid 80’s and 90’s – when ‘semi-vegetarianism’ was the defining factor,” Beasley says. “Fast forward, the more recent research seems to be focusing on veganism and orthorexia. Some researchers have found that veganism is not always orthorexia and the core motivation is the defining factor in determining whether disordered eating behaviors are primary.”

According to McBride, the research on veganism and eating orders can be summarized as, “Vegan doesn’t necessarily mean disordered,  it is possible to recover from an eating disorder as an ethical vegan, and vegans not engaged in disordered eating are able to enjoy eating and fun foods just as well as anyone.”

a deep green house plan on a grey background

Where to go for Eating Disorder Treatment as a Vegan

There are different “levels of care” for eating disorders, ranging from inpatient treatment in a hospital for the most severe cases, to outpatient counseling for the most stable cases. In between are residential treatment, partial hospitalization (PHP) and intensive outpatient counseling (IOP). 

Some treatment centers are more open to veganism than others, meaning they allow patients to eat vegan if it’s determined to be safe and appropriate (whereas some may not allow a patient to eat vegan, period). 

Sadly, many eating disorder treatment centers do not allow patients to eat vegan in treatment. Grimm believes, “If they can accommodate for religious reasons, I think that centers should accommodate veganism. There are as many calories in vegan cupcakes, cookies, and french fries, as there are in non-vegan versions!”

Residential, PHP, and IOP Eating Disorders Treatment for Vegans

Alsana, Center for Discovery, and The Emily Program offer vegan menus and will work with patients to determine if veganism is appropriate for their stage of treatment and recovery. And there may be more!

Outpatient Eating Disorder Treatment for Vegans

While I am passionate about eating disorder prevention and recovery, I am not currently accepting new clients who are struggling with eating disorders. There are loads of wonderful eating disorders dietitians who are trained and experienced in this area! 

Amy Taylor Grimm, RDN, LD, offers nutrition counseling for folks struggling with eating disorders in Maine. You can find her contact information on her website

Rachael McBride, MCN, RD/LD, CEDRD, also provides nutrition counseling for those with eating disorders and disordered eating. Check out her website for more information.

Jenny Weinar, LCSW, offers individual and group therapy for vegans (and non-vegans) struggling with disordered eating and body image concerns. The best way to keep up with her current offerings is to follow her on Instagram and sign up for her email list through her website.

You can also check out NEDA’s tool for finding treatment near you.

Tips for Vegans in Eating Disorder Recovery

“You can keep your values and recover at the same time. Be honest with yourself about why you chose veganism – if it is for animals, then you can fully recover and be vegan at the same time. If you are unsure, then maybe consider putting veganism on the back burner until you recover. The animals need healthy advocates, not sick ones.” – Amy Taylor Grimm, RDN

“Be curious and honest with yourself when exploring your motivations for veganism. It is possible to believe in the ethical principles of veganism and to be motivated by your eating disorder. Your recovery will be stronger the more you are willing to investigate this and disentangle your vegan values from your eating disorder. Learning about Health At Every Size and how weight stigma and other forms of oppression show up in the vegan community might also infuse your recovery with new meaning and purpose in addition to your own personal healing.” – Jenny Weinar, LCSW

“Sometimes vegans (those that are vegan for animal and ethical reasons) with eating disorders are at risk for eating disorder behaviors due to lack of food availability in certain settings. It would be wise to plan ahead for situations where you know you are likely not going to have access to vegan options. For example, if you know you’ll be traveling all day in a location without reliable options, pack extra food. Also, if your treatment providers are on the fence about you remaining vegan during eating disorder treatment, offer to show them how you can incorporate a wide variety of vegan foods (such as pizza, cupcakes, mac and cheese, etc!) without compensatory behaviors as part of your recovery. Veganism does not equal eating in a restrictive way. You can have just as much of a range of food choices as non-vegans, but you have to be willing to incorporate those choices.” -Caitlin Martin-Wagar, PhD

“Be open to challenging your fears around ‘types’ or categories of foods, letting your treatment team support you; be willing to challenge the eating disorder itself by learning to enjoy vegan desserts, vegan snack foods, vegan ‘fun foods’ that can be consumed simply for the taste or social event or pleasure in the moment.” -Tammy Beasley, RDN, CEDRD-S, CSSD, LD

Vegans in Eating Disorder Recovery

When to Get Help

The earlier you get help for an eating disorder, the better your odds are for recovery. Which is why it’s important to know the warning signs of eating disorders and to seek help as early as possible. 

If you are concerned you might have a problem with eating, whether or not you think you meet any diagnostic criteria for an eating disorder, I urge you to share your concerns with your health care providers. 

People of all shapes, sizes, genders, races and ethnicities suffer from eating disorders. No one is immune.

Remember:

“It is completely possible for some people to recover from disordered eating while maintaining their ethical vegan lifestyle. At the same time, some people may find it necessary to heal their relationship with food first before placing any limitations on what they eat. You’re not a ‘bad vegan’ if you fall into the second category. You can focus on all the other ways you practice veganism and go back to vegan eating when you’re able to do so safely.” -Jenny Weinar, LCSW

“You likely found veganism because of your passion for animal advocacy and compassion for non-human animals. In that fight for the ethical treatment of animals, you cannot forget your own self – you matter! Do what you need to do to focus on your health and recovery process. You can’t help others in a sustainable way if you are not taking good care of your own needs. Let your compassion motivate you in your recovery process.” -Caitlin Martin-Wagar, PhD

 

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