Is Vegetarianism a Marker for Eating Disorders among College Aged Women?

The American Dietetic Association published a study in June suggesting that college-aged women who self-identified themselves as vegetarians were at higher risk of eating disorders than those who did not self-identify themselves as vegetarians.

Sheree Klopp looked at 143 college aged women (she surveyed men as well, but not enough respondents were self-identified vegetarians to offer a valid statistical analysis). Of the 143 women in the study,

Thirty participants were self-reported vegetarians, and 113 participants were nonvegetarians. There was no significant difference between the vegetarians and nonvegetarians in height, weight, age, or body mass index. The median EAT score of the vegetarians (16.5) was significantly higher (P<.0001) than that of the nonvegetarians (9.0). A significantly higher (P<.0001) proportion of the vegetarians (37%) compared with nonvegetarians (8%) had EAT scores greater than 30 (indicating eating disorder risk). There was no difference in supplement use or meal skipping between the two groups. In conclusion, self-reported vegetarian college women may be more likely to display disordered eating attitudes and behaviors than nonvegetarians.

Each of the women was given the Eating Attitudes Test survey which is commonly used as an eating disorder screening test. According to Klopp,

The median EAT score of the vegetarians was significantly higher than that of the nonvegetarians (16.9 and 9.0, respectively, P<.0001). A significantly greater proportion of the vegetarians scored higher than 30 on the EAT compared with the nonvegetarians (P<.0001). Therefore, the vegetarians in the present study displayed an increased risk for weight preoccupation and eating disorders compared with nonvegetarians. This confirms conclusions from other studies (1-5,9) that the practice of vegetarianism may be associated with eating disturbances.

. . .

Vegetarians in the present study were more likely to feel extremely guilty after eating, have a preoccupation with a desire to be thinner, have a tendency to eat diet food, and like the feeling of an empty stomach. In addition, the vegetarians were more likely not to enjoy trying new, rich foods. Also, the vegetarian participants had a greater tendency to feel that food controls their lives, give too much time and thought to food, and have the impulse to vomit after meals compared with nonvegetarians.

Individual EAT responses also indicated that vegetarians in the present study were more inclined to exercise strenuously to burn off calories, weigh themselves frequently throughout the day, and take laxatives compared with nonvegetarians. As expected, nonvegetarians enjoyed eating meat more often than vegetarians.

Like most such studies, vegetarian here often means semi-vegetarian — 23 of the vegetarians in this group self-identified as semi-vegetarians who did not eat red meat but occasionally ate meat such as chicken. Should these people be counted as vegetarians? Maybe. As Klopp notes, “Red meat avoidance is often the first step taken by those desiring a vegetarian lifestyle.”

Additionally, other research suggests there is not a significant difference between attitudes toward eating between semi-vegetarians and vegetarians. Klopp writes,

In fact, most of the vegetarians (77%) in this study were semivegetarians, so generalization of results to all vegetarians should be avoided. It is possible that semivegetarians have different eating attitudes than lacto-ovo vegetarians, so it would be ideal to compare eating attitudes of semivegetarians, lacto-ovo-vegetarians, and nonvegetarians; however, the number of lacto-ovo-vegetarians (n=7) in the present study was not large enough to separate the types of vegetarians for appropriate statistical analyses. When Perry and colleagues compared characteristics of more restricted vegetarians (vegans, lacto-vegetarians, and lacto-ovo-vegetarians) with semivegetarians, the semivegetarians were more likely to engage in weight control practices (healthy and unhealthy), were less likely to be overweight, and exercised less than the more restricted vegetarians, but there was no difference between the groups in behaviors related to eating disorders, diagnosis of eating disorders, body dissatisfaction, and concern about controlling weight.


Self-reported vegetarianism may be a marker for college women at risk for disordered eating. Sheree A. Klopp, Cynthia J. Heiss, and Heather S. Smith, Journal of the American Dietetic Association, 2003;103:745-747.

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