Is vegetarianism among some teens possibly masking an eating disorder? When your teen says she wants to be a vegetarian, is it a red flag or any opportunity?
In a recent study published in the Journal of the American Dietetic Association, Dr. Robinson-O’Brien and colleagues examined the link between vegetarianism and a number of health indicators to help us better understand the benefits and risks of vegetarianism in young adults. The authors discussed how vegetarianism is associated with a number of benefits such as increased consumption of fruits and vegetable and lower caloric and energy intake. However, if not done properly, vegetarian diets may also lead to deficiencies in a number of nutrients. In addition, some studies have suggested that teens who have image problems and eating disorders may be more likely to turn to vegetarianism in order to lose weight.
Robinson-O’Brien, R., Perry, C., Wall, M., Story, M., & Neumark-Sztainer, D. (2009). Adolescent and Young Adult Vegetarianism: Better Dietary Intake and Weight Outcomes but Increased Risk of Disordered Eating Behaviors Journal of the American Dietetic Association, 109 (4), 648-655 DOI: 10.1016/j.jada.2008.12.014
In order to more carefully examine the possible risks and benefits of vegetarian diets in teenagers, the authors collected information from 2,516 teenagers (15 to 18) and young adults (19-23) regarding their eating habits, vegetarian status, weight, dietary quality, physical activity, binge eating practices, healthy and unhealthy weight control behaviors, and substance use.
The authors found that the rate of vegetarianism were relatively low. Only 4% of the teens and young adults stated that they were currently vegetarians, and 11% stated that they used to be vegetarians. Vegetarianism was associated with a number of benefits including:
- a lower body mass index;
- lower rates of obesity;
- higher consumption of fruits and vegetables and;
- lower consumption of calories from fat.
However, in the younger cohort, both current and former vegetarians were more likely to engage in more extreme unhealthy weight loss measures and binge eating. Specifically, 20% of current vegetarians and 21% of former vegetarians reported engaging in unhealthy weight loss behaviors, while only 10% of the never vegetarians reported unhealthy weight loss behaviors. Likewise, 21% of current, and 16% of the former vegetarians reported binge eating, while only 4% of the never vegetarians reported engaging in this behavior. Therefore, teen vegetarians were 2 times more likely to engage in unhealthy weight loss behaviors and up to 4 times more likely to engage in binge eating.
In the older group, 27% of former vegetarians reported using unhealthy weight loss measures, which compared to 16% of current vegetarians and 15% of never vegetarians. In addition, 18% of current vegetarians and 10% of former vegetarians engaged in binge eating, compared to only 5% of never vegetarians. Therefore, young adult vegetarians and former vegetarians were more likely to engage in binge eating than never vegetarians, but only the former vegetarians (not the current) were more likely to engage in unhealthy weight control measures.
The authors conclude that although there are some clear benefits of vegetarian diets, in some teenagers and young adults vegetarianism may actually be masking eating problems.
Study results indicate that it would be beneficial for clinicians to ask adolescents and young adults about their current and former vegetarian status when assessing risk for disordered eating behaviors. Furthermore, when guiding adolescent and young adult vegetarians in proper nutrition and meal planning (31), it may also be important to investigate an individual’s motives for choosing a vegetarian diet.
Thus an important issue for parents encountering a teen who wants to become a vegetarian is “why.” It seems less likely (although possible) that vegetarianism is masking an eating disorder in a politically active teen who decides to become vegetarian for well presented philosophical issues related to healthy diets and/or animal rights. However, it would be more concerning if a non-politically active teen with a history of unhealthy eating habits and self-image struggles suddenly decides to become a vegetarian as a form of weight control. Now, this is not necessarily bad, since one could argue that going on a vegetarian diet is a healthy weight loss alternative – one that may actually prevent these kids from engaging in even more unhealthy eating behaviors. However, the danger is that poor vegetarian diets may further compromise the child’s health, especially among adolescents already experiencing nutrient deficiencies due to unhealthy eating habits. Thus the answer may not be to keep your child from starting a vegetarian diet, but instead to make sure that such a diet is carefully monitored, so that the child does not experience further nutrient deficiencies.
Finally, please note that the authors never actually assessed for eating disorders. They assessed unhealthy eating and weigh loss behaviors, which are usually associated with underlying eating disorders. Therefore, contrary to some news reports about this study, this study does not show that vegetarian teens are more likely to have eating disorders than non-vegetarian teens. Instead the data show that vegetarian teens are more likely to engage in unhealthy behaviors that are often associated with eating disorders.
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