Are Vegetarians at Risk for Eating Disorders?

Are Vegetarians at Risk for Eating Disorders?
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Who has the healthiest thoughts, attitudes, and habits regarding food?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

At the turn of the century, if you would have asked teens why they chose to eat vegetarian, most might say they do it because they don’t want to kill animals, followed by wanting to eat a healthier diet. More recently, “to help the environment” became a leading reason among young people, followed by eating healthier, and then animals. A smaller fraction gave weight loss as a reason. Yeah, they might think it’s healthier, and care about animals and the environment, but they also might be doing it for weight-loss reasons. Yes, we’re in the midst of an “obesity epidemic,” but there’s also been a rise in eating disorders. Might vegetarianism be a red flag for the presence of an eating disorder?

A survey of adolescent and young adult vegetarians found they tended to eat better and have healthier body weights, but those who ate vegetarian were also more likely to report eating disorder-type behaviors. “It’s important, however,” commentators were quick to point out, “not to suggest that vegetarian diets cause eating disorders.” When people start eating more plant-based, their risk for chronic diseases goes down, not up. Maybe it’s the “children who have not yet adopted a vegetarian diet who require [our] special attention, as they have poorer diets and are at significantly higher risk for obesity.”

To which the authors responded, yes, they “agree that vegetarianism does not cause eating disorders”; they’re just saying that one should explore with them why they’re doing it. “While it is important to recognize the potential health benefits, it is also important to investigate a teen’s motives for adopting a vegetarian diet.” See, “studies have shown that adolescents who have symptoms of eating disorders may [then go on to] adopt a vegetarian diet as a weight-loss method, as a socially acceptable way of avoiding eating.” So, rather than an increased prevalence of eating disorders among those who eat vegetarian, there may be an “increased prevalence of vegetarianism” among those with eating disorders.

See, the study was just a snapshot in time; so, they couldn’t tell which came first. Might eating vegetarian just be “a way to disguise food restriction during the early stages of an eating disorder? Or does experience with vegetarianism increase vulnerability for the development of eating disorders in the first place?” To answer the question, you need to know which came first. And, in most cases, eating vegetarian came at least a year after the first eating-disorder symptoms. Similarly, in a series of anorexics, in fewer than 1 in 10 “did meat avoidance predate the onset of their [disease].”

It’s this kind of data that led the Academy of Nutrition and Dietetics to conclude that “prior use of a vegetarian or vegan diet does not appear to increase the risk of an eating disorder.” In fact, they may have even lower dietary restraint scores. “Dietary restraint represents the conscious limitation of food intake,” the perception of constantly having to limit food intake “to prevent weight gain.” Perhaps the reason vegetarian women exhibited less restrained eating is because they really didn’t need to worry as much, because plant foods are just calorically less dense. “This could translate into less concern or stress [when it comes to] eating,” which may, in turn, help explain why they saw fewer ovulatory disturbances among women eating vegetarian. In fact, maybe that’s one of the reasons vegans report less stress and anxiety. Perhaps one of the reasons increasingly restricting animal foods is associated with better mood is that vegans reported dieting significantly less, and that’s one of the things that seems to be stressing women out.

And vegans and true vegetarians didn’t just have significantly lower levels of restrained eating, but also less emotional eating, less compulsive eating, and “greater levels of acceptance in relation to food.” “This highlights previously unacknowledged positive aspects of adhering to a completely meat or animal product free diet” when it comes to thinking about food—though we don’t know if this actually translates into protection “against developing disordered eating.” “Vegans appear to have the healthiest attitudes towards food, closely followed by vegetarians.”

But no one had actually taken a large sample of vegans and just put them through the EDE-Q, which is one of the most widely used diagnostic tools…until now. “[T]he first large sample of vegans to complete the [official Eating Disorder Examination Questionnaire]. And…vegans scored significantly lower, significantly better, consistent with the data showing vegans tended to diet less frequently. “Taken together, these findings suggest that vegans and omnivores don’t differ markedly in reported eating attitudes and behaviors, and when they do, vegans appear to endorse overall healthier thoughts and habits.”

Please consider volunteering to help out on the site.

Image credit: iprachenko via Adobe Stock Photos. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

At the turn of the century, if you would have asked teens why they chose to eat vegetarian, most might say they do it because they don’t want to kill animals, followed by wanting to eat a healthier diet. More recently, “to help the environment” became a leading reason among young people, followed by eating healthier, and then animals. A smaller fraction gave weight loss as a reason. Yeah, they might think it’s healthier, and care about animals and the environment, but they also might be doing it for weight-loss reasons. Yes, we’re in the midst of an “obesity epidemic,” but there’s also been a rise in eating disorders. Might vegetarianism be a red flag for the presence of an eating disorder?

A survey of adolescent and young adult vegetarians found they tended to eat better and have healthier body weights, but those who ate vegetarian were also more likely to report eating disorder-type behaviors. “It’s important, however,” commentators were quick to point out, “not to suggest that vegetarian diets cause eating disorders.” When people start eating more plant-based, their risk for chronic diseases goes down, not up. Maybe it’s the “children who have not yet adopted a vegetarian diet who require [our] special attention, as they have poorer diets and are at significantly higher risk for obesity.”

To which the authors responded, yes, they “agree that vegetarianism does not cause eating disorders”; they’re just saying that one should explore with them why they’re doing it. “While it is important to recognize the potential health benefits, it is also important to investigate a teen’s motives for adopting a vegetarian diet.” See, “studies have shown that adolescents who have symptoms of eating disorders may [then go on to] adopt a vegetarian diet as a weight-loss method, as a socially acceptable way of avoiding eating.” So, rather than an increased prevalence of eating disorders among those who eat vegetarian, there may be an “increased prevalence of vegetarianism” among those with eating disorders.

