Skip to main content
PMC home page
Brain and Behavior logoLink to Brain and Behavior
. 2020 Aug 7;10(9):e01774. doi: 10.1002/brb3.1774

The inter‐relationship between diet, selflessness, and disordered eating in Australian women

Melissa Collins 1,✉, Stephanie Quinton 1
PMCID: PMC7507084  PMID: 32767655

Abstract

Personality traits and diet can be used to predict if a person is predisposed to disordered eating. Results of this study demonstrate a strong significant relationship between the personality trait of selflessness, diet group, and disordered eating. Vegans were most likely to display selflessness tendencies associated with disordered eating; however when selflessness was controlled for, vegans displayed substantially less disordered eating pathology than non‐vegetarians.

Objective

To explore the relationship between diet group (non‐vegetarian, semi‐vegetarian, true‐vegetarian, and vegan) and disordered eating while investigating to what extent personality trait of selflessness mediates the relationship between diet group and disordered eating.

Method

Cross‐sectional data from 634 Australian nonclinical women who completed a series of online questionnaires including measures of diet group, disordered eating, and selflessness were used to examine associations between diet, personality (selflessness), and disordered eating.

Results

Selflessness was found to be a significant positive predictor of disordered eating. Results confirm that selflessness played a suppressing role in the relationship between the vegan diet group and disordered eating, when compared to non‐vegetarians. Surprisingly, vegans displayed significantly less disordered eating than non‐vegetarians and semi‐vegetarians.

Discussion

Results of the current study imply that the role of selflessness on disordered eating, when broken down across diet group, may be more complex than first thought. If replicated, these results suggest that targeted treatment of selflessness in different diet groups may improve treatment outcomes for disordered eating. Further research should explore why diet groups differ in terms of selflessness and how this impacts disordered eating.

Keywords: diet, disordered eating, perception of the self, selflessness, veganism, vegetarianism

Personality traits and diet can be used to predict if a person is predisposed to disordered eating. Results of this study demonstrate a strong significant relationship between the personality trait of selflessness, diet group, and disordered eating.

graphic file with name BRB3-10-e01774-g002.jpg

1. INTRODUCTION

Disordered eating is a significant issue in the Australian population, with an estimated 15% of Australian women needing clinical treatment for eating disorders (EDs) during their lifetime (National Eating Disorders Collaboration, 2012). Disordered eating results from dysfunctional feelings, behaviors, and thoughts concerning eating, feeding, and body image (Mulders‐Jones, Mitchison, Girosi, & Hay, 2017) and is linked to an extensive range of emotional and behavioral disorders such as substance abuse (Krug et al., 2009), impulsivity (Boisseau et al., 2012), obsessive–compulsive disorder (Pollack & Forbush, 2013), suicidal attempts (Arcelus, Mitchell, Wales, & Neilsen, 2011), and self‐injurious behaviors (Svirko & Hawton, 2007). Given the impact disordered eating has on an individual's life, it is vital for researchers to identify relevant risk factors to enable the creation of effective prevention and intervention programs. Despite this, the contributing factors of disordered eating are not yet fully understood.

According to the cognitive‐behavioral perspective on body self‐schema (how individuals perceive their body and eating behavior; Greer & Cooper, 2016), an individual's cognitive biases (emanating from their personality traits) can prompt coping and self‐regulating behaviors such as the adoption of dysfunctional eating (Carraça et al., 2011). These cognitive biases are likely to be activated when individuals are excessively focused on food or avoid certain food groups as seen in vegetarianism or veganism (Stein, 1996). That is, an individual's dietary habits may predispose them to disordered eating behavior, where disordered eating can lead to an increasingly restrictive diet (Albery, Michalska, Moss, & Spada, 2019) or conversely, a restrictive diet can lead to disordered eating (Brytek‐Matera, Czepczor‐Bernat, Jurzak, Kornacka, & Kołodziejczyk, 2018). Prior research suggests that a vegetarian or vegan diet may be used by individuals with EDs as a socially justifiable way of restricting their food consumption and controlling their weight, therefore playing a crucial role in disordered eating behavior (Klopp, Heiss, & Smith, 2003; Martins, Pliner, & O'Conner, 1999; Robinson‐O'Brien, Perry, Wall, Story, & Neumark‐Sztainer, 2009; Timko, Hormes, & Chubski, 2012). Furthermore, one study found 52% of individuals with a history of EDs were vegetarian when compared to 12% of individuals within the control group (Barr & Chapman, 2002). While the transition to vegetarianism or veganism is not indicative of an ED, the ongoing graduated restriction of additional food groups is a clear behavioral characteristic of disordered eating (Kadambari, Gowers, & Crisp, 1986).

