Women with a history of eating disorders are nearly four and a half times more likely to have been vegetarian at some point in their lives than women without eating disorders, according to a new study. Sixty-eight percent of women in the study believed that their vegetarianism was related to their eating disorder.
"The Inter-Relationships between Vegetarianism and Eating Disorders among Females," published Aug. 2012 online in the Journal of the Academy of Nutrition and Dietetics by Anna Bardone-Cone, Associate Professor of Clinical Psychology at the University of North Carolina at Chapel Hill, says "when individuals with a suspected or diagnosed eating disorder adopt a vegetarian diet, health care professionals might worry that this choice could function as a socially acceptable way to legitimize food avoidance."
Compared with the control group of women with no history of eating disorders, women with an eating disorder history were more likely to have ever been vegetarian (52% vs 12%), to be currently vegetarian (24% vs 6%), and to be primarily motivated to be vegetarian for weight-loss reasons (42% vs 0%). The three recovery status groups (active eating disorder, partially recovered, and fully recovered) differed significantly in rates of current vegetarianism (33%, 13%, and 5% respectively).
"Being vegetarian... sits with a fixation around food and weight and calories," said Dr. Sloane Madden, co-director of The Eating Disorder Service. "The motivation seems to be tied up with a belief that vegetables are lower in calories and healthier and more likely to facilitate weight loss."
"Going vegetarian can be another way to cut out a food category," Vanessa Kane-Alves, a registered dietician with Boston Children's Hospital's Eating Disorders Program, told the Huffington Post. "It makes it easier when people ask you questions about where those foods have gone. It's a more socially aceptable way to restrict foods."
While the study does not argue that vegetarianism directly causes eating disorders or is unhealthy, it suggests vegetarianism "can be a symptom of an eating disorder for some women."
"The takeaway of this study is, as a clinician, if you have a patient who tells you they want to be a vegetarian, it's worth exploring that more than you would have otherwise," said Kane-Alves. "We always try to respect vegetarian eating practices, but what this suggests is that maybe we should have different recommendations for vegetarians with eating disorders who are trying to get better. We need to at least have a discussion with the person about how it might be getting in the way of their recovery."
Mark Berriman, Director of the Australian Vegetarian Society, said in a statement that "it does make sense [for] young women seeking to reduce weight [to] perceive the reduction/elimination of animal fat as a significant step for them to take, making vegetarianism attractive... [S]o often, however, the premise is set by the nature/intention of the study, which obfuscates rather than clarifies what may be a considerably more complex situation."
The American Dietetic Association said in its official position on vegetarian diets that "appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes..."
The study concludes by suggesting several ways that doctors can intervene with women suspected of eating disorders, including investigating motives for vegetarianism.
American Dietetic Association, "Position of the American Dietetic Association: Vegetarian Diets," Journal of the American Dietetic Association, May 27, 2009
Anna Bardone-Cone, "The Inter-Relationships between Vegetarianism and Eating Disorders among Females," Journal of the Academy of Nutrition and Dietetics, Aug. 2012
Sarah Berry, "Eating Disorder Link for Vegetarians," stuff.co.nz, Aug. 8, 2012
Sarah Berry, "Diet of Disorder," watoday.com.au, Aug. 7, 2012
Melissa Jeltsen, "Vegetarianism, Eating Disorder Study Reveals Worrisome Relationship Among Women," huffingtonpost.com, Aug. 2, 2012
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