Are you concerned about a potential overlap between veganism and eating disorders?
While veganism is a social justice movement (extending far beyond food) that aims to eliminate animal exploitation and suffering as far as is possible and practicable, its dietary restrictions can be misused when someone is susceptible to or is already suffering from an eating disorder.
So, how do you know when a plant-based diet is being used for restriction, and is it even possible for a vegan client to recover from an eating disorder while remaining vegan?
If you find yourself working with a client who’s vegan and potentially has an eating disorder, consider these six strategies.
Step 1: Check Your Biases
Before you begin working with a vegan client, it’s important to recognize and appropriately deal with any personal issues or negative opinions you have of veganism.
Whether or not you personally had a disordered relationship with food related to plant-based eating, or you know vegans who have issues with food, or feel defensive when people talk about the ethics of eating animals, you owe it to your client to set all of this aside.
If you don’t feel like you can keep any personal issues related to veganism out of client sessions, it’s important to refer the client to someone who’s a better fit.
It’s imperative that you understand vegan nutrition and how energy, protein, and other nutrient needs can be met with vegan foods and beverages. It’s also helpful to know about vegan alternatives and recipes.
Step 2: Assess, Assess, Assess
Assessment of dietary history is the first step of the nutrition care process and a crucial opportunity for to begin your work in understanding the client’s eating pattern. This is especially essential for vegan clients.
Consider asking the following questions:
- How long have you struggled with disordered eating or your eating disorder?
- When and how did you first get interested in veganism?
- When did you go vegan, and what was that process like?
- What do you hope to achieve by being vegan?
- Did you make changes in areas of your life other than food?
- Have your reasons for being vegan changed?
- Where do you get information about veganism?
- Can you describe a typical day of eating?
- Do you restrict any foods that are vegan? If so, why?
- Do you eat vegan meats and cheeses?
- Do you eat vegan ice creams and baked goods?
- Do you ever have cravings for nonvegan food? If so, how do you handle them?
- Do you ever binge on nonvegan food?
Your goal here is to learn about the client’s eating habits and create a timeline for when their veganism began and how it may relate to his or her food struggles. Sometimes the timelines are parallel and relatively independent, and sometimes they’re tightly interwoven.
Step 3: Get Curious About Intentions
As you get to know your clients, listen for comments they make about their eating patterns and lifestyles. Notice when they mention ethical vs health intentions for their choices. Note any food rules or fears they have, and ask them how their beliefs about animals (if expressed) relate to their food choices.
If vegan clients mention reading and following many health-focused or sensationalized plant-based content, consider asking them what they believe about veganism’s impact on human health.
Also consider asking clients where they “draw the line” with veganism. Do they eat nonorganic sugar? Do they consume alcohol that isn’t known to be vegan? Will they eat food that was produced on shared equipment? Ask them how they handle going out to eat, eating at friends’ homes, and eating foods that aren’t explicitly labeled as vegan.
Ask them whether they avoid animal fibers, ingredients, and testing regarding clothing, home care and personal care products. Remember that this isn’t an interrogation—make sure to keep the tone calm and curious. Your goal is to learn more about clients’ beliefs and intentions related to veganism.
Step 4: Gently Explore Goals
Have a discussion about clients’ goals for their veganism and recovery. Sometimes they intersect.
For ethical vegan clients, animal rights activism is often a motivator for recovery. They want to be healthy enough to advocate for animals. Some may have goals for hands-on work with animals that requires physical strength and stamina.
You also can consider asking clients how they feel about the intersection of their veganism and their eating disorder. Some clients may feel they can’t recover fully while eating vegan, which is true for some people), and this can come with much guilt and shame. Hold space for these difficult conversations.
Step 5: Provide Compassionate Support
As with all clients, we are here to provide support. Develop a nourishing and satisfying meal plan. Help clients work through their feared foods, which likely may include vegan foods that are refined and processed, high in fat, and carbohydrate rich.
It’s important for vegan clients to consume a wide variety of vegan foods and work through food rules that have nothing to do with veganism.
If clients are unwilling or unable to meet their energy and nutrient needs through vegan foods, explain that they may need to put veganism on the back burner to prioritize their recovery.
It’s also important to know when a higher level of care is needed for clients struggling with an eating disorder.
Step 6: Refer as Needed
It’s OK if you’re not an expert in vegan nutrition, but you need to know when it’s time to refer clients to someone who is.
If you don’t feel confident creating a vegan meal plan that meets clients’ needs, providing guidance on vegan cooking, or offering ideas for vegan products or dishes to try, it’s time to get supervision and/or refer. Or, if you do specialize in veganism but not eating disorders, make sure you’re referring to the appropriate specialists.
Recovery is possible for vegans, but that doesn’t mean veganism always can be sustained throughout eating disorder treatment. These cases are highly individualized and require personalized care.
— Taylor Wolfram, MS, RDN, LDN, is a private practice dietitian, health writer, and consultant based in Chicago. Her specialties include intuitive eating, vegan nutrition, research, and communications.