Although theory (transdiagnostic cognitive‐behavioral model of disordered eating; Fairburn, Cooper, & Shafran, 2003) supports the relationship between diet and disordered eating, research findings on this subject have been inconsistent. For example, studies exploring degrees of dietary restraint among non‐vegetarians and vegetarians found that vegetarians display greater dietary restraint than non‐vegetarians (McLean & Barr, 2003; Robinson‐O'Brien et al., 2009; Trautman, Rau, Wilson, & Walters, 2008), whereas others have found greater dietary restraint in non‐vegetarians (Fatima, Fatima, & Anwar, 2018). While other studies have demonstrated no significant differences between non‐vegetarians and vegetarians (Fisak, Peterson, Tantleff‐Dunn, & Molnar, 2006; Heiss, Coffino, & Hormes, 2017).

A possible explanation for the conflicting results could be the failure of past studies to differentiate between the different levels vegetarianism, often combining them into a single label. Interestingly, studies that have separated vegetarians into the different subgroups have consistently found semi‐vegetarians (Individuals who follow a vegetarian diet but occasionally eat meat or poultry) to display greater dietary restraint then either true‐vegetarians, vegans and omnivores (Curtis & Comer, 2006; Forestell, 2018; Timko et al., 2012). Therefore, it could be speculated that significant results found in previous studies, where participants have not been separated into the subgroups, are likely reflecting the eating attitudes of semi‐vegetarians and might not be characteristic of true‐vegetarians or vegans.

It has also been theorized that vegetarians motivated solely by weight are less inclined to adopt the more restrictive levels of veganism as it requires higher levels of self‐control, commitment, and adoption of a strict lifestyle (e.g., vegans being unable to use leather, suede, and fur; Alvaro, 2017; Curtis & Comer, 2006). This theory has been supported by previous research who found that both non‐vegetarians (Curtis & Comer, 2006) and semi‐vegetarians (Perry, Mcguire, Neumark‐Sztainer, & Story, 2001; Timko et al., 2012) displayed higher levels of dietary restraint than vegetarians or vegans.

While the prevailing theory and empirical evidence support the notion that certain subgroups of vegetarianism are linked to increased risk of disordered eating, little is known about the nature of these associations. For instance, is diet directly related to disordered eating? Or could it be related through intervening variables such as personality traits? Indeed, eating meat has long been a symbol of masculinity and dominance (Rothgerber, 2013; Ruby & Heine, 2011). In contrast, the consumption of fruits, vegetables, and grains generally is associated with femininity, weakness, and selflessness (Beardsworth & Bryman, 1999; Fraser, Welch, Luben, Bingham, & Day, 2000), suggesting that personality factors may play a role in an individual's diet choice.

Selflessness was first proposed as a predisposing personality trait in disordered eating by Goodsitt (1997) who considered EDs as disorders of the self. Self‐psychology posits that ED patients have dysfunctional relationships with their self, thereby deriving their sense of self through food, unwilling to believe that others would willingly fulfill their self‐object needs (Bachar, 1998; Bachar, Gur, Canetti, Berry, & Stein, 2010; Bachar et al., 2002; Bachar, Latzer, Kreitler, & Berry, 1999; Geist, 1989). Therefore, ED patients behave as a selfless person, always fulfilling self‐object needs for others, rather than themselves, resulting in neglect of their basic needs such as food and sustenance (Bachar, 1998).

