These two words, vegans and eating disorders, remind me of a story that has stuck with me since the start of uni.
I was on placement with a colleague. We were chasing our last set of blood results for a patient and were getting ready to go home. As this was prime time for chatting ourselves away, my colleague asked me, “Did you hear that ‘xyz’ went vegan so she could lose more weight?“
For starters, I was never really involved in the latest gossip or tea about my cohort. I was one of the last people to know the crazy things that happened on the night of the MedBall afterparty and such. But as uni students, we are the epitome of social creatures, so gossip was pretty much unavoidable. However, you could definitely avoid 95% of it for the most part, if you wanted to.
I was taken aback by her question. Firstly, I didn’t really know this person at all. She was another colleague of mine but our interactions had been limited to saying ‘hello’ when we saw each other on campus. I certainly didn’t have a basis to discuss her dietary choices and the reasons for them. Secondly and quite frankly, I didn’t really think that it was any of my business to do so.
In general though, wasn’t losing weight an ideal that a lot of uni and college students have? Plus, good on her for trying out a plant-based diet and attempting to achieve her goals. If you’ve been following my blog, you’ll know that I’m a big advocate for a plant-based diet especially for weight loss.
My colleague then followed up with this statement, “Aren’t vegans, like, associated with an eating disorder or something?”
But Surely Right?
The implications of that comment made me feel quite incredulous. How did that escalate to an eating disorder so suddenly? I was also becoming uncomfortable at the boundaries that we were pushing in the social context.
This interaction occurred a few years before I transitioned to a plant-based diet so I definitely didn’t have any personal bias towards that statement at the time.
Rather than an eating disorder, there were a lot of other, more common explanations that were popping up in my mind.
- What if she actually wanted to lose weight in a healthy and holistic way through a plant-based diet?
- What if she had done tonnes of research and decided a plant-based diet was good for her health?
- What if she loved animals and wanted to stick to her values and ethics?
- What if she had walked away from that sustainability conference with new ideas on how she could help better the environment with her lifestyle choices?
You could probably think of another million reasons too.
Truth be told, this did instigate my curiosity to the link between vegetarianism, veganism and eating disorders. I had just finished a term at a children’s psychiatric hospital and found topics like this to be quite interesting.
So I did some digging…
Just a Ruse for Unhealthy Eating Habits?
Surveys have shown that the main reasons people eat vegan or vegetarian are due to helping the environment, health reasons (does not necessarily mean losing weight) and animals welfare. Eating a plant-based diet to lose weight is a valid but one of the more uncommon reasons.
Research has shown that individuals who follow a vegan diet showed a higher level of knowledge about healthy eating compared to those on a vegetarian and omnivore diet. For those that ate vegan for health reasons they were also more likely to have greater knowledge about healthy eating.
Furthermore, when looking into psychological behaviours such as emotional eating, dieting intentions, food cravings and self-control, those who were on a vegan diet fared better than those on an unrestricted diet.
So the literature suggests that healthy eating behaviours are more prevalent in vegetarians and vegans.
But what about the link to eating disorders?
Studies have linked the risk of eating disorders with vegetarian diets, stating that the diets may be a guise for unhealthy eating behaviours. However, it is important to note that the studies were ‘cross-sectional’ meaning that it was only a snapshot in time. The researchers concluded that they could not determine which came first – the eating disorder or the vegetarian diet.
This limitation is common in studies. If we found that a high number of people who love dogs also hate their jobs, a cross-sectional design can only tell us exactly that and possibly why. But it cannot tell us if the people loved dogs first and then hated their jobs (because they want to stay at home to cuddle their dogs all day) or if they hated their jobs and found peace with dogs. Clearly both are reasonable explanations!
An even more compelling fact is that other studies have then suggested that vegetarian diets do not lead to eating disorders.
A position paper published by the Academy of the Nutrition and Dietetics explicitly states that “Eating disorders have a complex etiology and prior use of a vegetarian or vegan diet does not appear to increase the risk of an eating disorder…”
Two Sides to the Story
Little did I know that this story would stick with me so much because I was en route to becoming plant-based a few years later.
There is no denying that eating disorders are prevalent and a serious issue in our society. Many people especially young females are at risk and topics like this should be discussed and researched. I have had body image and self-esteem issues myself and have witnessed the destructive impacts of eating disorders through my medical school placements.
It is also important to recognise the myths that may surround vegetarian and vegan diets. Inaccurate and negative connotations are harmful not only to the evidence-based community but also to the mental health of many people who are simply trying to better their health and lives.
Another reason that I might’ve held onto this conversation was because I was in an uncomfortable situation at the time. I’ve learnt over the years that unless there is hard solid proof to back up our claims, people deserve understanding and empathy amongst our assumptions (which often tend to be the worst case scenario).
Whatever the reasons we may assume for someone going plant-based or even eating meat, a little kindness definitely goes a long way.
- Barnard ND, Levin S. Vegetarian diets and disordered eating. J Am Diet Assoc. 2009;109(9):1523‐1524. https://pubmed.ncbi.nlm.nih.gov/19699828/
- Brytek-Matera A, Czepczor-Bernat K, Jurzak H, Kornacka M, Kołodziejczyk N. Strict health-oriented eating patterns (orthorexic eating behaviours) and their connection with a vegetarian and vegan diet. Eat Weight Disord. 2019;24(3):441‐452. https://pubmed.ncbi.nlm.nih.gov/30155858/?from_term=vegan+vegetarian+eating+disorder&from_pos=2
- Çiçekoğlu P, Tunçay GY. A Comparison of Eating Attitudes Between Vegans/Vegetarians and Nonvegans/Nonvegetarians in Terms of Orthorexia Nervosa. Arch Psychiatr Nurs. 2018;32(2):200‐205. https://pubmed.ncbi.nlm.nih.gov/29579513/?from_term=vegan+vegetarian+eating+disorder&from_pos=5
- Heiss S, Coffino JA, Hormes JM. Eating and health behaviors in vegans compared to omnivores: Dispelling common myths. Appetite. 2017;118:129‐135. https://pubmed.ncbi.nlm.nih.gov/28780065/?from_term=vegan+vegetarian+eating+disorder&from_pos=4
- Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 2016;116(12):1970‐1980. https://pubmed.ncbi.nlm.nih.gov/27886704/
- Norwood R, Cruwys T, Chachay VS, Sheffield J. The psychological characteristics of people consuming vegetarian, vegan, paleo, gluten free and weight loss dietary patterns. Obes Sci Pract. 2019;5(2):148‐158. Published 2019 Feb 14. https://pubmed.ncbi.nlm.nih.gov/31019732/?from_term=vegan+vegetarian+eating+disorder&from_pos=3
- Robinson-O’Brien R, Perry CL, Wall MM, Story M, Neumark-Sztainer D. Adolescent and young adult vegetarianism: better dietary intake and weight outcomes but increased risk of disordered eating behaviors. J Am Diet Assoc. 2009;109(4):648‐655. https://pubmed.ncbi.nlm.nih.gov/19328260/
- Zuromski KL, Witte TK, Smith AR, et al. Increased prevalence of vegetarianism among women with eating pathology. Eat Behav. 2015;19:24‐27. https://pubmed.ncbi.nlm.nih.gov/26162593/