I got the following comment on a post, and I woke up this morning realizing that by trying to be too kind in my response. I had done this women, her daughter, and any other readers an injustice.

Here was the original question:

My daughter is a vegan who is receiving treatment in an Eating Disorders facility. So far, I haven’t found one that will accept my 21 year old daughter into a program. They will not work with her vegan diet, yet strangely said they would if she were vegetarian (also a restrictive diet.) Tabitha, you mostly mention vegans with ED who obviously were not in it for truly ethical reasons, but who used it as a nice mask for their ED. I am sure you will agree that there are indeed those who truly have a moral objection to animal products. My daughter most certainly falls into that category. I actually do understand how a restrictive mindset can send some down the rabbit hole of ED. But to tell an ethical vegan she has to eat animal products is basically like telling her that she needs to sprout wings and fly. Ain’t gonna happen. To me, it seems ironic that most eating disorders clinic would rather turn away a person potentially close to death, rather than try to work with her diet. (Note: I even offered to step in and prepare healthy, “non-starvation” vegan food for her program, but they would not allow that.) One more thought: before my daughter and I became vegan, I most certainly felt that vegetarian and vegan diets were ridiculously restrictive — as do most, if not all, omnivores. But when you are on the other side, eating so much delicious food, you will never think of it as restrictive. I eat more variety now than I did as a SAD [standard American diet] eater. Tabitha: can you give me any direction re: how I can help my daughter if an eating disorders program is not available for her? Maybe a vegan nutritionist?

Here is my full answer to that question:

(I have removed the original comment from the blog it was on in order to protect this person’s identity)

I am going to assume that you love your daughter very much. I also have compassion for you and the fact that this illness will likely challenge your own ethical and moral standpoints. Please read every word here in the knowledge that all I ever want is to help people get into full recovery from Anorexia. I have no other agenda here. I have no personal objection to people being vegan if they do not have a mental illness that means that they should not. I want your daughter to be well and I want to help you get her there.

Okay so first off I will address the treatment facility part. It is no wonder that no treatment facility will accept a vegan and I am actually glad that this is the case for the sake of every other patient in there. A vegan diet is a restrictive diet if done for ethical reasons or otherwise. It could potentially damage patients who are struggling to eat to see one person allowed to be vegan. If that was an option for one, why not all?

I have thought hard about this and I can hand on heart say I do not know anyone who has reached full recovery and is vegan. Full recovery means spontaneously being able to stop and eat at Wendy’s without having a freak out. Full recovery is being relaxed about eating anywhere, anything, at any time. Full recovery is allowing other people to make food for you without worrying about what is in it. Full recovery is eating without rules. All these things are possible on a vegetarian diet for sure, but not on a vegan diet. Hence it doesn’t surprise me that I do not know a vegan who has made a full recovery from an eating disorder.

Anorexia never “goes away.” It is a mental illness and you daughter will always have it. Reaching full recovery only ever really means remission. Those of us who sustain full recovery do so by practicing non-restriction actively. Relapse thrives on complacency. As a fully recovered adult there is not a day that passes when I do not actively check myself. This is a part of my life as much as insulin is for someone with Type One Diabetes.

I have met people who have recovered “enough” but not all the way on a vegan diet. I was one myself for a short while. I wrote a post on what living semi recovered is like here. A half like is a special sort of purgatory. It is not what either of us want for your daughter.

Maybe the knowledge that recovery while on a vegan diet is not realistic is another reason why no treatment facility will accept her? Not only could doing so damage others, but they know that all will happen is that they will weight restore her and she will relapse as soon as she is out as the mental restriction will not have been touched. IP is only a first step in recovery, but if she cannot let go of her vegan diet when her life is at risk, when can she?

Another side to this is that if she is very underweight, your daughter’s body needs saturated fats. There is no amount of vegetables in the world that is going to help her body rebuild in the same way saturated animal fats will. Her poor tiny stomach needs food that it can digest very fast and easy and it can use to rebuild the damage that has been done by starvation. The professionals likely know this is the case. Hence another reason it would not be right for them to accept her.