Bachar et al. (2002) argued that if ED patients did possess traits of selflessness, then they would rate higher than controls on a scale measuring one's rejection of life, that is, the rejection of the self. Indeed, he found that not only did both anorexic and bulimic patients have significantly higher traits of selflessness, they also felt significantly less attraction, and significantly greater repulsion to life than the control group.

More recently, selflessness scores were found to significantly predict disordered eating levels in female adolescents (Pinus, Canetti, Bonne, & Bachar, 2017) and were also found to predict disordered eating behaviors up to four years later (Bachar et al., 2010). These studies lend support to the self‐psychological theory that high selflessness may present as a risk factor in disordered eating, while reduced selflessness may be a protective factor (Bachar et al., 2010).

The primary aim of the current study is to determine whether the personality trait of selflessness mediates the relationships between diet group and disordered eating. If selflessness mediates the relationship between diet group and disordered eating, then it is hypothesized that any relationship between diet group and disordered eating scores will become weaker, or even disappear, once the selflessness scores are controlled for.

2. METHOD

2.1. Participants

Participants were a nonclinical sample, recruited using a snowballing technique on social media (Facebook), and a first‐year undergraduate sample was recruited through the Charles Sturt University psychology research experience program (SONA). As the current study sought a nonclinical population, participants that answered “yes” to “have you been diagnosed with an eating disorder?” were stopped from proceeding further. The sample included 780 women; however after data cleaning (removal of respondents missing data in questionnaires), a total of 634 women aged between 17 and 68 years (M = 28.83, SD = 10.71) remained. In the sample of 634 women, 578 (91.2%) self‐identified as Caucasian (non‐Hispanic); 6 (0.9%) identified as Hispanic; 18 (2.8%) identified as Asian; 11 (1.7%) identified as Aboriginal/Torres Strait Islander; 6 (0.9%) identified as Middle Eastern; 2 (0.3%) identified as Pacific Islander; and 2 (0.3%) identified as Black or African American. Eleven (1.7%) respondents selected “Other” classifying themselves as 2 mixed race, 1 Black and Caucasian mix, 4 Caucasian and Asian mix, 1 Eurasian, 2 Maori, and 1 Caucasian, Asian, and Pacific Islander mixed race.

2.2. Procedures

Ethics approval was obtained under ethics protocol number H18047 of the Human Research Ethics Committee, at Charles Sturt University (CSU). The quantitative study was delivered online via Qualtrics (provided by CSU School of Psychology). The survey link was distributed via social media and CSU psychology research experience program (SONA). Consent was embedded in the information statement in the survey that had to be electronically agreed to prior to participants being able to continue with the survey questions. Participants were advised that they could withdraw from the study at any point up to final submission. However, because the survey was anonymous, withdrawal after submission was not possible.

Participants were asked to answer demographic questions and then were directed to complete the Selflessness scale (SS; 15 questions) and the EAT‐26 scale (26 questions). The order of the scales (SS, EAT‐26) and the items within the scales were randomized to limit the possibility of order effect and response bias. The duration of the survey was approximately 15 min.

2.3. Materials

The online survey comprised of a demographic questionnaire including diet habits, the SS (Bachar et al., 2002) and the EAT‐26 (Garner, Olmsted, Bohr, & Garfinkel, 1982).

2.4. Demographics questionnaire

Sex, age, and race/ethnicity were based on self‐report data. Body mass index (BMI; body mass as weight in proportion to height, kg/m2) was determined by self‐reported weight and height. Weight status classification was determined based on the World Health Organization (WHO, 1997) standardized categories: BMI < 18.5 = underweight, BMI 18.5–24.99 = normal weight, BMI 25–29.99 overweight, and BMI > 30 = obese. Participant reports of weight trends (gain, loss, or stable) over the past year were collected.

