It’s safe to say that going on a diet can be a slippery slope into an eating disorder or relapse—but does the same go for veganism and vegetarianism? Eating a vegan or vegetarian diet is often a valid and important choice rooted deeply in someone's values and identity. However, vegetarianism and veganism can sometimes complicate eating disorder recovery, because it can be difficult to know who’s truly calling the shots: the person and their authentic values or the eating disorder.

In my practice as an eating disorder dietitian, I’ve seen both scenarios. I’ve seen people who start their recovery as vegans or vegetarians, and eventually realize that this choice was driven by their illness and that they’ll only be able to reach full recovery if they return to eating meat.

On the other hand, I’ve also witnessed people stay vegans and vegetarians throughout the course of their treatment and for whom the choice comes from their true values.

So, what can you do if you or your loved one is beginning the path toward eating disorder recovery while also practicing a vegan or vegetarian diet? Read on to learn more and navigate the complexities of veganism and vegetarianism in eating disorder recovery.

What’s the relationship between veganism and eating disorders?

First, let’s define the two eating styles: vegetarians avoid meat, poultry, and fish, but may eat dairy and eggs, while vegans avoid all animal products, including meat, dairy, eggs, and honey. While research shows that being a vegetarian or a vegan is not inherently a risk factor for eating disorders, their relationship is complex and depends largely on the “why” behind the way of eating.

A 2024 study of healthcare providers treating vegetarians with eating disorders shows that in recent years, vegetarianism has increased among people with eating disorders, particularly young women and teens. The study shows that two key factors can help determine whether vegetarianism is driven by the eating disorder or not: timing and motivation. They shared that it’s more likely an eating disorder-based decision when vegetarianism is adopted around the time of eating disorder development or during treatment, versus if it started well before the eating disorder began. Deciphering the motivation behind adopting a plant-based diet can be trickier, but it’s just as important. Was the diet adopted out of a desire to lose weight, or due to genuine values and preferences? “People may choose to be vegan or vegetarian for reasons like concern for animal welfare or environment, cultural or religious preferences, or health concerns,” says weight-inclusive eating disorder dietitian Ana Pruteanu.

One 2023 study of people following vegan diets for at least six months echoed the same notion: what matters the most is figuring out the “why” behind the veganism. In fact, this study showed a significantly low number of disordered eaters, likely because most participants cited ethics and animal rights as reasons for being vegan. Another 2020 study of college students showed motivation as a dominant factor again, as vegetarians driven by weight concerns showed higher eating disorder symptoms than non-vegetarians and vegetarians motivated by other factors. “Someone struggling with an eating disorder or disordered eating may choose to limit their diet by following a vegan or vegetarian diet in part motivated by fear of eating certain foods or by a desire to avoid certain foods,” Pruteanu explains. “It’s important to understand someone’s reason for this choice and how they are choosing to follow a vegan or vegetarian diet.”

Finally, a 2022 research review revealed that avoiding meat is not a clear risk factor for eating disorders like anorexia or bulimia, however it showed an association between “healthy eating obsession” or orthorexia-type behaviors and vegetarianism and veganism. Given this finding, the study concluded that flexibility is another factor to consider when trying to determine if a vegan or vegetarian is at risk of an eating disorder. “If you are vegan or vegetarian and notice that over time you become fearful of more foods, your diet becomes more limited, and your list of ‘safe foods’ is shrinking, think of that as a red flag that may be pointing towards disordered eating or an eating disorder,” Pruteanu says. “If someone is vegan or vegetarian but only eats fruits and vegetables, I would argue that is an extreme way of applying this lifestyle and can lead to nutrient deficiencies and potentially mask disordered eating or an eating disorder.”

When being vegan or vegetarian masks eating disorder behaviors

In some cases, a person’s eating disorder will use veganism or vegetarianism as a front or a justification for certain disordered eating rules and behaviors. “Sometimes being vegan or vegetarian is used to avoid going out to eat or eating sweets or other foods,” Pruteanu explains, “but with the abundance of options we now have at hand, there’s no reason to feel like you can’t enjoy desserts or go out to eat if you’re vegan or vegetarian.”