See, the study was just a snapshot in time; so, they couldn’t tell which came first. Might eating vegetarian just be “a way to disguise food restriction during the early stages of an eating disorder? Or does experience with vegetarianism increase vulnerability for the development of eating disorders in the first place?” To answer the question, you need to know which came first. And, in most cases, eating vegetarian came at least a year after the first eating-disorder symptoms. Similarly, in a series of anorexics, in fewer than 1 in 10 “did meat avoidance predate the onset of their [disease].”

It’s this kind of data that led the Academy of Nutrition and Dietetics to conclude that “prior use of a vegetarian or vegan diet does not appear to increase the risk of an eating disorder.” In fact, they may have even lower dietary restraint scores. “Dietary restraint represents the conscious limitation of food intake,” the perception of constantly having to limit food intake “to prevent weight gain.” Perhaps the reason vegetarian women exhibited less restrained eating is because they really didn’t need to worry as much, because plant foods are just calorically less dense. “This could translate into less concern or stress [when it comes to] eating,” which may, in turn, help explain why they saw fewer ovulatory disturbances among women eating vegetarian. In fact, maybe that’s one of the reasons vegans report less stress and anxiety. Perhaps one of the reasons increasingly restricting animal foods is associated with better mood is that vegans reported dieting significantly less, and that’s one of the things that seems to be stressing women out.

And vegans and true vegetarians didn’t just have significantly lower levels of restrained eating, but also less emotional eating, less compulsive eating, and “greater levels of acceptance in relation to food.” “This highlights previously unacknowledged positive aspects of adhering to a completely meat or animal product free diet” when it comes to thinking about food—though we don’t know if this actually translates into protection “against developing disordered eating.” “Vegans appear to have the healthiest attitudes towards food, closely followed by vegetarians.”

But no one had actually taken a large sample of vegans and just put them through the EDE-Q, which is one of the most widely used diagnostic tools…until now. “[T]he first large sample of vegans to complete the [official Eating Disorder Examination Questionnaire]. And…vegans scored significantly lower, significantly better, consistent with the data showing vegans tended to diet less frequently. “Taken together, these findings suggest that vegans and omnivores don’t differ markedly in reported eating attitudes and behaviors, and when they do, vegans appear to endorse overall healthier thoughts and habits.”

Please consider volunteering to help out on the site.

Image credit: iprachenko via Adobe Stock Photos. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

What about so-called “orthorexia”? I’ve got a whole series of videos coming about that—stay tuned!

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114 responses to “Are Vegetarians at Risk for Eating Disorders?

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  1. I assume by “vegetarian” you mean strict vegetarian — no animal foods whatsoever. As opposed to those calling themselves lacto-ovo vegetarians, for instance.

    1. Some people believe that veganism and vegetarianism ARE eating disorders…

      Of course, I have my own biases. I believe that anyone who would eat at a corporate fast food establishment OR is eating the SAD diet has an eating disorder so there’s that.

      1. Good point, Joe Caner. Also considering the fact that processed foods are made to be addictive, we can assume that processed foods can cause eating disorders.

      2. Lol, Joe. And you know they’re the ones who ask that stupid question, “Where do you get your protein?”

        As soon as I hear that, I know the person doesn’t have a clue about healthy eating & are drinking the industry’s kool aid, which may act a little slower than the Jonestown stuff.

        1. WFPB Nancy,

          Rich Roll, an ultra athlete, talks about how, when he was hopelessly addicted to alcohol nobody said anything about that, but when he went for whole plant foods only, everybody was asking where he got protein!

      3. Agreed, Joe! I think it’s safe to call eating a diet that is unnatural to our physiology and known to be harmful, an eating disorder. But the world is mad… Introduce a bit of that kind of logic and their heads just spin.

    2. I agree with Joe Caner’s comment. When I first watched the video, I thought to myself “they have it backwards”. The people that eat meat, eggs and dairy are the ones with the “eating disorder”! The vegans are the ones eating a diet more in line with human physiology. That is, if you exclude the “vegan junk food”, of course. ( I like to make the distinction between vegan and a WPF diet.)

      1. Phrases like “more in line with human physiology” make me uncomfortable, which is why Dr. Greger’s evidence based approach is so appealing. Beneficial eating habits do not require justification with untestable statements.

          1. .
            @Rebecca Cody 190211-5:31p–
            Thank you for the link to Dr. Mills’ discussion about the diet for which humans seem designed. The video is very effective, and the narrative– though less focused on research than anecdotes about Dr. Mills’ patients– is very compelling.

            Interestingly, and without missing a beat, it was followed by Dr. Greger’s annual research summary (to a live audience) on “Uprooting the Leading Causes of Death”. Sympatico.

    3. The older term of vegetarian was almost certainly plants and products made from milk. It generally happens later where people want to shortcut a lifestyle, and start drifting from the original ideal, i.e. start including dead animals: eggs, fish, chicken. Everything seems to work that way, harder drugs will follow pot, over time TV slowly lost all resemblance of decency, etc..

      By the way who pays for all these studies? Until this site came about, I would rarely to never even hear about the science? Does the government pay for it, or a university and then promptly ignore all the findings? What is the point of doing studies, when they just get ignored anyway.

      1. “Harder drugs will follow pot . . .”

        Drug overdose deaths involving prescription opioids rose from 3,442 in 1999 to 17,029 in 2017. Thus it is more accurate to say “Harder drugs will follow a visit to the doctor . . .”

        To plagiarize Hippocrates: “Let Food Be Thy Medicine”

        1. Navy Corpsman, a few years ago an EMT gave one of my family members Fentanyl for a broken bone. After that the doctors & nurses kept pushing oxycodone.

          Fortunately my family member did not become addicted & refused the oxycodone. But I could see how easily it could happen.