Participants were provided with detailed definitions of all diet categories and then asked to indicate current diet status by responding to the following question “Do you consider yourself a vegetarian or vegan at this time?” (1) yes; (2) no. Participants that answered “yes” were asked to respond to more detailed diet questions (e.g., length of diet), while those that indicated “no” were classified as non‐vegetarians. All participants were then asked to complete a food frequency questionnaire to validate self‐reported diet status.

Using Tonstad, Butler, Yan, and Fraser (2009) dietary classifications, participants were then placed into four categories, making up four levels of the independent variable (non‐vegetarian, semi‐vegetarian, true‐vegetarian, and vegan). Non‐vegetarians were classified as individuals who consumed red meat, fish, poultry, eggs, and dairy more than once a week. Semi‐vegetarians were classified as individuals who ate red meat and poultry less than once a week but more than once a month and still consumed eggs and dairy products (includes semi‐vegetarians and pesco‐vegetarians). Full‐vegetarians were classified as individuals who do not consume red meat, poultry, or fish, but may still consume eggs and dairy products more than once a week (includes lacto–ovo‐vegetarians, lacto‐vegetarians, and ovo‐vegetarians). Vegans were defined as individuals who do not consume any products derived from animals.

2.5. EAT‐ 26

The Eating Attitudes Test (Garner & Garfinkel, 1979) was originally designed to detect symptoms of anorexia. Empirical evidence suggests that the EAT‐26 (Garner et al., 1982) can discriminate between healthy controls and individuals with EDs (Garfinkel & Newman, 2001). EAT‐26 scores have also been used to discriminate between individuals with differing levels of disordered eating symptomatology, signifying that the scale is suitable as a continuous measure of disordered eating (Orbitello et al., 2006). The current study therefore used a composite score utilizing the three subscales in the EAT‐26 (Dieting, Bulimia, and Food Preoccupation and Oral Control). In the current study, participants responded to 26 items on a six‐point Likert scale ranging from “never” to “always.” As this study aimed to explore the entire spectrum of disordered eating in a nonclinical population, each item was scored on a continuum of 1–6 to examine the full range of possible participant responses, with a possible score range of 26–156. High scores suggest increased disordered eating symptomology. Garner et al. (1982) demonstrated reliability and validity of the scale, and Cronbach's α was 0.83. The present study's Cronbach's α was 0.91 suggesting strong internal validity.

2.6. Selflessness

The Selflessness scale (SS; Bachar et al., 2002) is a self‐report scale designed to measure an individual's level of selflessness (the proclivity to ignore one's own needs to attend to the needs of others). Participants are asked to score 15 items on a 4‐point Likert scale (1 = highly disagree, 2 = disagree, 3 = agree, 4 = highly agree. For the current study, the scale's total had an acceptable albeit low Cronbach's α of 0.68.

2.7. Statistical analysis

One participant was identified as being significantly different from the others based on data from the univariate analysis (Z score of −3.69 on the SS) and multivariate analysis (Mahalanobis distance of 13.57). This participant was removed leaving a sample of 633.

Assumptions of normality for all scales were assessed for the full sample, and across all levels of the independent variable (diet group) using visual inspections of histograms and box plots. Normality of data was further examined by calculating z scores representing kurtosis and skewness of the scales used for mediation analysis (EAT‐26 scale and SS). Z scores above 2.58 were classified as significantly different from normal p < .01 (Ghasemi & Zahediasl, 2012).

The EAT‐26 scale revealed both significant skewness 0.86 (SE = 0.20) and significant positive kurtosis 0.71 (SE = 0.20), and therefore, a log transformation was performed on the data. A bootstrapping procedure was utilized for the bivariate correlation and regression analysis to deal with any non‐normality issues in the SS.

