The rise in vegan and vegetarian diets
Vegan and vegetarian diets are growing in popularity in many countries around the world[1].
They are promoted and encouraged by the Academy of Nutrition and Dietetics and many other influential health care groups, proclaiming these diets as “healthy.”
While many people follow life-long vegan and vegetarian diets that meet their physical and psychological needs, eating disorder professionals like myself are concerned that these diets can be a socially acceptable way to restrict food or hide an eating disorder.
Vegan vs. vegetarian: What’s the difference?
Vegan diets typically avoid anything that comes from animals: beef, fish, poultry, dairy and eggs. Many vegans will also avoid honey and wearing any animal furs or skins, including leather and suede.
Vegetarian diets include various eating patterns that avoid meat itself, but still allow other animal products. Many vegetarians consume eggs and/or dairy products. Pescatarians consume fish or fish products (e.g., fish oil supplements).
According to the Vegan Society:
"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."
Compared to vegetarianism, the vegan diet and lifestyle is much more restrictive, requiring extensive changes to one’s diet and lifestyle. And that’s where the concern about eating disorders comes in.
Why do people choose a vegan or vegetarian diet?
People choose to become vegan or vegetarian for a variety of reasons, including:
Perceived health benefits
Believing it is the ethical or “right” way to eat
Positively identifying with the vegan/vegetarian community[2]
Cultural reasons (i.e., to align with your culture or religious beliefs)
Environmental reasons (i.e., to help slow down climate change)
Financial reasons (i.e., meat is too expensive)
Nutritional reasons (i.e., to eat more vegetables and fruits)
For weight loss
Do vegan/vegetarian diets lead to eating disorders?
Any type of diet (low-calorie, keto, low-carb, plant-based) can trigger an eating disorder in those who are susceptible.
In eating disorder treatment centers, many patients report that adopting a vegan or vegetarian diet was one of the first steps that led to an eating disorder.
While there are many reasons an individual may choose to follow a vegan or vegetarian diet, going vegan can be a socially acceptable way to restrict food intake. By saying, "I can’t eat that; I’m vegan," it’s less likely that other people will question the choice not to eat certain foods.
Veganism as a risk factor
Being vegan can help someone with an eating disorder fly under the radar. But a vegan diet can also lead to nutritional deficiencies, disordered eating behaviors, and, possibly, an eating disorder.
Since vegan and vegetarian diets are often socially accepted, many individuals may not even be aware that they are at risk. So, it is important for parents, caregivers, friends and loved ones to be aware of this link and to know the warning signs.
Eating disorder warning signs
Restricting one's diet in any way can lead to disordered eating. Common eating disorder warning signs include:
Being rigid/inflexible with food rules
Avoiding social settings that involve food
Significantly reducing the number or types of acceptable foods consumed
Spending a significant amount of time shopping for, preparing or thinking about food
Not wanting to eat foods prepared by others
Asking extensive questions about food ingredients or methods of food preparation
Mood symptoms that seem to be affected by the amount or types of food eaten
Weight fluctuations
Nutritional deficiencies
Note: A person can have an eating disorder and show some, all or none of the signs listed above. This is why we often say that you can't tell if someone has an eating disorder just by looking at them.
Eating disorders do not discriminate and can affect people of all ages, ethnicities, genders and backgrounds.
Orthorexia and "clean eating"
People with orthorexia often focus on "clean" eating: Eating organic, whole foods in as natural a state as possible, and avoiding processed foods and artificial colors/flavors.
Like those who follow vegan diets, many people claim that "clean" eating has helped them overcome mental and physical health challenges.
But "clean" eating can also be taken to an extreme. A desire to consume only "clean" foods can lead to nutritional deficiencies or malnutrition, resulting in troubling symptoms like hair loss or a lack of menstrual periods in females.