          1. We were just talking about that fear today.

            My brother is scheduled for surgery this week and he was talking about not wanting pain meds.

            My uncle became an addict or showed dependency – but he went on Morphine for his pain and it never produced addiction type responses in him.

    4. You might want to wait to read this until you are settled in for a bit of reading material, YR!

      I would assume so too. But it seems reasonable to guess that there are many more similarities between modified/semi-vegetarians and strict vegetarians than between the former and non-vegetarians.

      I’m actually not prone to disordered eating, but the mysterious fatigue definitely continues. I learned last week that at least so far, my bicuspid valve is not causing any of the typical related heart complications. (Hmmm, could the plant-based diet be helping?) I don’t fit the typical profile of people with this. The cardiologist said I should look elsewhere for the cause of my fatigue.

      Back to the old drawing board! And the prospect that I might possibly feel better on a modified/semi-vegan/vegetarian diet as opposed to my vegan and predominantly WFPB one. But my instincts are increasingly telling me that this probably is not diet related. I’m not ready to jump onto a test trial of that just yet. You might ask why, and I honestly don’t have a concrete answer. I am relying on the old instincts here too. I totally bought into the model of a vegan diet being highly beneficial for helping to keep cancer (prostate in particular for me) under control. Could it be that I just don’t want to be wrong about that? I don’t really think so, but maybe. Veganism for cancer patients is controversial for sure, but my assessment is that the opposite school of thought is most likely wrong. The thing is that there are an infinite number of shades of gray in between.

      I keep coming back to wondering if the fatigue is Lyme. I live in one of the hotbeds for it. My mainstream test for it was negative, but some insist that it is notorious for false negatives. I had set up a free consultation with a “Lyme literate” naturopathic practice in my region, but I backed out in part because mainstream medicine considers these alternative Lyme treatment places total quackery. They argue that chronic Lyme does not exist, even though they do think a post-Lyme syndrome occurs in I think about 20% of cases. Their contention is that lingering symptoms do not respond to any known treatment after the actual Lyme is killed off. Not a great reality to have to face, but oh well, if it IS the reality. The alternative people say that the Lyme bacteria was never eradicated in the first place.

      What actually steered me away more than anything is that these types of practitioners sometimes recommend the blood-type diet for chronic Lyme treatment. Sure enough, in scanning this clinic’s website, they do too. Seems like you may have mentioned it a time or two questioning whether it might be plausible, YR. I just can’t get on board with it myself. I am the same blood type as you, by the way, and would never consider consuming even a small amount of animal organ meats! So, that’s got me wondering if these Lyme literate places really are quacks…or misguided.

      These types of treatment centers seem to rely solely on case histories as their evidence. That’s not good quality evidence. Yeah, I’m one of those that wants the science backing. But until actually disproven by science, I like to keep an open mind about some things. Using lack of evidence to refute something is not nearly as definitive as direct evidence that something does not work. But the burden of proof is on the proponents, and in a lot of cases, it is totally lacking. In the case of the blood-type diet, there appears to be evidence that Dr. D’Adomo uses intentionally misleading tactics to promote it. See Dr. Greger’s video on it for more detail. Also, on Dr. D’Adomo’s website, see his rebuttal of Dr. Greger’s critique. I found his rebuttal to be a poor argument overall. I can find links for anyone that would like them.

      I’m not as self-absorbed as I may seem lately LOL! But I do think some of my experiences are probably common enough that telling about them might help somebody else.

      1. I have had a concern about lyme disease and really perk up my ears when someone reputable talks about it. I have thought seriously about trying allicin for it. But haven’t yet. It is an otc so you can try it yourself.
        “Natural garlic, eaten raw or in supplement form, is typically too weak to elicit real benefit in Lyme. Hence, many people give up on garlic. However, when the derivative of garlic is used, known as “allicin,” the supplement is much stronger and some people say 100 times stronger. So, Lyme sufferers may wish to give it a try. Strong herxing may result so be careful.”

        1. Thanks, cp. It seems that the challenge with allicin supplementation is in getting it stabilized enough so that it isn’t destroyed before the body has a chance to use it. My understanding is that there really isn’t any known way to effectively do that, even though there are supplements that are marketed as being able to.

      2. Scott, your experiences are powerful!

        Thank you for sharing.

        The woman who wrote about people who get healed from Cancer said that the ones who do follow their own intuition. That was one of the top factors. Take your time. If you don’t feel comfortable, slow down.

        When you said the sentence that the sites rely on histories, that rang a gonging cymbal in my brain.

        Yes. Histories are harder to argue against.

        1. Thanks for the vote of confidence, Deb.

          One thing I’ve learned is that as hard as it is to exercise with such unrelenting fatigue, doing so (brisk walking) is helping to treat it. It’s not a complete answer, but it definitely helps.

          I am so pleased to know your dog is hanging in there. It sounds like you have a well deserved reputation as a healer! Warm thoughts and best wishes go out to your brother.

          1. Scott,

            Thank you!

            Laughing at the reputation thing. I have walked through on the Internet and I have gotten rid of symptoms of so many diseases and so much of it was accomplished while I had brain problems.

            I wrote to you out of genuine experience. Cancer healing things like blood root and apricot seeds and CBD oil and Budwig Protocol would be things with histories which I paused at with little flashing alarms in my head, but tempted.

            Everything which I had the red flashing internal alarms over have been things I should have paused at and the good news is that other solutions came up and eventually Dr Greger did videos on each of the things and I no longer feel such confusion.

            You talk about exhaustion and my cousin had mono when he was younger and had something as an adult related to that, boy, I can’t remember the name, but it caused me to look at the Lyme Disease community information. I had the same flashing warnings about that.

            Anyway, whatever the name of what he had, it was related to mono but affected his body differently and it came and knocked him out for months, then went away on its own.