All analyses were conducted using SPSS version 25 (IBM, 2017). Descriptive statistics were analyzed for the group as a whole, and for each level of the independent variable (diet group: non‐vegetarian, semi‐vegetarian, true‐vegetarian, vegan). Bivariate correlational analysis was carried out to examine the relationship between diet group, BMI, age, selflessness, and disordered eating.

A mediated regression model was run using PROCESS macro model 4 for SPSS (Hayes, 2017) to test if selflessness mediates the relationship between diet group and disordered eating. Based on past literature findings of significant differences in disordered eating scores between non‐vegetarian, semi‐vegetarian, and vegan diet groups (Curtis & Comer, 2006; Forestell, 2018; Timko et al., 2012), mediation analyses were run using three different reference groups (non‐vegetarian, semi‐vegetarian, and vegan; a true‐vegetarian reference group was not needed as data on true‐vegetarians were subsequently captured while running the three reference groups).

Due to the lack of prior research on the relationship between diet group, selflessness, and disordered eating, the current study's objective was finding unique associations to be tested further (hence, avoiding Type II errors was deemed more critical than making Type I errors). Therefore, Bonferroni corrections were not utilized since these increase the probability of Type II errors and significantly diminish the power of analyses performed (Armstrong, 2014; Perneger, 1998). Consequently, it is imperative to interpret the study's results in the context of the subsequent increased risk of Type I errors.

Hayes (2017) bootstrap method of modeling was utilized to conduct the mediation models and estimate significance. As suggested by Hayes (2017), all mediation models used in this study were subject to 10,000 bootstrap samples, and 95% (percentile) bootstrap confidence intervals were calculated to test statistical inference.

It is important to note that the traditional criteria to establish mediation originally proposed by Baron and Kenny (1986), while historically important, are not consistent with more common practices. More recent assumptions indicate that an individual path in a mediation model need not be significant, and indeed, its significance is not pertinent to whether the indirect effect of a mediation model is significant (see Hayes, 2009, for discussion).

3. RESULTS

3.1. Dietary group characteristics

Sample characteristics split across diet groups are displayed in Table 1. Vegans reported the highest percentage of weight loss in the previous 12 months, with 26.4% of participants in the vegan diet group reporting weight loss. The semi‐vegetarian group displayed the lowest percentage of weight loss with only 2.8% of participants in the group reported losing weight in the previous 12 months.

Table 1.

Dietary group characteristics (with outlier)

Group Classification
Semi‐Veg True‐Veg Vegan Non‐Veg
Attributes n (%)/ M ± SD n (%)/ M ± SD n (%)/ M ± SD n (%)/ M ± SD
Age (year) 26.14 ± 8.40 28.88 ± 11.29 27.50 ± 10.10 31.42 ± 11.13
Height (cm) 166.85 ± 6.41 166.81 ± 6.55 166.26 ± 7.14 165.17 ± 7.76
Weight (kg) 68.68 ± 18.47 67.87 ± 14.81 65.12 ± 12.01 73.19 ± 17.97
Characteristics
Participants 36 (5.7) 104 (16.4) 281 (44.3) 213 (33.6)
Weight loss 10 (2.8) 28 (7.9) 94 (26.4) 61 (17.1)
Weight gain 13 (3.7) 25 (7) 58 (16.3) 67 (18.8)
Length in vegetarian/vegan diet (Years)
Under 1 year 8 (2) 25 (6.2) 39 (9.7)
1–2 years 3 (0.7) 24 (6) 72 (18)
2–5 years 4 (1) 27(6.7) 95(23.7)
5–10 years 0 (0) 8 (2) 32 (8)
Over 10 years 2 (0.5) 13 (3.2) 37 (9.2)
Entire Life 0 (0) 6 (1.5) 6 (1.5)
Open in a new tab

Percentages displayed in weight gain/ loss refer to percentages out of n = 356. Percentages displayed in “length in vegetarian/vegan diet” refer to percentages out of those who classified themselves as vegetarian/vegan. Semi‐Veg = Semi‐vegetarian, True‐Veg = True‐vegetarian, Non‐Veg = Non‐vegetarian.

