Eating disorders and vegan/vegetarian diets

I’ve been meaning to write this blog for a while, and now feels like the right time. Essentially, what I’m doing here is simply sharing some brilliant information from the “Weighty Matter’s” chapter of one of my favourite books, ‘Becoming Vegan’, written by vegan dieticians Brenda Davis and Vesanto Melina. It really does pay to source vegan dietary support from people who actually specialise in this field, and these two women are two of the best! Brenda is a leader in her field and an internationally acclaimed speaker. Past chairperson of the Vegetarian Dietetic Practise Group of the Academy of Nutrition and Dietetics, Brenda has written more than eight books and is the lead dietitian in a diabetes research project in Majuro, Marshall Islands. Vesanto taught nutrition at the University of British Columbia and Bastyr University in Seattle, co-authored the joint-position paper on vegetarian diets for the Academy of Nutrition and Dietetics and Dieticians of Canada and is a consultant to the government of British Columbia.

As the authors point out in their “Weighty Matter’s” chapter, there are many experts who believe that vegan and vegetarian diets can increase the risk of eating disorders and some treatment centres will force a reintroduction of meat into the diet as part of the recovery process. These ideas are based on data from 1997-2009 that reported significantly higher rates of disturbed eating among the vegetarian population in comparison to non-vegetarians. And the statistics are significant: approximately 50% of adolescents and young women with anorexia nervosa eat some form of vegetarian diet whereas only 6-34% of their non-anorexic peers eat a vegetarian diet.

The problem with these statistics lays in the way they are interpreted: we can’t look at them and simply assume that vegan and vegetarian diets lead to anorexia. Quite the contrary, research has shown that people with eating disorders adopt vegetarian diets, “using them to facilitate calorie restriction and legitimise the removal of high-fat, high-calorie animal products, and processed or fast foods made with these products.” In other words, the vegetarian or plant-based diet becomes a ‘front’ and can easily mask an existing eating disorder. This has been referred to as “pseudo vegetarianism.”

And most definitely, when we have people who get sick on a so-called vegan diet due to severe calorie restriction, the problem isn’t veganism, its the calorie restriction, and it is important to distinguish between the two. I would also like to point out here that there is a difference between a plant-based diet used with the express desire to control weight, and a genuine vegan lifestyle adopted on the basis of compassion. Veganism isn’t a diet, it’s a lifestyle. Here is the standard definition of veganism:

“Veganism is a way of living which seeks to exclude, as far as is possible and practicable, all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose.”

Obviously, vegans can develop eating disorders, and people with eating disorders may decide to become bona fide vegans while they’re they’re still ill, but to discern between genuine veganism and pseudoveganism, we need to look the underlying motivation behind a person’s plant-based diet. In a 2013 study of 160 women (93 with eating disorders and 67 controls), concern about weight was a primary motivation for almost half the participants with a history of eating disorders, whereas weight didn’t factor in at all for any of the people in the control group.

There were another couple of interesting studies in 2012 that showed vegans had the healthiest scores of all dietary groups. The researchers speculated that vegan diets may actually be protective against eating disorders. To quote Brenda and Vesanto: “…. the fewer animal products the vegetarians ate (in other words, the more vegan they became), the less likely they were to exhibit signs of disordered eating.”

All of this makes sense, given that genuine vegans are generally a lot more interested in how they are impacting the world around them  than they are concerned with the way they look or how much they weigh. This kind of reminds me of the approach some of us therapists take when treating depression and anxiety: we encourage acts of service like volunteer and charity work. Nothing like knowing you are making a positive difference to the world around you to stimulate some feel-good biochemistry!

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