In short: yes. It’s possible to progress in your recovery and follow a vegan eating pattern. And, it can also be challenging or even exacerbate eating disorder behaviors.
Why is this a sometimes complicated situation? Many people with eating disorders follow vegetarian or vegan eating patterns (1, 2) and the change in eating can stem from an effort at controlling weight (3). The motivations and rationale for food decisions can be nuanced, so it is worth exploring some of the topics, questions, and challenges that are frequently brought up in eating disorder recovery and explore them with your treatment team.
Vegan Eating Patterns & Values
There are many reasons people might choose to follow a vegan eating pattern. It can stem from concerns for animal welfare or caring for our environment and the earth’s resources. Sometimes it is about taste preference, how different foods feel for our bodies or the health benefits of including plant-based foods in your eating pattern. When following a vegan diet is closely aligned with your values, it can be a source of pleasure and fulfillment, especially as you take steps in your recovery.
When the dietary omissions come from a place of fear, or serve the eating disorder patterns of rigidity and restriction, it’s worth evaluating what’s really going on. Some questions that I’ve explored in my nutrition counseling sessions with patients and parents alike are:
- What was the reason for starting a vegan diet? Why follow a vegan eating pattern versus a vegetarian diet (where eggs and/or cheese and milk could be included)?
- When did the vegetarian or vegan eating pattern start, and how does that compare to the timeline of the eating disorder?
- How does the vegan diet impact the eating disorder? Is the part of you that aligns with the ED happy about the way vegan dietary restrictions limit your choices? Do non-vegan foods play a role in ED behaviors (for example, are they included in binge episodes)?
- How is your ability to nourish yourself impacted by choosing vegan foods? What is enjoyable?
- What thoughts or reactions come up for you if you consider increasing your range of food choices or challenging the vegan diet? (This question can help explore a values-oriented response from a fear-based response.)
I’ve found this handout, authored by ED RD Jessica Setnick, on evaluating food exclusions to be a helpful resource for some of these conversations.
Talk with your dietitian about how your eating patterns align with your values. While they are not the food police and your recovery should be a collaborative process, what they can do is help you explore nuanced and complicated emotions and thoughts around food.
Walden’s outpatient programs (Partial Hospitalization and Intensive Outpatient levels of care) are able to accommodate vegan and vegetarian eating patterns; we seek to honor existing family systems and personal values while targeting the eating disorder behaviors. Walden does not support a vegan diet in our residential or inpatient programs because of the degree of nutritional risk and medical concerns for patients in these treatment settings.
Outpatient meal plans are individualized to meet metabolic needs, allowing for vegan food choices. Goals of the nutrition plan are consistent with non-vegan eating patterns:
- Adequate intake at intervals throughout the day to maintain a biologically appropriate weight and meet metabolic needs
- Eat a variety of foods and food groups to support access to macro- and micronutrients
- Include food exposures that the eating disorder deems off limits or are vulnerable to ED behaviors (there are plenty of vegan options to choose for challenge exposures)
If your veganism is getting in the way of your recovery, or you have questions regarding your health while maintaining a vegan eating pattern, we can help!
Meg Salvia, MS, RDN, CDE is the dietitian at Walden Behavioral Care’s Peabody clinic. She sees adolescents and adults in the partial hospitalization program as well as in the binge-eating intensive outpatient program. She is also a board-certified diabetes educator (CDE). She began her career working in research at Joslin Diabetes Center and joined Walden Behavioral Care’s team in 2013. Meg earned a Master’s degree in nutrition from Boston University and a BA in English from Boston College.