The two things I talk about most frequently and with passion are eating disorders recovery and veganism but rarely in the same conversations. My working life as a senior nurse in children’s eating disorders means I get to guide young people and their families through the complex process of recovery, extolling the virtues of a balanced energy rich diet. This means any diet that is normal for the young person; omnivorous, pescatarian, vegetarian or vegan without any judgement. It is not my role to tell people how to eat only to help improve their challenging relationship with the foods that they would normally choose to eat.
In my personal life, I choose an animal-free diet that matches my ethical principles and strong desire to minimise harm to others. Anyone that knows me has to tolerate me posting endless pictures of delicious vegan food and talking about my deep unrelenting love for animals. So there is an obvious disconnect between my professional self and my personal self. This is something I am usually happy to maintain except in the rare circumstances that my two worlds meet.
In my ‘industry’ vegetarianism and veganism, so-called ‘restrictive diets’ get a bad rap and often because clinicians just like myself are quick to judge this choice as a negative thing, often overlooking the meaning attached to such a decision. Eating disorders awareness week 2017 has commenced so I felt it the most appropriate time to share my views on this controversial subject as someone from two very different sides of ‘the debate’. First up some facts:
- Over 725,000 men and women in the UK are affected by eating disorders
- Anyone can develop an eating disorder, regardless of their age, sex or cultural background
- Eating disorders claim more lives than any other mental illness – one in five of the most seriously affected will die prematurely from the physical consequences or suicide.
- Full recovery is possible
- At least 542,000 people in Britain are now following a vegan diet and never consume any animal products including meat, fish, milk, cheese, eggs and honey. Marking an estimated rise of 360% in the last ten years.
- The British Dietetic Association state “well-planned plant-based, vegan-friendly diets can be devised to support healthy living at every age and life-stage”
- People are motivated to adopt a vegan diet for a variety of reasons including animal welfare, to reduce impacts on the environment and for health reasons.
- As with any diet, you may miss out on essential nutrients if you don’t eat a wide variety of foods and maintain a balanced diet
There is very limited scientific evidence that makes a link between veganism (or vegetarianism) and eating disorders. Although there are several published studies on the subject no causal links have been proven; although some studies have shown higher proportions of vegetarianism in the eating disordered population than in the general population. Strangely some older studies defined a vegetarian as someone abstaining from red meat so their figures are likely a little ‘off’ and perhaps over represent vegetarianism in any population.
So why as professionals do we continue to panic when we hear our patients have adopted a vegan diet? I think this could stem from a lack of knowledge on the subject and perhaps misguided beliefs that vegans cannot be healthy or maintain a healthy weight. It also probably links to our lack of confidence when delving into the motivations behind the choice, asking direct questions about what meaning this has for the individual. Veganism is not just about the types of food you eat and if someone has become vegan for ethical reasons it will understandably cause significant distress if others put pressure on them to change.
I am not ignoring that fact that many people living with an eating disorder may use becoming vegan as a way to mask a restricted diet or avoid certain foods. Eating disorders push people to the extreme and they can develop very damaged relationships with food. This is why it is so important for those supporting the person in their recovery to make effort to understand what motivates them to be vegan and if it appears that this choice is truly led by an eating disorder encourage the person to seek support to manage this.
Veganism should not be used as an excuse to avoid eating or not maintaining a healthy weight. Many of those living well on a vegan diet will attest to how varied their choices are and that they do not have any difficulty meeting their daily energy requirements. If someone is passionate about their choice to be an ethical vegan I believe they should be offered the chance to maintain this whilst working towards recovery. Although this may present some unique challenges for clinicians when planning care, it should be embraced as an opportunity to learn about this ever growing movement of people making compassionate choices. I hope to see the day that clinicians feel less fearful of the ‘V’ word and able to support their patients to make a full recovery whilst maintaining their rights to choice.
Helpful ideas when supporting a vegan with an eating disorder:
✔ DO: Explore the meaning behind the choice
✔ DO: Get the facts
✔ DO: Seek support from professionals
✘ DONT: Judge choices harshly or with criticism
✘ DONT: Force someone to make changes
✘ DONT: Panic! there is help and support