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First No Meat, Then You Don’t Eat
8 December 2010
Though once looked down upon as an absurd and problematic diet, recent trends have shown an increase in the acceptance and popularity of vegetarianism. In fact, current research supports the idea that if practiced correctly, vegetarianism may provide an even healthier lifestyle than the typical carnivorous diet. Generally defined as excluding all meat consumption, vegetarianism encompasses a variety of eating behaviors and must be broken down into more specific sub-types. These sub-types range from extremely restrictive to relatively lenient in terms of meat exclusion. The most restrictive sub-type, veganism, eliminates the consumption of all types of animal products, including eggs, dairy, and processed foods containing animal-derived ingredients. A somewhat less restrictive practice, lacto-ovo-vegetarianism, allows for the intake of eggs and dairy but eliminates beef, poultry, fish, and any other types of animal flesh; generally, this is the sub-type that most people associate with the term vegetarian. Flexitarian, or semi-vegetarians, are the least restrictive type and apply to people who usually maintain a meat-free diet, consuming mostly fruits and vegetables, but occasionally indulge in a fleshy meal. Other sub-types exist within this basic range, however these three classifications include the majority of self- proclaimed vegetarians (http://vegetarian.about.com/od/vegetarianvegan101/tp/TypesofVeg.htm).
According to a 2010 Vegetarian Times study, 7.3 million Americans maintain a vegetarian diet, this number includes both lacto-ovo and vegan sub-types. Additionally, 22.8 million adults follow a vegetarian inclined diet; this number represents the flexitarian population (http://www.vegetariantimes.com/features/archive_of_editorial/667). Statistics of total numbers of vegetarians worldwide are ambiguous and varying, however one thing is certain: vegetarianism is on the rise. Recent reports in the United States suggest the following trends in vegetarianism: this group has the potential to grow nearly six times its current size, more women than men engage in this type of restrictive lifestyle, and younger age-groups are more likely to practice vegetarianism (http://www.researchandmarkets.com/reportinfo.asp?report_id=614204&t=e&cat_id). The potential growth of the vegetarian population has initiated further examination of the benefits and detriments of this dietary behavior. Many studies have found vegetarians to have lower BMIs, as a result of generally lower fat intake (25% less than meat-eaters), lower levels of cholesterol, and lower incidence of disease, (certain cancers and cardiovascular disease), as well as an overall longer life expectancy (http://www.benefitsofvegetarianism.com/).
On the other hand, vegetarianism has been associated with deficiencies in essential vitamins and minerals such as calcium, zinc, and iron. Additionally it has been linked to more severe outcomes such as eating disorders. In fact, multiple studies have found the eating disorder population to be comprised of higher percentages of vegetarians than non-clinical samples. O’Connor, Touyz Dunn & Beumont (1988), discovered that in their sample of 116 anorexics, 63, more than half, avoided eating red meat; of these 63 self-denoted vegetarians, only four followed this dietary practice prior to the onset of their eating disorder. This finding, the restrictive nature of vegetarianism as well as the population it seems to affect most (young women), has created an interest in the connection between maintaining a vegetarian lifestyle and the emergence of eating disorders. This paper will review the reasoning behind choosing vegetarianism while also discussing various behaviors in vegetarian and nonvegetarian populations in order to evaluate this seemingly complex relationship.
Vegetarianism: A lifestyle change for weight loss?
