Characteristics and clinical implications of the relationship between veganism and pathological eating behaviours

McLean, Courtney; Moeck, Ella; Sharp, Gemma

doi:10.1007/s40519-021-01330-1

Cited by 8 publications

(17 citation statements)

References 15 publications

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“…Conceptualized by Kadambari et al [ 19 ] in the late 1980s, the authors found vegetarian patients with anorexia nervosa were more likely to be dietary abstainers compared to omnivore patients. Since then, the notion that meat-avoidance may provide a socially acceptable way to avoid dietary intake and conceal eating disorder behaviors and attitudes has been widely recognized [ 20 , 21 , 22 ]. A recent systematic review examining the association between disordered eating and meat-avoidance did not find support for higher rates of disordered eating in these groups [ 23 ], and suggested that vegetarians and vegans have been under-researched in the field of eating disorders [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

The 26-Item Eating Attitudes Test (EAT-26): Psychometric Properties and Factor Structure in Vegetarians and Vegans

2023

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The eating disorder screener, Eating Attitudes Test (EAT), has been used widely; however, its usability in specific dietary groups such as vegetarians and vegans remain unknown. Considering the rising popularity of vegetarianism and veganism, the current study aimed to assess the psychometric properties and theoretical assumptions of the 26-item EAT in separate groups of vegetarians (n = 278), vegans (n = 580), and omnivores (n = 413). Confirmatory factor analysis of four models from previous literature revealed inadequate fit of the data, with the exception of a 16-item four-factor model in vegetarians and vegans. Further assessment of the original three-factor model and 16-item four-factor model demonstrated poor psychometric properties. The primarily inadequate test–retest reliability discovered in this study, independent of whether a shortened version was used, raises concerns around the utility and stability of the EAT-26 in vegetarians and vegans. Future research should potentially investigate novel ways of measuring eating disorder pathology in these groups.

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Section: Introductionmentioning

confidence: 99%

The 26-Item Eating Attitudes Test (EAT-26): Psychometric Properties and Factor Structure in Vegetarians and Vegans

2023

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“…For instance, a respondent XX term “semi-vegetarian” (Timko et al, 2012 ) may pretend to just follow a certain diet but actually adhere to a disordered relationship with food. Heiss et al ( 2018 , 2020 ) and McLean et al ( 2022b , c ) also reported relationships of ED and specific dietary preferences. Interestingly, they found the EDE-Q performing sub-optimal in a vegan/vegetarian sample.…”

Section: Discussionmentioning

confidence: 94%

“…Thus, important diagnostic information may be overlooked, especially in males (Murray et al, 2017 ). More generally, not only the gender aspect is underrepresented but also peculiarities regarding age (Peat et al, 2008 ; Mulchandani et al, 2021 ), BMI, diet preferences (McLean et al, 2022a , c ), and further specific populations. We found evidence for that claim in the latent correlation coefficients of the validity analysis which were 1) considerably higher in the female compared to the male subgroup, 2) considerably higher for the age group up to 34 compared to 35+, and 3) considerably higher for individuals with an BMI below 18.5.…”

Section: Discussionmentioning

confidence: 99%

Strengths and weaknesses of the German translation of the Inflexible Eating Questionnaire and of eating disorder assessment in general

2022

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ObjectiveThe present article introduces the German translation of the Inflexible Eating Questionnaire (IEQ-G), performs a psychometric evaluation, and explores the relationship of Inflexible Eating to the subscales of the Eating Disorder Examination-Questionnaire (EDE-Q) and Obsessive-Compulsive (OC) symptoms.MethodsThe cross-sectional study was carried out in the German-speaking area. A paper and pencil survey was completed by 612 females and 442 males of the general population.ResultsSEM analyses showed that the IEQ-G allows for calculating a total score and invariance tests were mostly promising. As a side result, the original 4-factorial structure of the EDE-Q could not be replicated, but a 3 dimensional solution proved convincing. From a psychometric point of view, the IEQ-G outperformed the EDE-Q. On a latent level, Inflexible Eating was remarkably strong related to OC-symptoms and the EDE-Q subscales.DiscussionThe detail analyses revealed that Eating Disorder assessment in general lacks subgroup-specific aspects, for instance, regarding gender or dietary preferences, important for early diagnosis and screening of ED. The IEQ-G proved applicable in a German speaking adult population and recommends itself for cross-cultural studies.