            1. My cousin had Guillame-Barre and it took him a few months of feeling weak before figuring it out.

              Looking it up tonight, that has bio markers of myelin sheath breakdown. If he gets it again, I will be looking up Dr Swank videos.

              1. What I have seen with Lyme is doing things to heal the gut lining and eating to build the immune system.

                Dr Greger has good foods to help the Immune system. Broccoli, blueberries, cardamom, mushrooms, etc.

                Healing the gut lining, it is eat a wide variety of organic fruits and vegetables, cut out things which destroy it in the first place and I think cabbage juice and eat broccoli sprouts were 2 things I remember. It was a long time ago, but that is what I remember.

                There are autoimmune diets, but I look at MS as an autoimmune condition and Dr Swank accomplished so much simply lowering saturated fats.

                As far as taking antibiotics or natural antibiotics, one theory I heard was that it could make it worse because of how it affects the gut microbiome. I think that was Dr Axe, who I don’t agree with about everything, but good gut bacteria seems seriously important.

                Start hanging out with vegans to see if you can share some good Microbiome.

                1. Water fasting and fecal transplants are two things that jump into my mind.

                  Not sure they have connected the dots to Lyme, but if I had more cell data minutes I would look those up for you.

                  1. Also, it seems like Modified Citrus Pectin research on Galectin-3 had Lyme references.

                    Not sure, but seems like Pectasol might be a place to look.

                    1. I actually have some Pectasol too, Deb! There were some possible indications I read about that it might be helpful with prostate cancer. My PSA may have reached its nadir sooner and higher than anticipated, so that has raised a bit of measured concern. That’s what motivated me to get some.
                      I sometimes feel like my life gets extended 6 months at a time, since that’s how often I get a PSA test! Pectasol is very expensive stuff, so it would not be sustainable for me as a maintenance supplement. It’s also hard to tell whether it’s doing good. That’s true of a lot of supplements, I think.

                      I have a hard time getting on board with treating for a condition that cannot be definitively diagnosed; and then if there is a response, making the diagnosis after the fact. I know it sometimes is used successfully, however. The first part of that is commonly used for Lyme in the alternative realm, but the various treatments seem to be so loosely indicated that there are no consistently expected responses. I’d hate to get into a false diagnosis trap. That could easily cause one to stop looking for the real cause. And that quest might be critically important too. My guess is that there are every bit as many false positives for Lyme as there are false negatives.

                      One can’t really go wrong eating various good quality fresh fruits and vegetables, since that’s good across the board. There is always room for improvement with that for me, but that kind of treatment advice is easy to accept and try.

                      These various auto-immune conditions and reactions like Guillain-Barr are sure mysterious. My C-reactive protein was low when I had it done last fall. I’m not sure to what extent that rules out auto-immune things. That is a question I should ask my PCP.

                      I hope by my mentioning you as a healer that you didn’t think I was implying that I wanted you to try to figure out my fatigue. But I greatly appreciate the insights and your interest.

                    2. Scott,

                      Yes, things like Modified Citrus Pectin are expensive. I used it because of the studies with preventing metastases, but that is so hard to figure out how to know whether it is worth it.

                      I didn’t think you wanted my help. I had just looked a lot of things up when my cousin went through.

                      He is back in the hospital again this week for other things. Heart or lungs, they aren’t sure this time. Every two weeks he ends up admitted. Mysteries require so much testing.

                2. Swank claimed to have achieved so much with his dietary advice but the methodology employed was poor and McDougall was unable to replicate Swank’s results with his much better designed and conducted trial.

                  Axe isn’t an MD. He is however a very successful internet marketer. i would, though, agree that killing off a good part of your microbiome with antibiotics carries risks. That is hardly a view unique to Axe however.

                  1. He isn’t an MD?

                    Calling himself Dr Axe is brilliant strategy.

                    I didn’t hear that about McDougalls trial. I did hear an interview before the results of that trial.

                    It didn’t work?

                    1. Axe has two doctorates. One is in chiropracty (or chiropractic) and the other is in ‘natural medicine’. Both are founded on certain principles but those principles or beliefs are not considered to have a scientific basis. So, he is a doctor but not an actual MD.

                      Yes, the results of McDougall’s trial were published in 2014. Patients experienced real benefits such as weight loss and lower cholesterol as you’d expect but as McDougall himself acknowledges

                      ‘The primary goal of the Diet & Multiple Sclerosis Study was to see, based on MRI images of the brain, a difference in the lesions characteristic of MS, often referred to as “plaques.” No real difference was seen between the “Diet” and “Control” groups; nor was a difference in disability or relapses seen between the diet intervention and control groups.’
                      https://www.drmcdougall.com/2014/07/31/results-of-the-diet-multiple-sclerosis-study/

                    2. Deb,

                      I’m sure challenged in navigating this forum. I wanted to reply to your last reply to me, but there is no reply prompt there for me. I’m on my phone and maybe that’s why.

                      Anyway… I should count my blessings that my issues aren’t requiring a lot of hospitalizations. It could always be worse and it’s probably good to be reminded of that now and then. I hope your cousin’s mysteries get resolved.

                    1. I got to the part where a year might not be long enough and paused.

                      The thing is, his patients were followed for decades and didn’t deteriorate in the natural.

                      Physical function over decades needs to still count for something, I think.

