By Dr Tracie O’Keefe DCH, published in New Vegetarian & Natural Health, December 2001
Eating disorders come in five basic different forms: obesity, binge eating, guilty eaters, anorexia nervosa (self-starvation), and bulimia (overeating and then making yourself sick). Four of these behaviours are generally as common in the vegetarian and vegan population as with those who eat animal products.
Obesity is less likely to occur in vegetarians and vegans because the body is not having to try to metabolise all those polysaturated fats that are eaten by meat-eaters. However, there are overweight vegetarians and vegans who eat lots of breads, sugars, cakes, pastas, and processed foods, with many vegetarians also eating animal based foods such as milk or cheese. A study done at Leicester University in the UK watched the behaviour of obese people under laboratory conditions, and considered their perceptions of the amounts of food they were eating. What was learned was that the overweight people are not generally aware of what they are eating, the frequency with which they eat, or the amounts they are putting in their mouths out of their conscious awareness.
Binge eaters are very erratic in their eating habits. They will eat very little and then binge on all the very things that they perceive are fattening or bad for them to gain some kind of consolation and comfort for the time they had stopped themselves eating. They believe their eating has control over them and cannot perceive themselves having control over their eating.
Anorexics are literally starving themselves to death. They are not eating enough food to maintain health and wellbeing, often developing osteoporosis. They will come up with all sorts of theories, reasons or beliefs to other people as to why they should not eat but what is common among many of them is that they often get depressed. Phobias about food can be present and they can have a multitude of psychological problems going on in their heads that causes them to see themselves as overweight or fat, when they are actually emaciated and thin.
Bulimics may also have anorexia or they may maintain an average weight for their body type. What they do is eat large amounts of food at one sitting and then in order not to suffer weight gain they make themselves vomit by putting their fingers or even objects such as spoons down their throat. This constant vomiting can eventually lead to problems with the heart and swallowing reflexes.
Guilty eaters do not want other people to be aware of what they are eating and often eat in private, hiding the food wrapping in the bin, under the car seat, pillow or stashed under the laundry basket. They will constantly tell other people and themselves that they ought to be on a diet to lose weight. Food is not properly enjoyed and the guilty eater’s weight may fluctuate dramatically as they bounce back and forward between their perceived ideal weight and the weight they dread. If they are not yo-yo dieters, they often refuse food and go off and eat away from other people so no one can see them.
There are people who may have a biological disorder that causes them to constantly feel hungry and others may have an illness where they lose their appetite, but those with psychological eating disorders are, for the large part, imprisoned by their own faulty belief systems. Those faulty beliefs, values and attitudes towards eating can be caused by distressing dynamics within their family, sexual and emotional abuse, media hype about how thin equals fashionable, and the desire to gain some kind of control in their life, which manifests as the eating disorder.
Schools, however, must be held primarily responsible because they are teaching children about geography, war history, economics, maths and so on, but teaching them about nutrition is practically unheard of within the educational system. The one common factor that usually runs through all eating disorders is that the person may know the calorific value of everything but they do not know the basic knowledge about what are the good foods to put in your stomach.
For vegetarians and vegans with eating disorders, trying to get advice and care from an animal eater can often be a nightmare. I am sure we have all been told over the years how if we don’t eat creatures with a face and a central nervous system then we will become ill through malnutrition because of lack of protein, or if we don’t drink cow’s milk, we won’t get enough calcium and so on. That, of course, is not only simply not true, but the reverse is often the case, with animal products causing all sorts of health problems.
Professional help, however, is exactly what a person with an eating disorder needs. Vegetarians and vegans with an eating disorder not only need vegetarian and vegan nutritional advice, but they also need counselling and therapy to help them learn to work through any issues that may be disturbing to them, educate themselves about food’s nutritional value and learn to habitually feed themselves in healthy and wise ways.
