'Ethical Orthorexia', Veganism & Moral Rigidity In Eating Disorders

You are what you eat - or what you don't eat.

A phenomena I see over and over in eating disorders is what I’ve coined as ‘ethical orthorexia’: an excessive focus on eating and living in a way that individual deem as the most ethical and sustainable, and guilt for taking up resources. The most obvious manifestation is around food and food waste, but interestingly enough there tends to be a ‘spillover effect’ onto other arenas and resources. For example, the individual with ‘ethical orthorexia’ (from now one shortened to EO) may be obsessed with recycling, thrifting, saving electricity and using up every last bit of shampoo or toothpaste in the container before throwing it away. Additionally, I often observe a difficulty spending money and excessive focus on budgeting and bargains (I coined this ‘budget orthorexia’ in my group coaching programme as I like coining terms, but that’s for another post). EO is especially common in vegans (and some vegetarians) with eating disorders, although not present in absolutely everyone. More on that later in this post.

Notice I use the word excessive here. There’s nothing inherently wrong or disordered with buying your winter jacket second-hand or recycling plastic waste. EO is when the focus becomes excessive to the point where it negatively interferes with ones day-to-day life, relationship and physical or mental health, and when it is related to an eating disorder and the state of undernourishment (therefore may improve w/ recovery and consistent re-feeding). See? It does not refer to someone who’s just genuinely eco-conscious. This refers to a phenomena occurring in people in eating disorders who are not particularly eco-conscious to start with. EO is driven by guilt, anxiety and OCD-ED (eating disorder-induced obsessive compulsive disorder) rather than a love for our planet, although it might conceal itself as the latter. Of course there is nuance here. Someone might be genuinely eco-conscious, but the ED blows it up and turns it into something more sinister and destructive.

(Recycling: good. OE: not so good.)

EO is when you end up in a screaming match with your partner because they came home with non-organic pasta or threw their water bottle in the general waste bin. EO is spending hours researching the most ethical way to eat, and feeling crippling guilt if you don’t. EO is saying ‘no’ to lunch w/ friends because the cafe’s eggs aren’t organic, or endlessly researching the menu prior. EO is cutting up the toothpaste tub to squeeze out the last bit, followed up a quick and cold shower. EO is going into three different grocery shops to get the organic pasta, whilst feeling unbothered about your friend getting the regular one (or even triggered if they show the same behaviour as you, plot twist!). EO is walking around every thrift shop in town for a pair of jeans (and eventually giving up) instead of just buying a pair new, because why on earth would you deserve that? EO can lead to undernourishment, ruined relationships, isolation, anxiety, crippling guilt, time-consuming rituals and overall lots of bad stuff that does not really serve you or the planet at all. What it does serve is the eating disorder.

So why does this happen? I believe there are a few key factors:

1. The cognitive effects of undernourishment. Your brain detects there is a scarcity of food, thus translates this to there also being a scarcity of resources in general. It makes sense from an evolutionary point of view, and fits neatly into the ‘Adapted to flee famine’ hypothesis (Guisinger, 2003).

2. Low self-worth. People with eating disorders often feel like they do not deserve to take up time, space and resources. Heck, I will have paying clients apologising for asking me a question!

3. Justifying restriction. The eating disorder loves any kind of excuse to justify restriction, and turning down foods or events involving food. Turning down something in the name of ‘a greater good’ can be a more socially acceptable form of restriction. Not to mention the eating disorder loves to narrow down ones food selection.

4. Wanting to do/be good. Overlaps with the above. People w/ eating disorders often have guilt around food and eating, and want to do it ‘right’ as a way to ease that guilt. They are often terrified of doing anything ‘wrong’ in terms of food (ironic, considering the diagnostic criteria for an eating disorder is that how you ‘do food’ has gone so wrong it is considered a serious mental and medical illness)

5. Reduced cognitive flexibility, and increased moral rigidity. We know people w/ eating disorders tend to score lower in cognitive flexibility; the ability to see nuance and ‘the bigger picture’. Therefore, they may be prone to moral rigidity, which can manifest as seeing themselves and the world as exclusively ‘good’ or ‘bad’, with no in-between. No surprise people with eating disorders have a tendency to end up in certain not-so-great sections of online social justice communities. (Shoutout to Megan Jayne Crabbe for discussing not-so-great sections of online social justice communities here).

6. Overlap w/ classical orthorexia. Individuals with OE might falsely believe their restrictive way of eating and living is ‘healthier’ (often a euphemism for ‘prevents weight gain’), for example avoiding certain additives. Sometimes this blows into full-blown conspiracy thinking, e.g thinking ‘big food’ is deliberately out to make people sick, or an excessive focus on ‘living clean’ and ‘avoiding toxins’ (here is a recommended read on just that, from de-influencer Lee Tilghman).