Overall, the vegan group contained the highest percentage of “normal weight” individuals, while the non‐vegetarian group contained the highest percentage of “overweight “and “obese” individuals. In addition, the semi‐vegetarian group contained the highest percentage of “underweight” (BMI < 18.5) individuals (Table 2).

Table 2.

Dietary group frequencies and percentages for BMI categories (with outlier)

Group classification
BMI category Semi‐Veg True‐Veg Vegan Non‐Veg Total
n % n % n % n % n %
Underweight 3 8.3 4 3.9 15 5.4 2 0.9 24 3.8
Normal Weight 22 61.1 65 63.1 191 68.2 100 47.2 378 59.9
Overweight 4 11.1 20 19.4 42 15.0 58 27.4 124 19.7
Obese 7 19.4 14 13.6 32 11.4 52 24.5 105 16.6
Total 36 100 103 100 280 100 212 100 631 100
Open in a new tab

Abbreviations: BMI, body mass index; Non‐Veg, Non‐vegetarian. % indicates percentage within diet subgroup; Semi‐Veg, Semi‐vegetarian; True‐Veg, True‐vegetarian.

3.2. Correlations between selflessness, diet, and disordered eating

To examine the relationship between selflessness, diet, and disordered eating, psychological data obtained from EAT‐26 and SS were analyzed alongside diet and weight data. Pearson r Pearson r zero‐order correlations were run for each level of diet group and are presented in table 3. Bootstrapping was utilized using 5,000 repetitions to deal with non‐normality issues. Selflessness scores showed a small significant positive relationship to disordered eating, but only for the vegan group, suggesting that as selflessness levels increased for vegans, so did their level of disordered eating.

Table 3.

Correlations among study variables across levels of diet group: Age, BMI, EAT‐26‐LOG, and Selflessness

Diet Group Age BMI Selflessness EAT‐26‐LOG
Age Non‐Veg – 0.251*** −0.118 −0.185*
Semi‐Veg 0.484** 0.033 −0.304
True‐Veg 0.158 −0.135 −0.151
Vegan 0.207*** −0.088 −0.805
n
BMI Non‐Veg 212 ‐ 0.162* 0.053
Semi‐Veg 36 0.194 0.104
True‐Veg 103 0.115 0.300**
Vegan 279 0.074 0.060
n n
Selflessness Non‐Veg 210 209 ‐ 0.130
Semi‐Veg 36 36 0.199
True‐Veg 104 103 0.102
Vegan 276 275 0.142*
n n n
EAT‐26‐LOG Non‐Veg 213 212 210 ‐
Semi‐Veg 36 36 36
True‐Veg 104 103 104
Vegan 280 279 276
Open in a new tab

*p < .05; **p < .01; ***p < .001; two tailed. Bottom triangle denotes sample size n.

3.3. The mediating effect of selflessness

3.3.1. Comparison against non‐vegetarian reference group

Table 4 illustrates the mediation model between diet group and disordered eating via selflessness with non‐vegetarians as the reference group. Interestingly, vegans had significantly higher selflessness scores (M = 42.26, SE = 0.254) than non‐vegetarians (M = 41.47, SE = 0.284) and significantly lower disordered eating scores (M = 1.78, SE = 0.007) than non‐vegetarians (M = 1.81, SE = 0.008).

Table 4.

