The link between Veganism and Eating disorders

For some time, clinicians have observed an increase in the number of vegan eating disorder patients

We have evidence to show that there is a greater proportion of vegans with eating disorders, when compared to the general population. An Australian study back in 2012  found that 52% of ED patients had been vegetarian at some point compared to 12% of general population. A Greek study  found that 45-50% of ED patients were ‘some form of vegetarian’ including vegan. And the Schoen clinic published that 35% of their patients were vegetarian, vegan or pescetarian. Current estimates of the proportion of vegetarians and vegans in the UK is 7-10%. Which has increased from 2-3% in 2012.

As a dietitian working in eating disorders (and as someone who went vegan as a teenager) this is a topic that I am invested in, while also being aware that I may hold some internal bias. In my current job I specialise in supporting vegan eating disorder clients recover.

The reasons for this crossover

The first reason that comes to mind, is the dietary restriction.

Veganism imposes dietary restrictions and rules. It is a socially acceptable way to refuse food, so can mask disordered eating behaviours. While veganism in current years is a lot less restrictive than it was, for many people rules around food can be problematic. I spoke to one person, who was vegan during their active eating disorder and at the time truly believed that it was due to ethical reasons, however in retrospect realised that a big motivation was the ability to restrict their diet. As well as being able to refuse food, vegan meals are typically less energy dense than animal-product containing ones.

Secondly, I think social media has something to answer for in this trend. There are several Instagram influencers who promote a restrictive vegan diet as the ‘healthiest’ way to live. Eating patterns that to health professionals appear extremely orthorexic are shown to be normal on social media. An example of this is the raw vegan movement.

The Rawvana Drama

A particular example is Yovana Mendoza Ayres ‘Rawvana’, a raw vegan who promoted her ‘extremely healthy’ way of life, that included 25-day water fasts (no food, only water for 25 days). She had 1.3 million followers on Instagram and half a million on Youtube, with many following in her footsteps the diet that she promoted to be so healthful. Yovana ended up being heavily criticised and cancelled online, when a video of her eating fish at a restaurant went viral.

Yovana came out with an explanation video stating that she was suffering with anaemia, had lost her periods and had severe gut issues. She described having a difficult relationship with food for many years. She said was advised by doctors to release the restrictions on her diet and reintroduce eggs and fish. After following the advice, Yovana got her periods back and her gut issues and anaemia resolved. But continued to promote the restrictive diet online, until she was caught out…

We can see that eating disorders may drive an individual towards the vegan diet, but does it work the other way? Can the restrictions imposed by the vegan diet trigger the onset of an eating disorder?

First of all, there is never a single ‘cause’ of an eating disorder, it is a combination of genetics and environment triggers. Equally, there is no specific evidence pointing at veganism as a causational factor in the onset of eating disorders. Looking at body image, research has found that vegans may actually have greater body satisfaction than their omnivorous counterparts. We do know that poor body image is a pre-disposing factor to eating disorders.

A study identifying orthorexia in vegans found that in those whose motivation for being vegan was being linked to animal welfare had no greater increase in orthorexia than the general public. In those whose motivation for being vegan was for ‘health and healing’ had a greater risk of orthorexia. The study concluded that it was the motivation for being vegan that dictated the risk.

“Veganism is a philosophy and 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; and by extension, promotes the development and use of animal-free alternatives for the benefit of animals, humans and the environment. In dietary terms it denotes the practice of dispensing with all products derived wholly or partly from animals.”- The Vegan society

 

It is important to also point out that by definition ‘veganism’ is not a diet and is instead a belief system protected by the Equality Act, as shown above. It then may be posited that someone whose motivation for veganism is solely due to health reasons, is not a true vegan as per definition.

The final reason for the increase in vegan eating disorder patients is due to the increase of the vegan population as whole, as shown above. The number of vegetarian and vegans in the UK has increased 2-3-fold in the past 10 years. The majority of these are women within young adulthood, in the 18-34 age bracket, which is almost the exact same population group as those suffering with an eating disorder (women, 16-40) 

The changing vegan diet

Being vegan in 2014, you would feel lucky to find an alpro yoghurt in your local supermarket and would have likely had a home-cooked-wholefoods diet. If you wanted fake meat you would have to make seitan at home or freeze tofu to get a meaty texture!

Today we have whole aisles of fake meats, vegan pukka pies, chicken nuggets, fish fingers, chocolate brownies, pizzas, cheese and crème fraiche… I recently went to a vegan Asian supermarket in London (Plantbase store). Where they had vegan alternatives for shark, frogs legs and goose meat… Anything can be made vegan as long as there is a demand for it. And demand has certainly increased. ‘Veganuary’ where one goes vegan for the month of January had a record number of participants, 610,000 people registered to do it 2022, and many more unregistered.

I can’t help but think, since veganism has become a lot more accessible and in many ways less restrictive. In the future will we see numbers of ED patients being vegan reduce closer to normal population levels? As it becomes less of a barrier to energy intake?

Summary

• There are a greater proportion of vegans within an eating disorder population.
• The popularity of veganism has increased 2-3-fold in the past 10 years.
• Veganism can be a way to mask symptoms of an eating disorder.
• The vegan diet is less energy dense compared to normal omnivorous diets
• Restrictive branches of veganism that may be linked to orthorexia, e.g., raw vegan diets are very popular on social media.
• Veganism is not shown to be a causal factor in the onset of eating disorders.
• Vegans may have better body satisfaction than omnivores
• Vegans whose motivation is for health as opposed to animal welfare are more likely to show orthorexic traits.
• Veganism is most common in the 18-34 age range, which is very similar to the most common age range of those suffering from an eating disorder.
• The vegan diet has changed in response to demand and now is less restrictive than it was 5 years ago.

Getting help

If you think you are suffering from an eating disorder, please speak to your GP or local health centre.

The following charities have resources and helplines that may be of help:

https://www.beateatingdisorders.org.uk/

anorexiabulimiacare.org.uk

papyrus-uk.org

samaritans.org

studentminds.org.uk

https://www.blackmindsmatteruk.com/

The British Dietetic Association has produced guidance for clinicians on Veganism and Eating Disorders: https://www.bda.uk.com/