What's the connection?
Search the web for "vegetarian eating disorder" and choose from millions of entries. Doctors have it on their risk checklists: vegetarianism or a sign of an eating disorder?
Is that fair, or is it outrageous to vegetarians everywhere?
Vegetarianism is unquestionably a healthy way to eat, lifelong. It is a smart and ethical choice. But it is also a very good way to control your weight by controlling your food - and that is where the danger lies for those of us with eating disorders. Control is the key.
Vegetarianism is not an eating disorder, nor does it cause eating disorders. But people who already have an eating disorder can use vegetarianism to enable their disorder.
A starving anorexic with skeletal bones on display inspires a combination of horror and pity, as does a bulimic whose reaction to food in her stomach is to forcibly regurgitate it at the first opportunity. Further reducing calories by adopting a vegetarian diet as an excuse to refuse animal foods can be dangerous.
What about compulsive eaters (such as I am) who are overweight? Most overweight people have an eating disorder (or unhealthy eating habits, if you prefer). Unlike anorexics or bulimics, society's reaction to the overweight is usually disgust and scorn. We are applauded for reducing calories when we are not nagged and shamed into it. So does that make it OK for us?
I went vegan (Dr McDougall style) simply to lose weight from a lifetime of compulsive eating. I reached early McDougall stardom for my efforts and achieved the dieter's nirvana of significant longterm weightloss. I take great satisfaction in my health since going vegan and pride in learning to care about the other advantages of the plant-based diet: animal and environmental welfare.
My success replaced my eating obsession with another - eating an extremely healthy diet in a world where the odds are overwhelmingly stacked against it. It does take obsessive commitment to succeed at this: the opposite of my previous habits. Reports from the National Weight Loss Registry indicate that people who lose weight successfully over the long term (30 lbs or more for more than 5 years) do so not only by eating a low-fat, high-carbohydrate diet, but also by adopting habits which are obsessive. These include weighing daily (or several times weekly), very high daily exercise levels, and often food journalling.
These are not actions of people who have achieved peace, but of people who strive constantly against their food and their weight.
I'm very glad to lose weight in a healthy way that will last me a lifetime. Yet I am simply now a vegan compulsive eater. With the stress and changed lifestyle of becoming a new mother, I have reverted to many of my old habits. Thanks to veganism, I have not suffered the common dieter's humiliation of "gaining back all I lost and more" but, just like mothers everywhere in the developed world, I am in a constant battle to return to pre-baby weight and health. I am no longer 25 but nearly 40. I still feel the impacts of the post traumatic stress disorder and postnatal depression from the birth of my son. And I am no longer a poster child for McDougalling (to my regret, as I am a fervent convert). My children have been vegan since birth.
War of the obsessions
Why fight one obsession with a physically healthier obsession? It's certainly not ideal. But as with many health problems, sometimes people are never cured, but they learn to manage their symptoms and accept the side effects.
The term "Orthorexia nervosa" has even been invented to describe people who are obsessed with eating only healthy foods. This is not a medically accepted term and has been discussed and even ridiculed here on VegSource. The diagnostic questions need work, but I don't see this as an attack from the mainstream on health food advocates (like the term "food police"). People with eating disorders use rules that allow them to eat, or not, and healthy eating can be used as their ruler. It is the obsession, the suffering when breaking the rules, and the impact on health which define the disorder, not just an unusually firm commitment to healthy eating.
All in the family
You may not relate to any of this. You may think real vegetarianism shouldn't be about those poor people who have eating disorders. Yet vegetarians have a higher incidence of eating disorders than the general population, and people in treatment for severe eating disorders report themselves as vegetarian alarmingly often (1/3 to 1/2). I'm speaking out because I know that I am not alone in being a fat McDougaller, seemingly a poor example of the lifestyle I promote. I know that others are out there. I know it because of the studies. And I know it because I have met you over the years - in person and on the McDougall boards - struggling along with me.
Like it or not, understand it or not, a sizeable percentage of your fellow vegetarians are vegetarians managing (masking?) our eating disorders. Ignoring, rejecting, or marginalising our path to vegetarianism denies our commitment, our efforts, and our contributions.
And if we seek help with our disorder, we need experts who will see our vegetarianism as a plus instead of the first problem to cure.