The warning signs of orthorexia can include:
Refusal to eat foods that are not organic or locally grown
Extreme food restrictions (cutting out entire food groups)
Anxiety around mealtimes
Avoiding all "junk" food, including dessert
Extreme concern about chemicals in the food supply, whether they are proven to be harmful or not
Taking an extreme amount of time to shop for, prepare and consume foods
Rigid, distorted beliefs about food
Social changes like avoiding restaurants, avoiding eating with others and avoiding holiday parties can also indicate orthorexia, and lead to isolation.
Who is at risk for orthorexia?
Risk factors for orthorexia include:
Perfectionism
Neuroticism
A history of obsessive-compulsive type behaviors
A history of dieting
A personal or family history of eating disorders [5]
While orthorexia is not officially recognized as an eating disorder, many experts agree that orthorexia symptoms are clinically significant and can be addressed in an eating disorder treatment program.
When a child goes vegan: A note for parents and caregivers
If your child has been following a vegan or vegetarian diet and shows signs of an eating disorder, consider the following questions:
Why did they choose to start the vegan or vegetarian diet?
When did the diet start and what was going on in their life at the time?
Does the diet get in the way of them fully engaging in their life?
Are they meeting their nutritional needs?
Are they flexible at all around meals?
Is the diet affecting their relationships with friends, family or in extracurricular activities?
Has their mood or mental health changed since adopting this diet?
If your child has become inflexible around foods, or shows signs of an eating disorder zoom out and consider the impact their food choices are having on their life. Food impacts far more than just nutrients consumed.
If a vegan diet comes at a high personal cost, leads to emotional difficulties, isolation, mental or physical health concerns, your child may need help.
Vegan diets in eating disorder recovery
Here at Eating Recovery Center, we encourage those who avoid meat or other food groups to be curious about:
How this diet choice affects their life
Their motivation for this way of eating
Whether they are able to practice flexibility around food
In treatment, we will want to know if they are willing to eat a variety of foods (as long as the foods are vegetarian), or if they are using vegetarianism/veganism as a way to restrict more foods. We encourage them to create meals focused on balance, variety and flexibility. And we emphasize that:
All foods fit.
Food is more than just the sum of its nutrients.
You can have a peaceful relationship with food.
Person-centered, individualized care can be life-changing.
There are many reasons to choose a vegetarian diet that are unrelated to an eating disorder. So, if someone is choosing to remain vegetarian for those reasons, it’s important for us to help them practice planning, preparing and eating foods that reflect what they will have when they transition back to their everyday life.
Our registered dietitians work individually with each patient to ensure nutritional adequacy. The team helps patients explore food options and flexibility at meals that promote recovery.
We do our best to respect and honor individual dietary needs and preferences. For example, we offer accommodations for a variety of diets including kosher, halal, vegetarian and allergen-free. And, at each meal, we have at least one vegetarian entree option available on our menus.
Offering you the best support in recovery
If you or a loved one need help, we would love to work with you to understand more about the role vegetarianism or veganism has played in your life, just like we work with all patients — to explore their relationships with food.
How does the individual relate to food?
What is the intent behind their food choices?
How do these eating patterns affect their overall lives?
To learn more about treatment at ERC, call us at 866-622-5914 or fill out this form. One of our compassionate team members will help match you with the exact support you need.
One conversation can make all the difference.
Vegan/vegetarian eating disorder facts and statistics
A 2018 study of 1,008 patients with eating disorders found a much higher rate of veganism in current patients compared to the general population (6-16% of patients vs. 1% in the general population)[1].
In a 2022 publication, researchers reported a possible association between veganism, vegetarianism and orthorexia, a form of disordered eating where an individual focuses on “clean” eating and often has very rigid food rules[2].
A separate study of 370 participants found that individuals following a vegetarian diet were more likely to have disordered eating habits that align with orthorexia compared to those consuming a diet containing meat[3].
In 2020, researchers found that 9.3% of college student respondents identified as vegetarian. Those who became vegetarian after starting college were more likely to do it for weight-related reasons. This study interviewed nearly 10,000 students across 12 college campuses in the U.S.[4].