Alsana treatment service have done a study with dieticians who work with eating disorder clients. They have something to say about veganism and eating disorders. What follows does not apply to people who are vegetarian for religious reasons. Asana writes:
“In a survey we conducted with hundreds of dietitians who specialize in eating disorders, we found that 98% of eating disorder dietitians saw clients who followed a vegan eating style. Of these, 75% of vegan clients realized that their eating disorder was enmeshed with veganism, while 25% of clients realized the eating disorder was separate and veganism was a true value in their belief system”.
We ask, how does a client KNOW whether their veganism is a symptom of eating disorder behaviour. Most insist that they have genuine concerns for the planet, for animal welfare and for sustainability.
The clients whose vegan diet is mostly a symptom of the eating disorder, do not have a therapeutic space to disentangle their veganism from eating disorder thinking. At the start of therapy most insist that veganism is essential to their identity.
At the NCFED we have many thoughts about veganism, while accepting how important it is at first. We want to know whether there are other hidden issues that make veganism a compelling dietary choice. Veganism has been linked to autism, to irrational contamination fears and to early attachment issues between a mother and her child during the developmental stage we sometimes refer to as Kleinian Rage! Freud may have linked eating choices to fears of oral impregnation. We have found that veganism and also vegetarianism can be associated with OCD especially if there is no flexibility in the person. In other words, would even thinking about eating a bit of fish cause a meltdown – or would it be OK if nothing else was available.
The vegan diet can lead to serious nutritional deficiencies such as choline, iodine, B vitamins and imbalances in essential fats that cannot always be rectified by vegan sources (especially Omega 3 fats). The effects on the neurochemicals of mood, metabolism and appetite can maintain eating disorder symptoms.
If veganism is a symptom rather than a true spiritual value for the 75% of patients identified in this study, the route to recovery must include broadening the choice of food. Supplements alone are not a good way to address the potential depletions of a vegan diet, because supplements lack the synergy of nutrients that exist in real food. Some people see supplements as an alternative to eating a balanced diet, and this is also part of eating disorder thinking.
No one has yet come up with a treatment that will confront the thinking that has led to their choices as well as to rebalance their physiology. Recovery is not just about dealing with childhood adversity.
If your client is vegan or vegetarian, recovery may entail getting more variety into their diet. and oh my goodness, how this will be resisted! Can they become a flexitarian, and use some form of animal based foods as a medicine? Will they secretly consider themselves superior to you because they make more ethical choices? This will interfere with your therapy.
If you the healer are vegetarian or vegan, can you congruently help a person to expand their food choices? Will you see yourself as superior to your meat-eating client? This will interfere with your therapy.
Eating disorders are not just about feelings, they are also about food. A restrictive diet is not great for anyone with an eating disorder. The vegan / vegetarian client may need a great deal of informed and compassionate support to disentangle their values from their eating disorder symptoms and be more open with their choices.