(How to spot a ‘shockumentary’, by dietician and science communicator Leah McGrath, full article here)

If anyone reads this post and have any other theories or insights as to what drives OE, I’d love to hear in the comments below. Unfortunately, there is very little (as in, pretty much none) research onto this topic. I believe this boils down to the fact that these behaviours are often seen as ‘good’, therefore why bother? A therapist might see an empathetic, eco-conscious client, passionate about saving the animals and growing their own chives, and maybe even applaud this, because hey, shouldn’t we all? (See above as to why EO is not good, actually). We often see the same when it comes to classical orthorexia or excessive exercise, where it is unfortunately not pegged as problematic until it has gone very, very far. Additionally, the field of eating disorder research has the last five decades been more concerned about blaming mothers or demonising normal starvation responses instead (I’ll leave my man Ancel Keys out of this, though).

So where does veganism and vegetarianism play into this?

Veganism and vegetarianism often get a ‘free pass’ because ‘if it is ethical, it is OK’, despite the fact that it often will start during an eating disorder, and rates of veganism and vegetarianism being far more common in those with an eating disorder than those without. Here’s the thing: does it really matter? Most vegetarians and vegans I’ve spoken to or worked with have cited ethics as a main reason. Traditional treatment often just conclude they are lying, but I believe there is some truth to it. I just don’t believe that ethics is an immediate opt out of investigating further. Any kind of over-emphasis on eating ‘right’ to the point where it interferes with ones mental and physical health, and social functioning, should be investigated. And in the context of eating disorder recovery, even the more subtle limitations this way of eating pose is important to discuss.

I see EO in veganism and vegetarianism often, veganism more so than vegetarianism due to it being more restrictive (restrictive in this context referring to selection of foods rather than energetic intake - veganism does not always mean ‘eating less’). This does not mean that every person who is vegetarian or vegan has EO. That would be a rather dogmatic claim that would pathologize a large segment of the population. What I will say is that if this way of eating just so happened to coincide with an eating disorder - even if ‘ethically driven’ - it may be worth investigating what is underneath, and if this way of eating holds you back in terms of reaching full recovery. I have worked with numerous vegetarian and vegan client where we have investigated and explored this together (with different outcomes!), and find that this group (which is a lot of people w/ eating disorders) is open for this work if they do not feel demonised or like someone is trying to catch them lying or have a ‘gotcha’ moment.

It may not be entirely veganism’s ‘fault’ per se, but more so the fact that we live in a society where veganism, although becoming more mainstream, is not the norm, thus being vegan means difficulty engaging in free, social eating, which we know is crucial for full recovery. Grabbing ice cream on the beach w/ friends, travelling and trying the local cuisine, visiting your in-laws for Sunday roast - these are the kind of experiences that entail full recovery rather than ‘just’ quasi, and due to how society is structured, veganism can complicate this. Yes, it is possible to have vegan ice cream, finding vegan restaurants or get your in-laws to cook up some baked potatoes, but there’s always an element of enhanced planning, checking and food-focus involved that the ED loves, and oh my God, what if they baked the potatoes in ghee?!

Realistically speaking, being vegan will involve a lot of turning down food and food-involving experiences due to society’s non-veganism. Chances are that random beach hut ice cream shop have exactly two flavours - chocolate and vanilla - and chances are your boomer in-laws just discovered ghee is not vegan, and is now having a stressful last-minute trip to Sainsbury’s before closing. Maybe it’s not vegan food that is restrictive per se, but more so society’s lack thereof.

(Half-melted ice cream on the beach: what recovery dreams are made of)

Back to OE. This work - whether investigating vegetarianism, veganism or OE in general - can be complex, and it can be difficult to figure out where you end and the eating disorder begins. The way an eating disorder will merge with your identity is no joke. For example, someone may have built their social and personal identity on being ‘the vegan one’, or ‘the conscientious one who always recycles, budgets and makes sure not to waste electricity’.

The caveat with OE (and orthorexia in general) is that there is no such thing as the perfectly ethical diet. This is cause of great despair and crisis for the person in OE’s claws, who will quickly realise the game was rigged against them from the start, and that the participation trophy is nothing but guilt for not doing ‘enough’. Yes, you can swap the butter for avocado, but then you read about the dodginess of the avocado farming business and start to spiral. Similar to classic orthorexia and eating disorders in general, OE seeks to limit your intake and participation in life, not expand them. How can this co-exist with recovery, which is all about expansion, metaphorically (and some times literally)?

I don’t think it can, but I stand to be corrected.