For those with an eating disorder, however, their reasons for restricting certain foods extend far beyond wanting to avoid meat and other animal products. Underneath the surface, vegetarianism and veganism can be about:

• Being smaller (in multiple ways): In the context of an eating disorder, vegetarianism or veganism may be about both physical smallness and striving to have as little impact on the earth as possible, a feeling that can come from low self-worth..
• Reinforcing moral worth: Identifying as a vegan or vegetarian can create a false sense of moral superiority or righteousness.
• High standards of purity/perfectionism: Identifying as a vegan/vegetarian can be a way to chase after a narrow definition of “purity,” which can also placate the eating disorder’s desire for perfectionism.
• Black and white thinking: The eating disorder can hijack real moral beliefs (compassion for animals, environmentalism, etc.) and turn them into a rigid, all-or-nothing mindset. Realistically, small steps can make a difference in the health of our planet, but black and white thinking shows how the eating disorder can be stronger than one’s personal desire to make an impact in a practical, sustainable way.
• Normalizing restriction and food avoidance: Adhering to a vegan or vegetarian diet can be one way to easily say no to challenging foods or “junk” foods, as well as restrict food in contexts where there’s not much (or any) plant-based food available..
• The safety blanket: Having a label to describe one’s diet can make eating feel safer and more controlled. For example, eating dairy-based ice cream could be viewed as scary, but vegan ice cream may be doable. While this could seem harmless on the surface, it can mask situations where restriction is still happening and create an illusion of safety and control.

“I know many people that have sought treatment for an eating disorder who were vegan or vegetarian, and after spending time with them and exploring their eating disorder, it’s determined that their veganism or vegetarianism are a part of their eating disorder,” says therapist Amanda Marks, LPC, RYT. “It takes a lot of exploration in therapy and working with the individual's dietitian to determine what is actually an eating disorder behavior and what is something that is aligned with their own true values.”

The differences between disordered eating and healthy veganism or vegetarianism

If you’re a truly healthy vegan or vegetarian, there will be stark differences in the way you eat and live, compared to someone whose eating disorder is running the show. “Eating vegan or vegetarian without restriction looks like having the freedom to go out with friends to restaurants that offer vegan or vegetarian options and being able to enjoy vegan baked goods without guilt,” Pruteanu explains. “And most importantly, it looks like eating a diet that fully nourishes the body, providing the nutrients your body needs to function well without deprivation.” Here are some other signs of healthy veganism or vegetarianism:

• Your food choices are connected to your values, and your veganism or vegetarianism is driven by factors like animal welfare or the environment.
• You can be flexible and are okay if you need to bend your “rules” sometimes.
• Your veganism or vegetarianism supports your mental health and well-being and is just one part of your identity.
• You’re able to meet your energy and nutrient needs daily.

“If someone is vegan or vegetarian but feels a lot of fear about eating foods prepared by others, eating foods that are still vegan but are outside of their safe foods list, is afraid of certain nutrients like sugar, carbs, sodium, or fats, these are red flags for disordered eating,” Pruteanu adds.

Here are some other red flags of unhealthy vegetarianism or veganism:

• Your reasons for being vegan or vegetarian are wrapped up in diet culture (e.g. weight or shape control, moral superiority, or food avoidance).
• You have rigid, black-and-white rules and are anxious if they’re broken.
• You spend much of your day thinking about food, and experience food-related fear and guilt.
• You find yourself avoiding social outings or gatherings because of food.
• You’re unable to meet your body’s energy and nutrient needs and are medically unstable.

Can you stick to a vegan or vegetarian diet while recovering from an eating disorder?

Whether or not you can stick to a vegan or vegetarian diet in recovery depends on your situation and some key factors, like your motivation for being vegan or vegetarianism and whether or not you’re able to meet your energy and nutrient needs and be medically stable. “I do think that recovery from an eating disorder while being a vegan or vegetarian can be possible,” Marks says, “however, it would take a solid treatment team and a lot of discussion around the reasons for restricting food, as well as having ongoing, transparent discussions around food and values.”

