"If There Are Restrictions Within the Restrictions, That's When You Can Probably Get Concerned": Key Indicators for Untying Vegetarianism and Veganism From Eating Disorder Pathology.

Objective: Changes in eating patterns and/or food exclusion strategies, including the uptake of vegetarianism and veganism, may reflect disordered behaviors and attitudes in people with eating disorders. For this reason, health professionals often attempt to assess whether a client's vegetarianism or veganism is tied to, or driven by, their eating disorder. Yet this may be difficult considering a lack of formally recognized guidelines for the treatment of vegetarians and vegans with an eating disorder, meaning that often a one-size-fits-all approach to treating these groups is employed. This study aimed to integrate lived eating disorder perspectives to qualitatively inform indicators of potential pathological vegetarian or vegan adherence in people with an eating disorder.

Methods: Seventeen participants (aged 19-48, 76% [n = 13] female, 47.06% [n = 8] vegetarian) with a history of receiving eating disorder treatment were recruited.

Results: Five themes were identified: (1) Timing matters, (2) Explore motivations for dietary adherence, (3) Fear reaction causes for concern, (4) Flexibility within vegetarianism or veganism, and (5) Hold space for eating disorder deception.

Conclusions: Our findings demonstrate several key indicators that may be useful areas of discussion in clinical practice when working with vegetarian and vegan clients. Being able to potentially quantify genuine vegetarian or vegan adherence from eating disorder-driven behaviors and attitudes provides a valuable stepping stone to the future development of clinical guidelines for the treatment of people adhering to these dietary groups.