By: Shriya Swaminathan
The relationship between veganism and diet culture is complex especially in the day and age of social media and celebrity endorsed ‘diets.’ A lifestyle rooted in causing no harm is often criticized for advocating restrictive and disordered eating, which perpetuates a harmful misconception in our society. It’s fascinating how many vegans attest to the contrary and credit this lifestyle for having healed their relationship with food and their bodies. Food is no longer an enemy to be demonized, but rather a source of nourishment. It fuels them to live their best lives, while doing good by the animals and the planet. But how does the Eating Disorder recovery trajectory compare between vegans and non-vegans? Does the added misinformed perception of veganism deter recovery centers from accommodating vegans? Are vegans challenged out of their food choice if they were to receive inpatient care?
When Alsana Eating Recovery Centers took an informal survey in January 2019 of registered dietitians who treat eating disorder clients, the results revealed that 98% of dietitians surveyed provide consultation to vegan clients for an eating disorder; however, treatment for vegan clients at the residential level of care for those who are unable to recover on an outpatient basis was not available. Vegan clients with eating disorders did not have access to 24/7 treatment with a multidisciplinary team within a program that truly accommodated their vegan lifestyle throughout the recovery process. Research has also revealed that an individual who is denied treatment, such as the inability to accommodate a vegan lifestyle, will not seek treatment again for an average of two years. With the mission to ensure equal access to quality care at the forefront, Alsana’s Vice President of Clinical Nutrition Services Tammy Beasley, RDN, CEDRD-S, CSSD and her team are spearheading a vegan-friendly eating disorder treatment program that launched in August 2019 and continues to evolve. We hope this unprecedented move inspires other treatment centers around the world to encourage vegans to seek the care they deserve without compromising on a lifestyle that encompasses their ethics. She graciously sat down with VEGWORLD for an insightful conversation about her team’s goal to bring high level care for vegans to the mainstream.
To Treat or Not to Treat? That’s the Vegan Question…
As a veteran in this field of care, Tammy recalls how as recently as the late 90s, being a vegetarian was recognized as indicating an Eating Disorder (ED) among the professional community. Research on vegetarianism or veganism and eating disorders is limited in the first place, and the majority of the research studies from the 80s and 90s are flawed in methodology and definition, most often using ‘semi-vegetarian’ as the defining variable to classify ED without a concrete or consistent definition of what ‘semi-vegetarian’ means. This may have caused widespread misunderstanding among professionals, who had difficulty accepting that being a vegetarian and having an ED can be mutually exclusive. But over time, professional perceptions have changed and looking at the system of care now, all residential treatment centers cater to vegetarians with ease! It’s only a matter of time that the same progress is made for vegans.
A New Frontier for Eating Disorder Treatment
In the case of ethical vegans, who align their values with their food choices, denying care unless they consume animal products as a planned meal challenge within their treatment can hinder their progress instead of improving their relationship with food. Overall, the program emphasizes a no judgment or shame approach when it comes to ones’ food choices. That is precisely the mindset that the ED feeds off of and Alsana’s staff are here to equip vegans with the tools to challenge their ED and embrace their nourishment through a wide variety of nutrient-rich plant foods. In cases where veganism can be enmeshed in the ED, the focus becomes highlighting the abundance of nutrient-rich variety of plant foods, challenging the fear of enjoying foods for taste and sensory pleasure, and emphasizing that veganism is not a means for deprivation. The objective is to empower patients to shift their mindset and view veganism for its copious variety, including fun foods like vegan desserts and vegan snack foods, rather than as a restrictive ‘diet’.
Comprehensive Adaptive Care
Alsana’s commitment to vegans is to provide holistic care that includes routine medical monitoring, educational lectures on nourishing the body that includes vegan meal plans, meal and snack challenges to embrace variety, intuitive eating principles, mindfulness sessions, and immersive culinary classes. According to Tammy, the more cooking and kitchen life skill-type experientials offered, the better. These experientials include pantry inventory/budget pricing, grocery shopping for ingredients, basic kitchen skills, and preparing a meal alongside the chef for the community. In fact, many vegan clients who participate in these challenges prepare delicious vegan meals for all to enjoy! Tammy recounts- “In California, we have done things like “CHOPPED” in which the clients find ingredients already available and brainstorm together on what to make for dinner using those ingredients – it was a really fun experiential! In 2021, we plan to offer more culinary exposures and skills labs related to learning how to nourish yourself in the kitchen and prepare meals with variety and balance” Overall, the approach to treatment and care is described with this thoughtful metaphor- The client is the driver and Alsana’s resources assist them in navigating their unique roadmap to recovery.
Space for All to Learn and Grow
Being the first center to fully embrace veganism within the entire scope of treatment at all levels of care is not without its challenges and drastic learning curve. Tammy recounts the skepticism rooted in internal biases that the thought leadership encountered during the early stages of developing the program. Discomfort with an all-vegan treatment plan within the ED community and a lack of research in the field also pose complications to navigate. However, the determination to treat was unwavering and after thorough consultations with ethical vegan therapists and vegan dietitians to review the program guidelines, the overarching mission, and gain a comprehensive understanding of catering to vegans effectively, vegans are able to receive the vital care they deserve. The dedicated staff are committed to providing homemade vegan entrees as part of the meal plan, identifying all recognizable animal-based products, labeling vegan foods to assist staff in accuracy and working with the client to embrace more vegan variety. Owing to their diligence and eagerness to always improve, Tammy and her team are coordinating with mental health and nutrition experts on a pilot assessment for their vegan clients. The objective is to distinguish between clients whose ED behaviors reflect in their veganism and those with more strictly ethical or environmental motivations in order to provide the appropriate tools for recovery.
The Journey has Just Begun, and the Best is Yet to Come
Since its implementation, Alsana has treated over 60 vegans who joined the program because the doors were open to them. Based on an internal review of current data, a majority stick to veganism throughout the course of treatment! They learn how a vegan lifestyle can provide optimum nutrition to not only meet individual energy and protein needs but also sustain nourishment for continued recovery, to celebrate the variety of wholesome plant-based foods and maintain their mental health as a vegan in a non-vegan world. This effort has paved the way for more and more centers to incorporate extensive care at every stage of recovery for vegans. It’s high time the community come together and challenge the stereotypes of what a vegan body ‘ought to’ look like and dismantle the diet culture that may trigger individuals to choose veganism for reasons outside of their ethics. The fearless Alsana team is here to show us that despite how daunting the challenge may seem, progress is only achieved when we find the courage to take the road less traveled by.
Image Sources: Alsana Instagram, Taylor Wolfram, BELatina
Hello! Glad to see the eating disorder community has recognized the need to have treatment and support for vegan clients. We are a group of dietitian who take insurance and have dietitians on staff that specializes in ED and vegan/ Plant Based lifestyle. We are located in Chicago land area but provide telehealth across the country.
Great article…