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“…Table 3 Summary of the psychometric properties of eating disorder measures in veg*ans EAT eating attitudes test; EDI-DT eating disorder inventory-drive for thinness scale; DM drive for muscularity; EDI-B eating disorder inventory-bulimia scale; DEBQ Dutch eating behavior questionnaire; TFEQ-CR three-factor eating questionnaire-cognitive restraint scale; TFEQ-D three-factor eating questionnaire-disinhibition scale; TFEQ-H three-factor eating questionnaire-hunger scale; EDE-Q: eating disorder examination-questionnaire; BES binge eating scale; YFAS Yale food addiction scale a Three-factor model = restraint, eating concern, shape/weight concern, two-factor model = restraint, eating/shape/weight concern, one-factor model = global, brief one-factor model = brief weight and shape concern (items 11,22,23,24,25,26,27,28) b Brief three-factor model = restraint, shape/weight over-evaluation, body dissatisfaction (items 1, 3,4,22,23,25,26) c Short-three-factor model = restraint, shape/weight over-evaluation, body dissatisfaction (items 1, 3,4,22,23,25,26) Author (Year) Measure Veg*an sample Psychometric properties…”

Section: Discussionmentioning

confidence: 99%

“…At its very core, veg*ism involves a high level of cognitive restraint to consciously regulate and restrict several food groups. While dietary motivations for veg*ism do not appear to influence disordered eating rates [ 8 – 11 ], it has been posited that veg*ism in and of itself may act as a socially acceptable method to restrict food intake and camouflage disordered eating behaviours [ 12 – 16 ]. Orthorexia nervosa, a form of disordered eating characterised by a pervasive obsession to eat “clean” and “pure” foods, has shown the strongest link with veg*ism due to similar overlapping food selection strategies [ 17 ].…”

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confidence: 99%

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

2022

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Purpose Meat avoidance has long been thought to be related to eating psychopathology; however, research does not necessarily support this notion. Furthermore, commonly used eating disorder scales may be picking up on normal meat-avoiding behaviours in vegetarians and vegans. As such, we systematically reviewed the association between vegetarianism, veganism, and disordered eating, and reviewed the psychometric properties of eating disorder scales for use in these populations. Methods We searched electronic databases MEDLINE, PsychINFO, and CINAHL for literature published until June 2021. Results Forty-eight studies met eligibility criteria, with no consensus as to whether meat avoidance was associated with higher rates of disordered eating. Most studies reported a significant positive association with both vegetarianism and veganism, and orthorexia nervosa. Six studies provided evidence for the use of eating disorder measures in vegetarians and vegans, reporting poor psychometric fit among all scales. Conclusion This systematic review highlights the extent to which vegetarians and vegans have been highly understudied, with limited research suggesting higher levels of orthorexia nervosa behaviours in vegetarians and vegans. Furthermore, our results provide tentative evidence that the factorial validity of commonly used eating disorder scales, such as the EDE-Q, may be poor in vegans. Level of evidence Level I, systematic review.

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Characteristics and clinical implications of the relationship between veganism and pathological eating behaviours

Cited by 8 publications

References 15 publications

The 26-Item Eating Attitudes Test (EAT-26): Psychometric Properties and Factor Structure in Vegetarians and Vegans

The 26-Item Eating Attitudes Test (EAT-26): Psychometric Properties and Factor Structure in Vegetarians and Vegans

Strengths and weaknesses of the German translation of the Inflexible Eating Questionnaire and of eating disorder assessment in general

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

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