Eating disorder services are struggling to respect the dietary requirements of vegan patients who need to be fed through a tube because of a lack of available products
The Royal College of Psychiatrists, the British Dietetic Association, and eating disorder charity Beat have published a joint statement calling for drug companies to develop life-saving feeds for vegans in treatment for eating disorders.
No prescribable vegan options
There are currently no nutritionally complete vegan feeds that are approved by the Advisory Committee on Borderline Substances - the body responsible for advising on prescribing of foodstuffs - for clinicians to prescribe to vegan patients during treatment for an eating disorder.
This means eating disorder inpatient services sometimes are unable to meet the dietary requirements of patients.
No prescribable vegan-friendly medications, supplement drinks, and feeds currently exist and the three organisations are calling for drug companies to develop them. There are also no prescribable multivitamin or mineral supplements that are vegan-friendly.
The organisations’ advice highlights that most prescribed medications contain animal-derived products – such as gelatine, lanolin, and lactose – which are often not clearly identifiable on the labelling. This makes it challenging for prescribers who will need to fully explore and understand their patients’ veganism to make sure they are prescribed medication in line with their diet.
Veganism is not limited to animal-derived products
Whilst the term 'plant-based' refers just to someone's diet, veganism is about more than just what people consume; it is about making ethical choices in all aspects of life, including avoiding products that are tested on animals such as makeup, skincare, and cleaning products.
But this isn't always possible. Most vegans strive to avoid animal products and products that test on animals 'as far as is practicable and possible', according to The Vegan Society. Whilst national and international laws require medication to be tested on animals before human clinical trials, a move towards avoiding animal-derived ingredients in medications - without compromising their efficacy - would be a success for vegans, allowing them to receive the treatment they need without having no choice but to compromise on their ethics.
Dasha Nicholls, chair of the eating disorders faculty at the Royal College of Psychiatrists said:
“There have been cultural shifts around diet and the choices people are making. It is important that clinicians respond to these changes and that the right treatments are made available to treat vegans with an eating disorder. We know that changes in diet can be associated with the onset of disordered eating behaviour. It is hoped that this statement will facilitate improved dialogue between clinicians and patients regarding diet and nutrition.”
More research is needed to understand if a link exists between veganism and eating disorders, as anecdotal evidence from clinicians suggests a noteworthy proportion of patients requiring in-patient admission had been following a vegan diet. There is no current evidence to suggest following a vegan diet will cause an eating disorder.
- See more: Find out more about treating anorexia from our Disorders Hub
- See more: Treating anorexia: an alternative to prolonged hospitalisation
Sarah Fuller, vice-chair of the child and adolescent mental health specialist group at the British Dietetic Association, said:
“A specialist dietetic assessment will support an individual’s right for choice while appreciating the complexities of mental illness and the challenges that this brings to the patient, family and professionals. Due to the lack of appropriate prescribable products, patients are sometimes receiving life-saving treatments that are not in-line with their beliefs. This can create difficult therapeutic relationships. Until there is consistent availability of vegan diets and ACBS – Advisory Committee on Borderline Substances - approved nutritional products across all service provisions this will continue.”
The statement comes at a time when veganism is growing in popularity, with more than 1% (660,000) of the UK population now following a vegan diet.
Andrew Radford, Chief Executive of Beat, said:
"This guidance will be useful in supporting clinicians to provide effective treatment while respecting patients’ beliefs and values. Choosing a vegan diet could be part of a patient’s illness or it may result from a well-considered ethical or lifestyle decision. If clinicians understand an individual’s veganism, they will be better able to support effective recovery in a trusting relationship.”