20 Mar 2019
Eating disorder services are struggling to respect the dietary requirement of vegan patients who need to be fed through a tube because of a lack of available products, three leading health organisations have warned.
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 their dietary requirements of very sick patients, the Royal College of Psychiatrists, the British Dietetic Association and eating disorder charity Beat say.
No prescribable vegan-friendly medications, supplement drinks and feeds currently exist and the three organisations now have published a joint statement 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 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.
The organisations’ call come at the start of the three-day International Eating Disorders Conference starting in London today (Wednesday).
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.
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. This increase has been largely driven by younger females living in urban areas making ethical and compassionate choices around their 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.”
Notes to editors
- The consensus statement is available here.
- Beat is the UK’s eating disorder charity, providing information and support 365 days to anyone affected by eating disorders. Beat also provides expert training for health and social care professionals and for schools: https://www.beateatingdisorders.org.uk/
- The British Dietetic Association (BDA), founded in 1936, is the professional association and trade union for dietitians in Great Britain and Northern Ireland. It is the nation’s largest organisation of food and nutrition professionals with over 9,500 members. www.bda.uk.com
- Dietitians are highly qualified health professionals that assess, diagnose and treat diet and nutrition problems at an individual and wider public health level. They are statutorily regulated by the Health and Care Professions Council (HCPC), alongside other Allied Health Professions.