When 21-year-old music student Katie Alice Macdonald was an inpatient for anorexia, she wasn’t allowed to follow a vegan diet. But when she became an outpatient, Macdonald used veganism as an excuse to control her eating.
“I think being vegan made it easier for me to not comply in treatment because I stated that I didn’t want to be made to have animal produce, and restoring weight on a plant-based diet can be problematic for some dieticians, so I do think I used it as an excuse,” she says.
Macdonald, who has been vegan for three of the eight years she’s had anorexia for, says veganism often gave her an easy excuse to restrict unhealthy foods.
“Veganism can definitely mask a very restrictive diet, and it makes it so much easier to hide eating disorder symptoms, especially as veganism is seen as such a green, plant-based lifestyle,” she says.
“It allowed me to cut out lots of stereotypically fatty foods like dairy and chocolate without anyone really seeing it as a bad thing.”
There are a number of studies that have found disordered eating among vegetarians, however, while the number of vegans is rising year on year – it’s estimated that up to 3.5 million people in the UK are vegan. The trend has come from the fringes relatively recently, and is therefore a much less researched area.
A study in 2013, for example, looked at the relationship between vegetarianism and eating disorders among women, and found that about half of those with anorexia reported eating some form of vegetarian diet, compared to around 2 per cent of the UK population.
More than two thirds of participants with a history of eating disorders and vegetarianism agreed that there was a relation between vegetarianism and their eating disorder, and many said being vegetarian helped them lose weight, maintain their eating disorder and provide another way to cut calories and feel in control.
Abbey Sharp, registered dietician and food blogger, lived on a diet of just boiled broccoli, dry kale and baked chicken breasts in her attempts to eat healthily, and lost 50lbs in one year.
Sharp’s career helped her overcome her disordered eating, when she realised how much being a food blogger clashed with her endless clean-eating rules. And as she observes veganism rise through the ranks and gain a trendy status, she is concerned for those susceptible to disordered eating.
“While there are a lot of fantastic reasons to choose to eat more plant-based, I have seen it often lead down a disorderly road,” she says.
“Veganism can be incredibly healthy, so I don’t want to dismiss the benefits of plant-based food. But it’s a very challenging diet to adhere to and often can be isolating and overly restrictive.
“When a specific way of eating gets in the way of us enjoying social events, or when we use our ‘lifestyle’ as a way to eat less or fewer foods we deem ‘unclean’ or ‘unhealthy’, we dip down that slippery slope.
“Orthorexia is simply taking healthy eating ‘rules’ to an extreme. While my orthorexia was largely based around a fear of sugar, for others that could be fat, gluten, or in this case, animal products.
“Veganism is an extreme diet, and without a very clear, moderate head space, it can often lead to orthorexia or other eating disorders.” Some argue veganism is a lifestyle, not a diet, but Sharp disagrees that there is a distinction.
“Veganism requires a set of very strict rules, and setting up any rules around what you eat is a diet. At their least problematic diets fail. But often, diets also often lead to disordered eating.”
In one study earlier this year, researchers from the University of Dusseldorf looked at orthorexic and restrained eating behaviours among vegans, vegetarians and those on a diet.
Orthorexia, a term coined in 1997, is used to describe an unhealthy obsession with eating healthily, however it isn’t an officially recognised eating disorder in the Diagnostic and Statistical Manual of Mental Disorders.
The researchers found that vegans and vegetarians scored higher in orthorexic eating behaviours than those who eat red meat.
Lead author Friederike Barthels says the research was conducted as a response to increasing anecdotal evidence of a connection between orthorexia and veganism and vegetarianism. However, he clarified that the levels of these behaviours observed among participants wasn’t high enough to be categorised as at risk of orthorexia.
The study couldn’t conclude where this link may come from, but Barthels says one explanation could be because veganism is associated with health. “It’s quite likely that people with higher levels of orthorexia omit meat from their diet,” he says.
“Nonetheless, unpublished data from a previous study revealed that only vegans who omit foods of animal origin due to health reasons display higher levels of orthorexia. Those who go vegan due to ethical reasons did not display elevated levels of orthorexia, so the underlying motives are crucial.”
He adds that veganism could both attract those with orthorexic behaviours, and play a part in causing them. “One might drift from a vegan or vegetarian diet into an eating disorder, but I think that a vegan/vegetarian or orthorexic way of eating might also be a coping strategy for people suffering from a severe eating disorder,” he says.
“For these individuals, eating is such a problematic issue that any diet allowing at least some foods is better than starving.”
Laura Dennison, founder of no-nonsense healthy eating resource Not Plant Based, used veganism to hide multiple eating disorders, and argues one of the biggest risks to disordered eating within the vegan community is some of its bloggers. “I went vegan because I wanted to lose weight, and it became a shield for a lot of other problems I had with food,” she says.
“I had multiple eating disorders for years and I thought that to cure myself I needed a permanent lifestyle where I could remain thin, and in my eyes, be healthy. But I was actually eating junk food, and the same things every day, I was able to say ‘I’m vegan’, so no one would question what I was eating and the restrictions I’d put myself on.”
She warns that some food bloggers, who are increasingly influential in telling people how to go vegan, often have disordered eating themselves. “A lot of people who have plant-based brands and earn a lot of money that way have eating problems, so it’s unethical for them to say that if you eat like me you’ll be healthy, when actually they have an eating disorder they’re disguising.
“The problem is they get so deep into their brand they feel like they can’t be honest, in case people feel deceived. It’s difficult with the rise in blogging, and this is where people find vegan-eating plans.”
Dennison says this lack of reliable information can abet people to cut out foods. “It’s difficult when you can’t afford to see a nutritionist or dietician and if you’re feeling unwell you can’t tell if it’s something in your diet or not. It’s really hard to find the correct information. This means a lot of people scare themselves out of eating certain foods.