                    2. Hi Deb

                      I appears to help with fatigue symptoms and blood lipid measures (cholesterol) and insulin but not ms progression. See McDougall’s description of his study’s results. Here is the study report’s abstract as published in one of the professional journals:

                      ‘CONCLUSIONS:
                      While a very-low fat, plant-based diet was well adhered to and tolerated, it resulted in no significant improvement on brain MRI, relapse rate or disability as assessed by EDSS scores in subjects with RRMS over one year. The diet group however showed significant improvements in measures of fatigue, BMI and metabolic biomarkers. The study was powered to detect only very large effects on MRI activity so smaller but clinically meaningful effects cannot be excluded. The diet intervention resulted in a beneficial effect on the self-reported outcome of fatigue but these results should be interpreted cautiously as a wait-list control group may not completely control for a placebo effect and there was a baseline imbalance on fatigue scores between the groups. If maintained, the improved lipid profile and BMI could yield long-term vascular health benefits. Longer studies with larger sample sizes are needed to better understand the long-term health benefits of this diet.’
                      https://www.msard-journal.com/article/S2211-0348(16)30100-6/fulltext

                    3. There are problems with Swank’s study such as lack of randomisation and of adjustment for potentially confounding factors which mean his reported results may not be reliable.

                      It’s also woth noting that Swank’s diet was low fat BUT he recommended some fish consumption and low fat dairy for example.

                      ‘ butter fats and hydrogenated oils were eliminated, and saturated animal fats were limited to 15 g/day-ie, margarines, hydrogenated peanut butter, and all shortenings were eliminated from the diet. 5 g of cod liver oil and 10-40 g/day of vegetable oils, which contain a preponderance of unsaturated fatty acids and are fluid at room temperatures, were added. However, two oils, coconut and palm, which contain a preponderance of saturated fatty acids, were eliminated from the diet. The diet contained from 60 to 90 g/day of protein from fish and seafood, white meat of chicken and turkey cooked without the skin, skimmed milk, small amounts of lean meats, 1 egg/day, and vegetables, cereals, and nuts. ‘
                      https://eurekamag.com/pdf/002/002084089.pdf

      3. @Scott 910211-5:11p–
        Yes, I would be delighted to be linked to the debate between D’Amamo and Greger. Much can be learned from the debate, itself, and any links you care to provide. The jury is still “out” on blood-typing and diet, at least in the sense that a jury never was empaneled, in the first place, because few mainstream medical authorities even begin to take D’Amamo seriously.

        That is why I plan to begin with Dr. Greger, and proceed from that point. I place 90 percent confidence in Dr. Greger’s reading of the research, leaving about 10 percent open to doubt and skeptical points, however convoluted. Sometimes, medical discoveries are royally derided and deprecated, only to gain a degree of acceptance, later. Dr. Kempner’s rice diet– with pristine research in corroboration– is a case in point. With D’Adamo, However, that is no argument for accepting poor scientific research, utter lack of it, or fraudulent claims, so I plan to proceed cautiously in the review.

        Dr. Greger, himself, when asked about his mission with NutritionFacts.org (“Does your website promote the vegetarian diet?”), invariably answers that his task is to present the best research.

    5. YR, I don’t know why my LONG reply to you went WAY down where it is, But I am almost always on mobile and the threads aren’t very well delineated in the mobile version.

      1. Scott, I know the EatRight4YourType diet was debunked several years ago. Which made me very happy indeed, as I’m a peanut butter addict and I like black coffee and tea. And several other things on his no-no list..

        Actually, I’d suggest not only checking for Lyme disease, but also (if all else fails) find a top-notch psychic who can pick up on such things. They do exist, you know. (But don’t let Fumbles know I’m suggesting this to you. Such things upset him for some reason. :-)

          1. I did but my reply disappeared. I am currently travelling and the wi-fi signal at the hotel keeps dropping out so that’s probably why.

            If I remember, the reply was something along the lines of this site is about nutrition science not New Age con artists. Also, why stop at psychics? That’s simply limited and blinkered thinking. What about witch doctors – a long tradition of healing there. Or perhaps an exorcism to drive out the evil spirits? Then again, why muck about, go the whole hog and sacrifice a few goats or perhaps a virgin. Traditional techniques like these have been used ffor thousands of years so they must be effective.

    6. I have a co-worker who described herself as a vegetarian. “I only eat fish and chicken”, she says. I have met many, many others like that. When people see me eating almost all of my meals without any animal products, they call me a vegan. Then I try to explain the difference between vegan, vegetarian, and plant based. What I think they mean is people who really don’t eat flesh of any animal.

      1. John,

        Yes, people think avoiding red meat is vegetarian.

        I laugh because I have driven across the country 5 times and trying to explain vegetarian when I was one, was so challenging.

        I went to a Chinese restaurant in the middle of the country and said “vegetarian? ” and they said’ “yes, yes, yes” and chicken and fish were what they meant. I went to another after that and they had vegan duck tongue, but didn’t speak English and my friend and I pondered whether the misspellings on their menu made their vegan a safe bet.

        Years later I went back and they still had vegan duck tongue but it was a professional menu explaining what it was made from and they became my favorite place until they sold to someone else who used different recipes which may have been vegan but I didn’t care.

        1. .
          WHEN IN CHINA…
          .
          @John 190211-8:59p–
          Your comment about “authentic” Chinese restaurants brings to mind the original meaning of “chop suey” is simply, “hash”. According to the urban legend, some over-worked, time-pressured Chicago-area Chinese were about to close their restaurant when some loud locals entered, demanding to have some authentic Chinese food.

          In short order, their dishes were prepared and set before them. Asked what the dish was called, the smiling Chinese waiter said “chop suey”!

          My own version of this translation frontier is even more hilarious– As I reviewed a Chinese restaurant menu, I recalled MSG is heavily used as a flavoring agent. So, pointing to a particular dish, I asked the waiter,”Is this free of MSG?”, and the waiter replied, “Yes!” Cautiously, a rephrased the question– “Does this menu item contain MSG?”, the waiter said “Yes! Yes!”. (Presumably as in, “Yes, we have no bananas, today!”