If you’re unable to eat adequately while following your vegan or vegetarian diet, it may be necessary to take a break to achieve medical stability and increase mental flexibility. Once you’ve accomplished these goals, it will be easier to clarify who’s calling the shots: you or your eating disorder.

Here are a few other considerations to keep in mind:

• One way you can support your own recovery or the recovery of a loved one is by honoring the idea of activism while simultaneously trying to remove the focus on “food as activism.” Activism doesn’t just happen on a plate, after all. You can engage in animal welfare or environmental activism that is unrelated to food, like volunteering at an animal shelter or picking up litter in a park.
• Remind yourself or your loved one that to be kind and compassionate to animals and the earth, we first must practice those qualities with ourselves. Sometimes, especially in recovery, that may mean choosing to eat meat or meat products.
• Ultimately, an eating disorder can hijack a person’s kindness and compassion and transform it into fear, which is not the spirit of veganism or vegetarianism.
• Being vegan or vegetarian in recovery is possible, but sticking to a strict vegan or vegetarian diet may also mask eating disorder beliefs and behaviors, making both progress and engagement with loved ones and the planet impossible.

How to ensure a plant-based diet doesn’t become disordered

Finally, here are some tips for following a vegan or vegetarian diet without falling into disordered behaviors:

Connect with your core vegan or vegetarian values.

Identify why you’re choosing a vegan or vegetarian diet, write it down, and make sure it’s in alignment with core values and that it’s a genuine decision. Then, let it be a guiding and flexible principle rooted in health and authenticity, not a rigid tool for self-deprivation or control.

Eat fun foods and remember pleasure.

If you’re a vegan or vegetarian for ethical reasons, it doesn’t mean you have to eat the “cleanest” foods—but that’s how the eating disorder operates. Allow yourself the vegan or vegetarian cakes, cookies, chips, and any other foods you enjoy. If you restrict these foods, it’s easier for an eating disorder to re-emerge or develop. Remember, eating is meant to be a nourishing and pleasurable part of life.

Be flexible.

One of the hallmark symptoms of an eating disorder is rigidity around food, so check in about your flexibility, and loosen up if you notice obsessive and strict tendencies. “Stay flexible, enjoy foods, and be okay eating a variety of foods in different settings,” Pruteanu says.

Notice how much mental space it’s taking up.

It’s possible to be a vegan or vegetarian without being preoccupied with thoughts of food all day every day. However, if you notice a large amount of your mental space is taken up by food and crowding out the rest of life (like relationships, work, and hobbies), it’s time to re-evaluate.

Make sure you’re eating enough food and meeting your nutrient needs.

It can be challenging to get enough calories, and meet your macronutrient needs (carbs, fats, and proteins) and your micronutrient needs (vitamins and minerals) being a vegetarian or vegan. “If you are new to a vegan or vegetarian diet, or not sure if you’re getting all the nutrients you need, consider working with a registered dietitian who specializes in plant-based eating and who is at least eating disorder-informed,” Pruteanu says. “You may need to supplement certain micronutrients that aren’t easy to access through a vegan diet.” For example, you may need to add B12 and iron supplements into your routine.

Keep moral superiority out of it.

Being a vegan or vegetarian doesn’t make you a better person than someone who eats meat or animal products. Remember, it’s a part of who you are and one value in your life—not your entire life.

Ultimately, it’s your decision whether you will remain vegan or vegetarian long-term. “If you’re not sure whether the eating disorder was part of the choice in becoming vegan or vegetarian, find a supportive dietitian who is willing to explore this with you and approach this process without coercion or an expectation that you will or won’t change your mind,” Pruteanu encourages.

“You can work towards learning how to fuel your body fully, giving it enough nourishment to thrive, regaining freedom and flexibility and joy with eating—whether you are following a vegan or vegetarian diet or not.”

If you are concerned that your or your loved one’s vegan or vegetarian diet may be driven by an eating disorder, schedule a call with an Equip team member to talk through your concerns and explore treatment options.