What are eating disorders?

Eating behaviour may fall anywhere on a spectrum between having a positive and healthy relationship with food (intuitive eating), to an eating disorder, such as anorexia nervosa or bulimia nervosa:

The 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM) – 5 classifies eating disorders on their presenting symptoms (1). The three most common eating disorders are:

Anorexia Nervosa – characterized by a restricted energy intake that leads to a significantly low body weight; an intense fear of becoming fat or gaining weight; and a disturbance in self-perceived weight or shape.

Bulimia Nervosa – involves recurrent episodes of binge eating, followed by inappropriate compensatory measures to prevent weight gain, such as fasting, vomiting, or excessive exercise.

Binge Eating Disorder – includes frequent binge eating (i.e. a large amount of food is consumed in a short period of time, while feeling out of control) without the use of compensatory measures described above.

An individual suffering from disordered eating may exhibit characteristics of an eating disorder, but not meet diagnostic criteria.

Who gets eating disorders?

An eating disorder can develop at any age, regardless of an individual’s education, income, social class, sexual orientation, culture, or religion. Eating disorders are more likely to occur in the following populations (2):

  • Women: most individuals diagnosed with anorexia nervosa or bulimia nervosa are women, although binge eating disorder affects women and men equally
  • Adolescents: youth are particularly susceptible to internalizing media messages about beauty and body image. Many eating disorders first appear in childhood
  • Family history of eating disorders: eating disorders run in families due to both genetic and environmental factors
  • Existing mental health conditions: eating disorders may occur alongside other mental illnesses, such as depression, anxiety, and obsessive compulsive disorder
  • Personality types: individuals with poor self esteem, perfectionistic and/or control tendencies, or those who struggle with emotional tolerance/regulation may be at a greater risk of suffering from an eating disorder
  • Chronic dieting: many eating disorders develop from dieting. Binge-eating is particularly common following restrictive weight-loss diets
  • Body-focused careers/activities: individuals who work or spend a lot of time in positions that focus on body-image, such as dancers, athletes, and models, may be at an increased risk of developing an eating disorder

Are eating disorders serious?

Eating disorders are very serious medical conditions that can significantly impact an individual’s physical, mental, and emotional well-being. Depending on the disorder, an individual’s age, and the duration of the eating disorder, an individual may experience negative short and long-term outcomes, such as (3):

  • Loss of friendships and relationship conflict
  • Impaired academic or job performance
  • Compromised athletic performance
  • Heart failure or cardiovascular disease
  • Osteoporosis
  • Tooth decay
  • Hair loss and nail brittleness
  • Depression, anxiety, or other mental health illnesses
  • Malnutrition
  • Gastrointestinal issues such as heart burn, constipation, and inflammation of the esophagus
  • Obesity-related disease such as hypertension, cardiovascular disease, and type 2 diabetes

Can I stay vegan or vegetarian while recovering from an eating disorder?

Many eating disorder programs, whether private or publicly funded, will not allow an individual to maintain a vegan or vegetarian diet while in recovery. This is out of concern that vegetarianism will be used as a means to limit dietary intake and control weight. Additionally, these organizations may experience logistical challenges in meeting such dietary preferences.

If you are currently suffering from an eating disorder, and identify as vegan or vegetarian, it’s important to openly reflect on your reasons for choosing to follow this dietary pattern. Choosing to be vegan or vegetarian to reduce your environmental impact or avoid harming animals is a valid justification for following a plant-based diet. In contrast, if you feel that your plant-based diet manifested as part of your eating disorder and is being used as a means to control your weight, letting go of your plant-based diet (at least in the short-term) may be beneficial to your recovery.

Where can I get help?

Due to the serious nature of eating disorders, it’s important to seek out professional help early if you, or someone you love, is suffering from an eating disorder. An important first step is meeting with your family doctor who can refer you to the appropriate treatment facility or a healthcare professional that specializes in treating eating disorders.

In my practice, I see children, adolescents, and adults struggling with an eating disorder or disordered eating. I specialize in helping ethical vegans and vegetarians recover from disordered eating/eating disorders and develop a positive body image and relationship with food. I also work with those struggling with disordered eating/eating disorders following bariatric surgery.

To discuss your food and eating concerns and ensure you are a good fit, please get in touch with me.

Resources:

References:

  1. Attia, E., Becker, A., Bryant-Waugh, R., Hoek, H., Kreipe, R., Marcus, M., et al. (2013). Feeding and eating disorders in the DSM-5. American Journal of Psychiatry, 170(11):1237-1239. Abstract available from: http://europepmc.org/abstract/med/24643829
  2. Canadian Mental Health Association BC Division. Eating Disorders. (2014). Accessed April 6, 2017 from: https://www.cmha.bc.ca/documents/eating-disorders-3/
  3. National Eating Disorders Association. Health consequences of eating disorders. (n.d.) Accessed April 6, 2017 from: https://www.nationaleatingdisorders.org/health-consequences-eating-disorders