My friend went vegan and now her hair’s falling out and her period stopped.
I don’t know how many times I’ve read something similar in the comment section of a blog post or a video on youtube. I want to talk about this because it’s a topic that touches on serious mental health issues, but also a sadly mistaken view of the vegan community as a whole. If you know someone who fits that description they may be using veganism to mask an eating disorder.
This is a challenging discussion as there’s very little to be said that can be applied to everyone, and each person can only know the truth about their own motivations for choosing a vegan lifestyle, and not everyone is honest with themselves, which muddies the waters. If you know someone who is vegan and you’re legitimately concerned about their mental health vis-a-vis their diet, you may want to put some extra time into really trying to understand the difference between an eating disorder and being passionate about vegan advocacy & caring deeply about maintaining a vegan lifestyle.
Orthorexia: the vegan eating disorder?
The main eating disorder that I want to discuss is orthorexia nervosa. The reason I’m limiting my discussion to this particular eating disorder is because it offers the most opportunity for confusion, and for people to mistakenly pinpoint vegans as having an eating disorder.
I have a real problem with the official definition of orthorexia.
It seems impossible not to include vegans within this definition. No wonder people are confused! I systematically avoid foods that cause irreparable harm to myself, the planet, and trillions of animals – meat, dairy & eggs. And I also almost never eat very sugary things, like candy and chocolate. Does that make me orthorexic? Certainly not – I’m just a vegan who has never had much of a sweet tooth, even when I was a kid. Anyone who systematically avoids cigarettes and cigarette smoke or someone who is lactose intolerant systematically avoiding dairy products doesn’t have mental health problems any more than vegans do.
Veganism can be an attractive lifestyle to young girls and boys with a penchant for eating disorders and who want to be super skinny because it naturally eliminates many of the sources of dietary fat – animal products. A good sign to look for if you’re worried about someone who’s vegan having an eating disorder is the avoidance of ANY fat at all, even healthy fats like those found in avocado and nuts. But be sure that you’re aware of what actually constitutes a healthy fat. If someone is avoiding oils (olive oil, canola oil, coconut oil, etc.) and products made with them (such as potato chips, margarine, etc.), that is not necessarily a warning sign! Plant-based doctors, such as Dr. Esselstyn and Dr. McDougall warn against consuming any oil at all because it clogs arteries and can lead to heart attacks. Nuts, seeds, avocados, olives, soybeans & soy products are all healthy whole-food sources of fat.
To omnivores, my diet sounds very restrictive, but in fact I eat bountifully as a vegan, so keep in mind there is a matter of perspective to account for. Having said that, if a person only eats 5 different foods, that’s objectively extreme and a clear warning sign.
Another warning sign, as mentioned at the start of this post, is hair & period loss (on any diet, by the way). Anyone experiencing this should look at the calorie density of their food. If you consistently eat food with low calorie density, then it will be difficult to eat enough calories in any given day and, if your weight falls below a healthy level, then bye-bye hair and period. It’s a natural consequence of being underweight, and an important warning sign.
Another by-product of a failure to consume a sufficient amount of calories is being nutritionally deficient. If you’re worried, get a blood test to find out if you’re getting enough vitamins & minerals.
The Bratman test for orthorexia
I believe that it’s important to look at each individual person within their own context when it comes to figuring out if they might have orthorexia. I’m going to use the Bratman test for orthorexia to show you why. It’s a series of questions to assist in self-diagnosis.
- Do you spend more than 3 hours a day thinking about your diet?
- Do you plan your meals several days ahead?
- Is the nutritional value of your meal more important than the pleasure of eating it?
- Has the quality of your life decreased as the quality of your diet has increased?
- Have you become stricter with yourself lately?
- Does your self-esteem get a boost from eating healthily?
- Have you given up foods you used to enjoy in order to eat the ‘right’ foods?
- Does your diet make it difficult for you to eat out, distancing you from family and friends?
- Do you feel guilty when you stray from your diet?
- Do you feel at peace with yourself and in total control when you eat healthily?
“Yes to 4 or 5 of the above questions means it is time to relax more about food. Yes to all of them means a full-blown obsession with eating healthy food.” (source).