  2. “Orthorexia nervosa is a proposed eating disorder characterized by an excessive preoccupation with eating healthy food.” (Wikipedia)

    Trust the medical establishment to make a “disorder” out of something simply because it is not “normal”. This is especially ironic when that thing is so obviously beneficial.

    1. plant_this_thought, I have a friend who accuses me of suffering from orthorexia due to my plant based whole foods eating. Even though I’ve been a vegetarian — an ova-lacto-vegetarian — for about 47 years, I slowly switched to only plant based eating a few years ago for several reasons,one of which was a diagnosis of cancer. This friend would like to lose weight, but says she really doesn’t know how to, or can’t. She knows that I, my husband, and my brother have all lost weight eating plant based whole foods — even her sister and BIL are vegans and slender and healthy — but she is convinced that it wouldn’t work for her.

      1. Dr. J, it’s a shame that your friend is in such a deep state of denial. At least this video & Denise Canellos’ post below offer good retorts to your friend’s unfounded accusations.

    2. It might look like it, but the history of orthorexia is actually much more convoluted. It wasn’t made by the medical establishment, quite the opposite, the term was coined by a what you would call a “lifestyle” or “diet” doctor living in a commune of food-conscious people. Worth a read: http://www.orthorexia.com/original-orthorexia-essay/

      Now the true cases of orthorexia are actually quite serious, patients deficient in many nutrients, even calories. I would say that these could be classified as anorexia, but whatever. Their motive is different.

      Now, one thing is noting the existence of some very distressed individuals, another is talking about it as some universal phenomenon, as mainstream psychiatrists do. Orthorexia currently doesn’t exist as a diagnosis, doesn’t have any agreed upon diagnostic criteria and current diagnostic tools (questionnaires) are a laughing stock – they ask questions like “do you think there’s unhealthy food on the market” (if you do, you are sick) and can’t discriminate between healthy (judged by the psychiatrists) people and diagnosed orthorexics. This putting the cart of diagnosis and treatment before the horse of science is however quite common (mainly) in psychiatry (cf. sex addiction).

    3. From the Greek, the term Orthorexia literally means “correct diet.” Physicians and mental health professionals classify individuals living with Orthorexia Nervosa as possessing an unhealthy obsession with the quality of foods being consumed. An oxymoron, isn’t it?

      Gluttony (Latin: gula, derived from the Latin gluttire meaning “to gulp down or swallow”) means over-indulgence and over-consumption of food and drink.

      Modern medicine condemns the former, while embracing the latter.

  3. What an interesting concept that vegans and vegetarians are more likely to have healthy attitudes towards food. Now the question is why? Maybe healthy food = healthy attitude, or a plant based diet is so filling making it easier to feel satiated and maintain a healthy weight.

    1. VegGuy, I believe healthy food choices stem from self respect. Education plays a foundational role here too in that people have to recognize the connection between what they eat, and how they feel and look.

  4. I don’t agree with many things in this video. To many biais, to oriented conclusions (and i guess many MD advicating for vege will tell the same thing. The proof is they assimilate vegan as a diet.
    I consider myself has having food cravings and I’m vegetalian now (since 5 years and 3 years vegetarian before that). I identified some of my dependancies, but not all. I had great expetations seeing the video title, but in the end it just analyse garbage publications.

      1. Yes, sounds like vegetarian and Italian.

        Cheese?

        Speaking indirectly of pasta, I tried Pasta Zero fettuccini and loved it.

        For those of us who overeat pasta, having something which is 15 calories per serving and which chews like pasta is fabulous.

        Could it possibly be good for me? Inquiring minds want to know.

    1. I would be cautious as people have had heart attacks after being subjecting to ‘very cold’. Cold makes your heart work harder to keep your body warm, so your heart rate and blood pressure may increase. … The cold can also cause changes to your blood that may increase the risk of developing blood clots, which could lead to a heart attack or stroke.

    2. Tim, Wim Hof certainly thinks so but I am posting his science page so you can check his articles yourself. People train to accustom themselves to the cold slowly apparently. They are downloadable files.
      https://www.wimhofmethod.com/science

      Here is one trial where Wim was one of the participants
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025014/?report=classic

      You might enjoy reading this page about potential benefits of cold water baths and showers. The science articles behind the claims are linked in the blue lettering.
      https://www.care2.com/greenliving/8-ways-you-can-benefit-from-a-cold-shower.html

    1. I find that more often than not, the people who say such things are also shaped like the cows or pigs they consume but want to imply that a skinnier vegan is the person with a ‘disorder’.

  5. It was hard to follow this video and a few others that have been posted recently. It seems that Dr. Greger has been speaking at a higher than natural speed. Is this because there is a time restraint on the length of his videos and the playback has been artificially speeded up? I’d like to ask that he please slow down just a bit. I’m sure both I and others would get much more out of his videos if he simply spoke at a normal pace.

    1. @ Ron 190211-11:47a–
      Agreed. Dr. Greger seems even to push or force his narrative to be as fast as he can deliver. The problem with that his words of often slurred, jumbled or inaudible– and even those words should matter. Increasingly, we must resort to the transcript, and lately, the transcripters have begun to state their transcription is an approximation.

      Whether from a change in his neurology from aging, or from simply his belief he should “run through” the script because he has so much to cover, the mannerism does reduce the quality of his spoken delivery.

      Also, in the past year or so, Dr. Greger has begun to punctuate his shifts in thought with an audible aaaaaah…. ummmm… (etc) which was not noticeable in his videos back in 2010-2014. Thought “bursts”, punctuated with long pauses with an audible “filler”, are understandable, but when doing an audio narrative, it suggests Dr. Greger now works from only a loose script.

      Whatever the case, we want Dr. Greger not to push himself quite so hard, and deliver at a more natural pace. Dr. Greger should be pleased people follow his videos and narrative so closely that every word (as well as general context) counts. This adjustment can only benefit all viewers/audience.