Shane was basically living on boiled lentils and a few vegetables thrown in the pot for good luck. As a student she was terrified that if she went out and bought fresh food it would be too expensive and she would get deeper into debt and be unable to finish her medical degree. After a year she got so she would throw up if she tried to eat anything other than her now permanent meagre diet. Drained of energy, stressed and losing weight by the week, she began to faint so often in class that eventually the university told her to take a year off to get her health back in order.
She saw the professor of psychiatry at the university who wanted her to take Prozac for depression and consider ECT (Electro-Convulsive Therapy) to wipe out the memory of her recent past. Instead she came into therapy where I challenged her head on about her lack of understanding on nutrition and the validity of the nutritional advice they were teaching at the university she was attending. I did my best to make her as angry as possible during the initial sessions and many years of frustrated repressed feelings began to emerge and get dealt with, before she was able to face up to her responsibility for taking care of her own nutritional needs.
Thomas had always been the fat boy at school. At 19 he was around 160 kilos, had never had a girlfriend or even a sniff of a date. Everyone referred to him as Fat Tom and that had automatically become they way he introduced himself to other people. Because his best friend for the past 12 years had been his dog Buster and he had a great love of animals, he had not eaten meat or fish since he was 10. All day long he would eat cakes, pasta and pizza and when he plonked himself down in front of the television at night he would eat mashed potatoes, endless bags of sweets and crisps, and drink cola.
Just before his 20th birthday he found himself having to visit a sleep apnea clinic because he would stop breathing during his sleep due to his excess weight and its affect on his diaphragm and breathing reflex. This frightened him so much that he decided to seek professional help to get the confidence to go on a diet. However, I asked him to eat more than he was doing at that time, in order to lose weight. He was very confused but did his best to eat as much as I asked him. What I asked him to eat more of, on top of his normal diet, was fresh, raw fruit and vegetables. He also started to lift weights – very small ones at first – and then larger ones at a gym under the direction of fitness instructor.
The exercise and the gradual replacement of raw plant food in his diet where he used to each starch and processed fats, combined with the increasing exercise regime helped him to cut his weight in a year to 85 kilos, which is when he stopped weighing himself, because he was happy with his healthy size.
Being vegetarian or vegan alone does not mean that you will be well nourished.
Some clinics help people with eating disorders to gain or lose weight but the real need is to help people to take responsibility for looking after their body. Learning about taking care of yourself and the nutritional value of the food you place in your mouth are the fundamental building blocks to recovery from any eating disorder.
There is also a need to learn to focus your mind by using hypnosis, visualisation or active yogic meditation in order to install a healthier set of beliefs, values and attitudes towards yourself, food, and your body’s nutritional needs. Resolving the reasons why the eating disorders occurred in the first place during therapy is a very powerful way to be able to deal with unfinished business and move on to the next stage of your life.
No one who is vegetarian or vegan should fool themselves that just because they do not eat animal flesh or products that they are automatically exempt from eating disorders. The majority of people who seek professional help, when they have an eating disorder can recover and have a full and happy life, but there are people dying from eating disorders every week and some of them are vegetarians and vegans.
People can become so confused about the different kinds of eating advice given and books they have read that they get worried they are not eating correctly, so they literally focus on too narrow a range of foods and become nutritionally deficient. You can have malnutrition while weighing 200 kilos because you are not getting a natural balance of nature’s intended foods that give you the correct carbohydrates, fats, proteins, vitamins, minerals, enzymes and water content. It took nature millions of years to adapt our gastrointestinal systems and we need to know how to service them healthily every day, several times a day. If you learn to listen to your body you can hear that it is talking, so pay attention to what it is saying and you will live a long, healthy, and happy life.
Eating Disorders Support Group, QLD Tel (07) 4728 2399
Eating Disorders Support Network, NSW Tel (02) 9412 4499
Dr Tracie O’Keefe DCH, BHSc, ND, Clinical Hypnotherapist, Psychotherapist. Counsellor, PACFA registered Mental Health Professional and Naturopath In Sydney. You can get help by booking an appointment with her at Australian Health & Education Centre.