I answered yes to 1,2,3,5,7,8,10. That’s a shocking 7 out of 10! And yes to 4 or 5 means that I’m supposed to “relax more about food”? Why on God’s green earth should I “relax” about food when animal agriculture is literally destroying the planet and human health? For each question to which I answered yes, I’m going to explain why, so that you know how I can feel so certain about not having orthorexia myself, and so you can see why new, more pointed, questions are needed to test for this eating disorder.
1. Do you spend more than 3 hours a day thinking about your diet? YES. Not only am I a vegan who prepares virtually all the meals in my household, but I also love to cook, and am always searching for new and interesting ways to substitute for things like cream (my latest discovery is onion cream, which I now use in pasta dishes). In addition, I have 2 blogs which both focus on veganism. The other one is specifically about healthy meal planning in accordance with Dr. Greger’s recommended daily dozen. I also have a large garden, and I devote time to thinking about what I can grow that will offer the most nutritional yield for my hard work, and will also be the most cost- and space-efficient. When I’m harvesting, I like to think about meals that I can make with the food I’m gathering. This all comes back to veganism, and so, yes, I’m sure I spend far more than 3 hours each day thinking about my ‘diet’.
2. Do you plan your meals several days ahead? YES. We go grocery shopping once a week. I go with a prepared list of what I need for the week’s meals. I like trying new things, so I don’t just buy the same things every week, which means I need to plan meals and prepare a list in advance or I’ll never remember everything I need.
3. Is the nutritional value of your meal more important than the pleasure of eating it? YES. Though I really enjoy cooking and love love love good food, I always start by finding something that is nutritious. If I go to a dinner party and the extent of the effort that the hosts went to to accommodate me was to cut up a few raw vegetables, well, then, that’s what I’m eating even though I’m certainly not going to get all that much pleasure out of it. It’s definitely a bummer when that happens, but I won’t compromise my health & principles just because someone doesn’t know how to use Google. But, to be fair, it’s not just about nutrition for me. I’m an ethical vegan as well, so I guess I can sort of give this a semi-yes. I’ve always made sure that I maintained healthy eating habits, and not fallen into a rut of eating lots of fatty or sugary foods. In that sense, even before I was vegan, my first priority was health & nutrition.
5. Have you become stricter with yourself lately? YES. It’s very recently that I found out that refined oil is as bad for your body as animal products, so I’ve been working to eliminate oil from my diet. I use aquafaba to replace oil in hummus and pesto and salad dressings, etc. I don’t like water-sauteed onions, though, so if anyone has suggestions for me about that, I’d be happy to hear them.
7. Have you given up foods you used to enjoy in order to eat the ‘right’ foods? Uh. Hello. Cheese. Bacon. I even had to give up my favorite dish detergent because it has whey in it.
8. Does your diet make it difficult for you to eat out, distancing you from family and friends? YES. I don’t let it prevent me from going where I’m invited, but I think some people don’t invite me over for dinner because it’s scary for them to try to cook vegan. When it definitely distances me from people is when they behave like asses and make fun of me, or ignorantly declare total disapproval of my ‘sissy’ ethics, ‘sickly’ diet, and ‘high-horse’ lifestyle. Yeah, whatever. Sometimes I cry a little, but then I get over it. It’s their problem, not mine. And, no matter how rude people have been, I’ve never regretted my decision to be vegan for a single second.
10. Do you feel at peace with yourself and in total control when you eat healthily? YES. Of course I feel at peace and in control of myself when I healthily. Not only am I living my ethics, but I know I’m doing as much to be in control of my own future health, well-being and healthcare costs as I know how to do, which is a good feeling. And that’s NORMAL!
While orthorexia is as serious as any other eating disorder, and there are some orthorexic vegans out there who do need the people in their lives to lovingly and compassionately try to get them help, most vegans are not orthorexic. They are individuals who have opened their eyes to the truth of the damage that is caused by consuming animal products – the damage to the planet, to the animals, and to our own bodies, and they are acting completely rationally in the face of that information. I would argue MORE rationally than people who flatly refuse to consider veganism.
If a vegan is orthorexic, they can recover from their eating disorder while still being vegan. Here is a good discussion of that possibility.
Lastly, mainstream media sometimes uses the idea of orthorexia to try to scare people out of becoming vegan (I’m looking at you, BBC). It’s utterly ridiculous, and it needs to stop because they are doing actual harm. Don’t be afraid to: