Disordered eating and the meat-avoidance spectrum: a systematic review and clinical implications

Area of Science:

• Psychology
• Nutrition Science
• Dietary Habits

Background:

• Meat avoidance is often presumed to correlate with eating psychopathology.
• Existing research provides inconclusive evidence regarding this association.
• Current eating disorder scales might misinterpret normal dietary choices of vegetarians and vegans as pathological.

Purpose of the Study:

• To systematically review the association between vegetarianism, veganism, and disordered eating.
• To evaluate the psychometric properties of eating disorder scales in vegetarian and vegan populations.

Main Methods:

• A systematic review of literature was conducted.
• Searches were performed in MEDLINE, PsychINFO, and CINAHL databases up to June 2021.
• Forty-eight studies met the eligibility criteria for inclusion.

Main Results:

• No consensus was found regarding meat avoidance and higher rates of disordered eating.
• A positive association was reported in most studies between vegetarianism/veganism and orthorexia nervosa.
• Six studies indicated poor psychometric fit of eating disorder measures in vegetarians and vegans.

Conclusions:

• Vegetarians and vegans remain understudied in the context of disordered eating.
• Limited evidence suggests potential higher levels of orthorexia nervosa behaviors in these groups.
• The factorial validity of common eating disorder scales, like the EDE-Q, may be inadequate for vegans.