Secondly I will address the assumption that my posts on vegans and eating disorders were about people who were not really ethical vegans. This is wrong. I actually assume that anyone — eating disorder or not — is vegan for ethical reasons. It makes no difference. If you have an eating disorder you cannot do it. It is a serious mental illness that feeds off food restriction. Additionally, I think that due to the manipulative nature of Anorexia and other eating disorders, nobody can ever truly know. Not the sufferer, and certainly not an outsider. Who am I or anyone else to judge a person’s motivations for being vegan? I’m not so I don’t try. And it doesn’t matter. An eating disorder can kill a person for being vegan regardless of the intention behind it.

Now let us look back at the original documentation we have for Anorexia: Anorexia Mirabilis.

Anorexia Mirabilis was the term used to describe the women in the middle ages who starved themselves to death in the name of god. Now, ask any one of these woman about their intentions? I think that their intentions were 100 percent solidly Christian in their minds. But they still died.

So when a person has Anorexia, intentions need not be considered too heavily. The outcome would be the same if your daughter was vegan due to “true moral objections” or otherwise. Not worth taking the risk, is it? We can argue about you daughter’s intentions until the cows come home, but this illness could kill her in the meantime.  Let’s focus on what is best for her — and that is not going to be the same as what she thinks is best for her right now. 

Now the part where you say that eating vegan is not as restrictive as eating the Standard American Diet. It interests me that many vegan people refer to the SAD as if it is a binary question. One either eats the SAD or one eats vegan. It is not. No matter what you buy, how creatively you cook, or where you live, it is not possible that by cutting out all products made with animal products that you have more choice then if you were able to eat a diet made with animal products as well as plant-based. Not possible. That is math.

All foods = 100%

All foods minus foods made from animal products = < 100%

There are ethical ways to eat animal products. When I made the decision to start eating eggs again I gave up my yard and turned it into a home for my free range chickens. I love their eggs, they are happy as clowns.

Not being vegan doesn’t mean that you HAVE to eat burgers from McDonalds every mealtime. But it might mean that you do it every now and then. It means that you have not closed your mind down to eating meat and animal products; and here is where the importance of not being vegan lies for a person with an eating disorder. In the mind.

Finally: I was vegan (and believe me, it was for ethical reasons,) but I realized that it was something I could not do due to the mental illness — Anorexia — that I have. I cannot imagine being able to come to that conclusion for myself if my family had been vegan. Nope. It would have been too hard.

I would never have been able to do it even when I knew that coming off my vegan diet was my only shot at full recovery. Luckily for me, I was married to a man who supported my decision to eat meat with him and encouraged it. Fighting my eating disorder’s attempts to tell me that what I was doing was wrong was hard enough. I would not have been able to get there if I had been surrounded with friends and family who were vegan too. That would have been like trying to overcome alcoholism while living in a pub.

I want finish with this simple truth: “What is more important to you?”

My intention here is not to question that you love your daughter. I know you love your daughter. I am trying to be as kind as I know how to be whilst still getting across the importance of this. I do not believe that your daughter can make a full recovery on a vegan diet. In order to get there, she will need as much help as she can get — and mostly yours.

Won’t you consider not being vegan along with her as she makes the recovery journey?

Surely, that would be the most powerful thing that you could do as her mother right now. Take the journey with her every step of the way. Eat her into health together. 

So what can you do? I would suggest coming away from the vegan diet now. Getting her into IP and backing the treatment team there up when they ask her to eat meat. Then, when she comes home, continue her care with family-based treatment at home. Eat non-vegan foods with her. Share this recovery journey with her.

With love, Tabs

 


New Online (Global) Meal Support Service

 

I am excited to announce that this week we launched Active Eating Disorder Recovery for Adults (AEDRA) Meal Support Service.

This is a worldwide service where any person can receive support at a mealtime to help overcome anxiety. We also have post meal support slots available for people who struggle with purging and post-meal anxiety. Binge Eating Disorder is also supported!

You can find out more about AEDRA here, and in the video below:

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