Vegetarian food patterns are becoming increasingly popular among adolescents, especially women; the recent rise in this trend and findings that confirm higher prevalence of vegetarianism in eating disorder populations, creates concern as to why more people are choosing this lifestyle. While many choose health reasons as their motivation to be meat-free, many studies attest that a significant portion of vegetarians select their restriction of meat consumption as a method of weight loss or control. The implications of these findings are severe as they indicate a relationship between vegetarianism and eating disorders. In study a study by Baş, Karabudak, & Kiziltan (2005), participants who labeled themselves vegetarians were asked their reasoning behind this decision; 9.6% selected weight control as their principle motivation. However, further studies such as the one conducted by Klopp, Heiss, and Smith (2003) found that 18.8% of their vegetarian population chose weight loss as their purpose for maintaining a meat-free diet; Gilbody, Kirk, & Hill (1999) found that 25% of its vegetarian sample selected this reasoning. Additionally, a study by Robinson-O’Brien, Perry, Wall, Story, & Neumark-Sztainer (2009) concluded that 17% of current vegetarians chose this lifestyle in order to lose weight or keep from gaining weight. Worsely & Skrzypiec (1998) recognized an association between the desire for thinness and selecting a vegetarian diet, concluding that teenage vegetarians are more likely to be concerned with obtaining a slim physique when compared to nonvegetarians. Though disparities exist (likely due to varying samples and definitions of vegetarianism) in the numbers of vegetarians choosing weight control as their purpose for abstaining from meat, these results indicate that many people select a flesh-free diet based on some of the same mentalities and anxieties that lead to eating disorders.
Comparing Vegetarian and Nonvegetarian Populations
Bas et al., (2005), examined eating attitudes in vegetarian and nonvegetarian Turkish adolescents aged 17-21, to determine if differences exist within the two groups. Using a sample of 1,205 adolescents from four universities in Ankara, the researchers conducted a series of face-to-face interviews over a 6-month period to obtain their data. After defining oneself as vegetarian or non-vegetarian, each participant responded to the Eating Attitudes Test (EAT-26), a commonly used self-report that determines eating disorder tendencies. The three factors used to score this test include: dieting (degree of avoiding fattening foods and preoccupation with thinness), bulimia and preoccupation with food, and oral control (degree of self-control around food.) In this study, scores for this assessment were based on a scale of 0-53, with a score of 20 or above, designating a participant as having “abnormal eating behavior” (Bas et al., 2005). Out of the 31 participants who defined themselves as vegetarian, 14 individuals, (45%), scored greater than 20 on the EAT-26 assessment and were labeled as having “disturbed eating behaviors.”
Klopp, et al., (2003) implemented similar methods to measure eating attitudes in a population of 143 college-aged women. This study used 30 as the cut-off point for indicating risk for disordered eating on the EAT assessment and found that within the sample of self-reported vegetarians, 38% scored in this range, as compared to only 8% of the nonvegetarian sample. This variance in cut-off point likely accounts for the discrepancy between these results and those of the previously described study. The specific test items that showed the largest response variance between the two groups reveals an increased likelihood of eating disorder behavior in vegetarians; such items include: feeling extremely guilty after eating, constant preoccupation with the desire to be thinner, weighing oneself several times a day, and exercising strenuously to burn off calories (Klopp, et al., 2003). The findings of these two studies support the idea that compared to meat-eaters, vegetarians maintain an increased risk for weight preoccupation and thus, a higher likelihood of developing eating disorders.
Disordered Eating Patterns
In a study of a school-based Minnesotan population, Neumark-Sztainer, Story, Resnick & Blum (1997) compared vegetarian and nonvegetarian groups to determine if differences exist in the prevalence of disordered eating patterns. Their sample included 107 vegetarian adolescents who ranged in age from 12 to 20 years, as well as a control group of 214 nonvegetarians who were matched for age, sex and ethnicity. Through surveys and questionnaires researchers assessed general eating behaviors (vegetarian vs. nonvegetarian diets) and disordered eating behaviors (frequency of dieting, binge-eating, laxative use, etc). Additionally, respondents were asked questions indicating if they practiced behaviors characteristic of bulimia nervosa. These questions included, “Have you ever eaten so much food in a short period that you felt out of control and would be embarrassed if others saw you?”, “ How often do you vomit on purpose after eating?”, and “ Do you use any of the following to lose weight: Laxatives, ipecac, or diuretics?” (Neumark-Sztainer et al., 1997).
