Written By: Marni Mackey, RDN, LDN (She/Her)
Senior Registered Dietitian Nutritionist
Veganism is a lifestyle and dietary choice that seeks to eliminate the consumption, use or exploitation of animals and animal products. While a vegan diet can lead to potential health benefits such as lower cholesterol and reduced risk of certain diseases, like any dietary pattern, it also has the potential to mask or exacerbate eating disorder symptoms—particularly for those already struggling with disordered eating.
Before we get started, it’s important to note that this blog is not an attack on veganism or an assessment of its merits. Whether veganism is considered “good” or “bad” is completely subjective and depends on an individual’s values and ethical beliefs. It’s also important to note there are various forms of veganism, and individual choices may vary.
That said, to better understand its relationship to eating disorders and their symptoms, we must first understand the ‘basics’ of veganism.
What Is Veganism?
Those who follow veganism choose to avoid ingredients produced or derived from animals. Vegans generally do not eat meat, poultry, fish, shellfish, or dairy. Often, a vegan diet is followed by those who are objecting to the exploitation of and cruelty to animals.
However, there seems to be an uptick in the amount of people who are going vegan, making it feel somewhat of a trend. While this can seem like an ethical way to advocate for animals and protect the environment, it can also be a way to mask dangerous eating disorder symptoms.
Eating Disorders, Veganism & The Challenges of ‘Dietary Restraint’
Certain eating disorders and veganism share the characteristic of ‘dietary restraint’, making it challenging for eating disorder treatment providers to assess whether food choices are driven by eating disorder beliefs or by the ethics of veganism.
There are a variety of lesser-known eating disorders that include dietary restraint, but anorexia is one that people tend to be more familiar with. Anorexia is characterized by restriction of food intake driven by distorted body image or fear of weight gain.
Another eating disorder that can be masked by veganism is ARFID, or Avoidant Restrictive Food Intake Disorder. Some people that have ARFID deal with sensory avoidance, meaning they struggle with textures, consistencies, and temperatures of certain foods. Another impact of ARFID is fear of adverse consequences, such as fear of illness or choking. Animal proteins can increase these barriers for ARFID patients because of the perceived higher risk of food borne illness as well as the unique textures that animal proteins contain.
Orthorexia & OSFED
Orthorexia Nervosa is characterized by an obsession with restricting intake to only “healthy” food, resulting in various medical and psychological issues. Orthorexia is not yet included as a standalone diagnosis in the DSM-5, however those who are struggling with its symptoms often meet diagnostic criteria for an Other Specified Feeding or Eating Disorder (OSFED).
For clinicians working with eating disorder patients, it can be difficult to determine whether a patient’s vegan diet is purely rooted in ethics or if it is functioning as a socially acceptable way to engage in the eating disorder symptom of restriction. This can become an issue when patients are underweight and/or undernourished. Because animal proteins provide an enormous amount of nutrients such a protein, vitamin B12, iron and zinc, it takes extra effort to ensure vegan patients are getting adequate amounts of nutrition.
It’s even more difficult for non-clinicians—like you or your family members and loved ones—who lack the necessary training and experience to identify an emerging problem.
So, what should you look out for?
5 Ways a Vegan Diet Can Mask Eating Disorder Symptoms
There are five key signs to look out for if you or a loved one is unsure if veganism has creeped into an unhealthy realm.
#1 – Obsessive focus on health and/or food choices
While following a vegan diet can complicate social eating situations, signs that it has possibly taken a turn towards an eating disorder would be increased anxiety around mealtimes and an inability to enjoy food due to the stress, anxiety or guilt associated with eating it. Grocery shopping, preparing dishes, and eating food should not take up a significant amount of time or mental energy. Planning for vegan meals is normal, but constantly stressing about it is not.
#2 – Rapid weight loss and fluctuations
Because it is much more difficult to include enough nutrients with a vegan diet, rapid weight loss could indicate either an intention to lose weight or lack of nourishment. When following a vegan diet strictly because of animal or environmental beliefs, rapid weight loss should be concerning and there would likely be motivation to increase intake with vegan meals and snacks. If you are noticing push back on reversing weight loss from veganism, there could be an underlying issue.
#3 – Strict adherence to veganism despite negative health consequences
Following veganism CAN be healthy. However, if your body is lacking nutrition and you still do not want to incorporate more foods, then this might be a sign of a deeper issue. Typically, vegan diets require MORE food for nutrients like protein. Being unable or unwilling to increase amounts of food can be a sign that your relationship with it is headed in the wrong direction. If you refuse to re-assess your relationship with veganism, there is a chance it might be covering up a disordered eating pattern.
#4 – Social Isolation
Avoiding social situations, such as parties, weddings and get-togethers because of a vegan diet is a major red flag. Avoidance of social interactions because of food is an indication that following veganism has become more important than family, friends, and your social wellbeing. This should call for a pause and reassessment of the “why” behind following veganism.
#5 – Disordered Eating Patterns and Rituals
When following a vegan diet, there does not have to be a change in mealtimes or your approach to eating. Using veganism as a reason to skip meals or begin using rituals to make eating easier are signs that maybe an eating disorder is driving these behaviors. While there are bound to be situations without vegan options available, skipping eating altogether would not be a healthy solution. Typically, the recommendation would be to plan for or seek out adequate backup options in order to ensure proper nourishment.
What to Do If You’re Unsure There’s a Problem
If the signs above resonate for you, or you are still unsure, there are experts that can help identify whether you are practicing veganism or strengthening an eating disorder. At Renfrew, we take an individualized approach to each patient’s needs in order to develop treatment goals together. Whether the issue is restriction because of anorexia, orthorexia, or ARFID, there are individualized approaches that can help.
There is nothing inherently wrong with Veganism, and it can be a sustainable way for some people to eat in the long term. Just as any approach to eating, it makes sense to continuously monitor the intention and impact over time. And most importantly, be willing to reach out for help if needed.