      1. Hi alphaa10, thank you for the input. I just wanted to note that while the transcript says it’s an “approximation,” all that means is that we sometimes change one or two words just to accommodate reading vs. listening. Otherwise the transcripts are verbatim from the video, so the information is complete. Hope that helps clarify!

  6. I believe that encouraging people to become ‘foodies’ is encouraging them to have an eating disorder. Every foodie I know, including myself back when I was one, is guided by taste/flavor/texture only. We have companies like Americas Test Kitchen who churns out cookbooks of very tasty recipes and little to no attention is given to nutritional content. It is as if Paula Dean food is openly encouraged to be your normal diet by not just her but most sources of food and recipes. People are openly eating themselves to death, are openly encouraged to feel ENTITLED to doing so constantly, then walk into the doctors office expecting a ‘cure’ so they can go right back to doing more of the same. Statins and such are not ‘cures’ by any means.

    And to make matters worse even doctors openly talk about how ‘most health problems are genetic’ when they do not look at the fact that most people eat the way their family raised them to eat. My family has so called ‘genetic’ high blood pressure, atherosclerosis, and osteoarthritis. I do not eat like the rest of my family and have none of those health problems at an age older than all the others started having problems.

    1. That’s the exact truth. I’ve said this for years and people look at me funny. But how I know to be true is I’m adopted. Two families couldn’t have had more different approaches to food. Bio family everyone almost was normal weigh. Adapted family everyone was fat. Not only because of food choice but because of the excitement to est until there was discomfort.

      And several dr’s including dr g have pointed out that even if you have a genetic disposition to one thing or another, epigentics can be turned off or on based on food choices. So genetics plays a smaller role than mainstream wants to admit.

    2. Jimbo, I think you have a good point.
      THere are people who luxuriate on expensive caviar.
      However, my wife the vegan and I, as well as many others, enjoy the challenge of making healthy food delicious. When you go to Japan, Vietnam, Thailand, Korea, China, France, Spain, and Italy, people enjoy healthy food that is delicious with low stress. Their economic and political systems aren’t dominated by giant corporations, trying to increase shareholder value. They are people who enjoy the connection between environment, history, nature, seasonal food choices, flavor and our health. Some movements involved in that here are permaculture, slow food, biodynamics, and regenerative/sustainable agriculture.
      John S

  7. As someone who treats people with eating disorders, I can say with certainty that many young women are choosing a vegan diet as a way to justify food restriction and to have an excuse to not eat may foods. It is very scary and the recovery rate for Anorexia Nervosa hovers around 50%. These girls are desperately trying to stay underweight and veganism is a socially acceptable way to restrict their food intake – to a dangerous level. I think the point of the video is that becoming vegan won’t give someone an eating disorder – although in young women the two can intersect.

    Orthorexia Nervosa refers to people who only eat a small number of foods they deem healthy – like a list of superfoods. It is disordered, restrictive eating. For example, if the only green vegetable you eat is kale because you think it is the healthiest, and the only orange vegetable you eat is a sweet potato, and the only fruit you eat are blueberries. No one who is eating a varied, healthy plant-based diet would be classified as ON.

  8. I would love to see an evidence-based analysis on pure vegan protein powders like pea protein isolate regarding health. I need to know this because of sports. I hope the doc will tackle this issue.

  9. In my completely subjective and non-scientific way, I have long thought that “diets” (setting aside those to combat specific disorders like diabetes) have a fundamental flaw. They focus the attention of the user on food and food consumption when doing as much as possible to direct attention AWAY from food might be more desirable! Perhaps someone engrossed in other activities might be less likely to abuse food?

    1. YR, I just watched the youtube video that you posted with the interview of Dr Joel Fuhrman. He really covered a lot of material, most of which was identical to what Dr Greger reports on! I haven’t followed Dr Furhrman very often, what I’ve seen is that he seems to be a very logical thinker and knows his nutrition well. I guess a lot of people fault him for selling supplements on his website, but that doesn’t mean the information he gives is incorrect! Everyone has a different economic model for producing some income to live on. And, wow, he is another fast talker … I almost had to slow down the audio!

      Thanks for sharing the link. Very informative video.

      1. YR, I watched the video too, and may watch parts of it again.. I enjoyed it and agree with Hal that it had lots of good information there. I don’t care really that he sells supplements or web content, he seems to be very careful about what he lends his name to. Very knowledgeable.
        Thanks for posting it!

        1. I take a few of his supplements and have bought some of his food products too. They seem to be high quality. I think some of his products have met needs that were previously unfulfilled in the marketplace. One of them was a multiple vitamin without folic acid, beta carotene or selenium. I get more annoyed with the membership tiers on his website and the luxury wellness retreats that he promotes. But I think his information is generally very reliable.

      2. “And, wow, he is another fast talker …”
        – – – – – –

        According to Wikipedia (although, not everybody trusts that outfit), Dr. F. is a New Yorker.

        Which means he talks fast and knows how to be a sharp, shall we say, businessman. :-)

        I lived in Manhattan for many years, and you learn how to be street smart, if nothing else.

        https://en.wikipedia.org/wiki/Joel_Fuhrman

        1. @YR 190212-2:12a–
          .
          ABOUT WIKIPEDIA
          .
          The Wikipedia system is much like any peer-reviewed, self-regulated forum– it relies on the quality of submitted material, and subsequent review by editors. However, quality seldom has been an issue.

          In one instance, I submitted minor suggestions to an article on a historic event, and my trial suggestions were accompanied by a fact-based argument for the suggested changes. My criticism was reviewed and eventually accepted. Which means what we read on Wikipedia is not simply what the local chapter of Americans for a Better World (if there is such a PAC) decides to offer on a particular topic, but must pass a common-sense, fact-based review by Wikipedia editor(s). Seldom, if ever, have I found an instance of egregiously cherry-picked evidence or politically-slanted discourse. Considering the political environment, that is quite an achievement.