The results of this study revealed that higher percentages of vegetarians than nonvegetarians engaged in disordered eating behaviors. Vegetarians were almost twice as likely to report frequent dieting, four times as likely to practice self-induced vomiting, and eight times as likely to use laxatives than nonvegetarians. Further studies have found similar results by assessing disordered eating behavior through measurements of binge-eating and weight-control behaviors in current and former vegetarians. Higher percentages of former vegetarians reported engaging in more extreme un-healthful weight control behaviors, such as taking diet pills, laxatives and/or diuretics or inducing self-purging. 20% of the vegetarian population, compared to 4% of the nonvegetarian sample reported binge eating with loss of control (Robinson-O’Brien et al., 2009). This finding may be attributed to the fact that in restricting their diets, vegetarians have an increased awareness in their food intake, which leads to a greater chance of feeling out of control when eating.
Patterns of Restrained Eating and Dieting Behaviors
Other researchers have examined the relationship between concern with weight and vegetarianism through application of dietary restraint questionnaires. Martins and Pliner (1999) distributed the restraint subscale of the Three Factor Eating Questionnaire, which evaluates conscious effort to restrict food intake, among a population of 227 individuals ranging in age from 14-45. As a result of measuring degree of vegetarianism (differentiating between semi-vegetarians and full vegetarians), as well as dietary restraint, the researchers found a positive correlation between higher or more restrictive degrees of vegetarianism and conscious control of eating behavior. A study by Gilbody et al., (1999) confirms this finding as its results display significantly higher dietary restraint scores among vegetarians. Furthermore, Janelle & Barr (1995) assessed dieting behaviors and found vegetarians to score higher on restraint scales of the Three Factor Eating Questionnaire, again validating this association. The implication of these findings suggests that vegetarian ideals, such as restricting meat intake, may be applied across all categories of food, thus increasing the potential for eating disorders to emerge.
Worsely, & Skryzpiec (1997) further studied this relationship in vegetarian and nonvegetarian populations by concentrating on the influence of social ideologies, specifically the social and fashion motives for loosing weight, increased interest in body appearance and influence of the media. To examine the function of these three factors in vegetarian food patterns, the researchers used the Three-Factor Eating and the Body Weight Control Questionnaires, The Food, Fitness, and Looks Questionnaire, as well as an interview that assessed the role of television in each participant’s life. Results of these questionnaires found higher restraint scores and more extreme dieting behaviors in vegetarians as well as a higher concern in body image as compared to their nonvegetarian equivalents. Additionally, participants’ responses to the media-related interviews suggest that vegetarians use the media as a reference for their ideal appearance more often than meat-eaters. By focusing on social influences of dietary restraint, the findings of previously described studies can be further expanded upon and generalized.
Taken as a whole, research on the basis for selecting a meat-free diet, as well as studies comparing vegetarian and nonvegetarian populations in terms of eating attitudes, disordered eating patterns and dietary restraint scores, indicate a definite relationship between abstaining from meat and displaying typical eating disorder symptoms. Further studies should evaluate motivation for choosing vegetarianism in a broad-based sample of adolescent girls since this group has been determined to have a higher likelihood of developing eating disorders. Furthermore, studies of this type should compare results between a preadolescent and older adult populations in order to determine if age of vegetarian onset is a factor that influences reasoning for choosing this type of diet. Though limited in its scope of generalization, the previously reviewed literature suggests that many adolescents may use vegetarianism to conceal eating disorder behaviors and symptoms. Vegetarianism is seen as a socially acceptable type of dietary restriction; therefore many adolescents may resort to this lifestyle in order to escape family or peer criticism and/or intervention for their eating disorder. Additionally, parents of young vegetarians must be cautious of their child’s intentions in seeking this lifestyle change. Being educated about the negative outcomes associated with vegetarianism can prevent full-fledged eating disorders from developing. Though evidence supports a relationship between vegetarianism and eating disorders, it is possible to maintain a meat-free diet and experience a physically and psychologically healthy life.
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