          With really mind-bogglling technical matters, editing is handed to those with expertise in the field. Many articles are written by deep specialists, technical experts and even (apparently) inventors. (That, or present at The Creation, at least.)

      3. Hal, I think the idea is that since he’s selling products, his advice will be geared more toward selling those products. Don’t know for sure whether or not that’s the case with Dr. Fuhrman.

        That’s what I like about Dr G & NF. They don’t really give advice. There’s no sales pitch. They just tell us the facts & let us make our own decisions.

  10. Two things happened when I transitioned to a vegan diet. First, I became a lot more knowledgable about food, requiring research and study, and second, I lost weight without really trying. I became much more relaxed about eating and no longer even worry about how much I eat. I eat a much wider variety of foods and feel satiated after eating. The key is to eat whole foods that you prepare yourself or as a family. When my wife and I prepare food and clean up together, we do not really notice the extra work much. And being really fit and feeling well is also such a great motivator.

    1. Robert Haile, I recently read that an hour preparing a meal (washing, chopping, cooking) burns about 100 calories per hour. I don’t know if those are active calories. (For comparison, according to my Apple Watch, I burned 126 active calories during 1 hour of yoga today.) I also don’t know if it applies to cleaning up the kitchen afterward, but I would guess so. Housework and meal preps are considered light to moderate exercise. I cook, my husband does the dishes. So we both get exercise. And like you, when we switched from an ova-lacto vegetarian eating to plant based whole foods eating, we lost more weight without meaning to — and we thought our previous weights were fine. We love our food! And our new weights. We are cleaning out our closets, in preparation for a remodeling project, and donating the clothes that are now too large.

  11. AN INTERESTING EXPERIMENT?

    Which dietary approach is favored by those already confirmed to have a compulsive eating disorder (CED)– a whole food, plant-based diet, or the “Standard American Diet”?

    The proposition– Significantly more confirmed CEDs prefer the whole-food, plant-based diet.

    The context / rationale– the vegetarian approach is perceived by CEDs as more satisfying than eating animal-based products. Our vegetarian evolution is programmed deeply within all of us / our genes, so a vegetarian preference represents an archetypical, natural “survival response” to stress.

  12. People can accuse you (or make a remark) of having an eating disorder from an emotional trigger. But since emotions can be revealing, they may create something like a reason thought as a cover. Now that I think of it, most thoughts come from emotions. What do emotions reveal?

    1. Panchito,

      There is a paradox about which comes first, the emotions or the thoughts.

      People who are mature often have such control over their thoughts that their emotions dissipate.

      I know for a fact that negative thinking fuels emotions AND that emotions can fuel wrong thinking and I also know that emotions like joy or love can cause something higher than thought it emotion – a hormonal or spiritual bonding – where mothers can be so bonded to a child that her thoughts and emotions are trumped by that bonding.

      I have known men who were millionaires who were so miserly that they wouldn’t give gifts to their mother fall in love and change completely and both their thoughts and emotions changed.

      I can name so many men who changed 1000% and it has lasted decades into marriages.

      My father started cooking and cleaning and going to plays and started loving sports when he fell in love after my mother passed away. He never went back to the old thoughts or feelings and it is over 20 years. Both of my brothers have those kind of marriages, too, both met their wives fell in love at first site and changed how they think and how they respond emotionally to everyone. My older brother changed and it is 40 years later and love or hormonal bonding are beyond normal thoughts and feelings.

  13. Nothing like science… wish I knew this about three years ago. My daughter was admitted to a residential hospital specializing in eating disorders in females. NOW I know (not because of this hospital by the way) that she has high-functioning autism and her eating disorder (ARFID) was related to her autism/anxiety problems. But when she was in the hospital, they were adamant that eating a vegetarian diet was a harbinger of anorexia nervosa. I explained over and over that she had done fine with a vegetarian diet in the past but it didn’t matter, that fact that she didn’t want to eat animals was considered to be abnormal and she was forced to return to an omnivorous diet to be released eventually. The dietitian eventually agreed that I could be right, but that the majority of the time she saw anorexics refuse animal products to decrease their caloric intake. Sooooo, the anorexia came first – not the vegetarian diet.

    1. Wow, Angela! So glad you figured it out. Not an easy thing to do when the medical establishment doesn’t have a clue & is working against you!

    2. Angela,

      The concept of needing to become an omnivore to be released is the part of the mental health community which terrifies me.

      They are so narrow-focused and so inflexible.

      I have friends who had children institutionalized and get worse on the meds and better years later when they got off the meds but they found themselves in that couldn’t get out unless they cooperated place.

  14. In my nutrition practice which focused on vegetarians, I had a number of parents bring in their vegetarian/vegan daughters, worried about a link between v/v diets and eating disorders. My experience and reading of the literature is consistent with this video. V/v diets do not cause eating disorders. People with eating disorders often seek a restricted diets, which v/v diets can be perceived to be, thus fit the bill for people with a disordered relationship with food. Reverse causation.

  15. I think this is a very important topic, and I think needs to be taken seriously considered when it comes to the latest, trendiest forms of “fasting.” You definitely need to look into why people are doing this and whether it’s not a cover for disordered eating. Personally, I do feel that generally in mainstream culture the desire to control oneself or show self-control through diet is very prevalent, and we’re all at risk of falling into more serious disordered eating patterns.

  16. Hi. I was wondering if there has ever been any research done regarding risks of long term bulemia, besides the obvious weight problems (esophageal cancer, low poor digestion/absorption, stomach cancer, etc). For instance, if someone had bulemia for 5-10 years, almost daily, but has been healthy for 20-30 years, are there still risks from damage done? Thank you!

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