Multiple mediation model for diet group, Selflessness and EAT‐26‐LOG (disordered eating). Reference group: Non‐vegetarian

Path Coeff SE t p value LLCI ULCI
Reference group: Non‐vegetarian
Path a
Semi‐vegetarian 0.140 0.766 0.182 .855 −1.37 1.64
True‐vegetarian 0.182 0.509 0.358 .720 −0.818 1.18
Vegan 0.789 0.389 2.03 .043* 0.026 1.55
Path b 0.004 0.001 3.41 .001** 0.002 0.006
Direct effect (C’)
Semi‐vegetarian 0.032 0.023 1.41 .158 −0.012 0.075
True‐vegetarian −0.010 0.015 −0.653 .514 −0.039 0.019
Vegan −0.032 0.011 −2.85 .004** −0.055 −0.010
Total effect (C)
Semi‐vegetarian 0.032 0.023 1.43 .155 −0.012 0.076
True‐vegetarian −0.009 0.015 −0.599 .549 −0.038 0.020
Vegan −0.029 0.011 −2.56 .011* −0.052 −0.007
Indirect effect Effect Boot SE BootLLCI BootULCI
Semi‐vegetarian 0.001 0.004 −0.006 0.008
True‐vegetarian 0.001 0.002 −0.003 0.005
Vegan 0.003* 0.002 0.0001 0.007
Open in a new tab

95% Confidence intervals. LLCI = lower limit confidence interval; ULCI = upper limit confidence interval. BootLLCI = bootstrapping lower limit confidence interval. BootULCI = bootstrapping upper limit confidence interval. SE = standard error. *p < .05; **p < .01; ***p < .001.

The vegan diet group was the only group which did not have zero occurs between the upper and lower boundaries of the indirect effect 95% confidence interval, implying that a partial inconsistent mediation had occurred (MacKinnon, Fairchild & Fritz, 2007) and concluding that the mediator variable had acted as a partial suppressor variable. Therefore, the negative relationship between the vegan diet group and disordered eating was strengthened by the addition of selflessness as a mediating variable (Figure 1). (b = 0.003, SE = 0.002, 95% CI [0.001, 0.007]).

Figure 1.

Figure 1

Open in a new tab

Mediating role of selflessness on the relationship between diet groups and disordered eating with non‐vegetarian as reference group. A‐path: coefficient describing the difference in selflessness in comparison with non‐vegetarian group. b‐path: b‐coefficient reflects change in EAT‐26‐LOG scores per one‐point change in selflessness scores when diet group is constant. c′ (c) ‐path: direct (total) effect. *p < .05; **p < .01; ***p < .001

3.3.2. Comparison against vegan, true‐vegetarian, and semi‐vegetarian reference groups

Further analysis was run with the vegan diet group as the reference group. Results indicated that when compared to vegans (M = 1.78, SE = 0.007), semi‐vegetarians (M = 1.84, SE = 0.025) had significantly higher disordered eating scores, c path = 0.061, t (622) = 2.78, p = .006. No significant difference was found in selflessness scores when semi‐vegetarians and true‐vegetarians were compared to vegans. Contrary to expectations, selflessness did not mediate the relationship between diet group and disordered eating when semi‐vegetarian and true‐vegetarian groups were compared to the vegan diet group, or when the true‐vegetarian and semi‐vegetarian groups were compared to each other.

4. DISCUSSION

4.1. Diet group and disordered eating

Previous studies examining disordered eating have focused on either personality traits or diet group, with very few exploring both factors simultaneously. The present study therefore sought to answer the following questions: Does selflessness significantly predict disordered eating? and Does selflessness mediate the relationship between diet group (non‐vegetarian, semi‐vegetarian, true‐vegetarian, and vegan) and disordered eating?

In line with previous research (Curtis & Comer, 2006; Timko et al., 2012), the semi‐vegetarian group displayed the highest levels of disordered eating, having higher scores than non‐vegetarians and true‐vegetarians, and significantly higher scores than vegans. Further to this, the current study's results found vegans to have significantly lower disordered eating scores than both semi‐vegetarians and non‐vegetarians. A similar result was found by Timko et al. (2012), who reported lower levels of disordered eating and dietary restraint, in vegans when compared to other diet groups.

The current study's findings raise concerns over past research grouping together semi‐vegetarians and true‐vegetarians (Kadambari et al., 1986; Perry et al., 2001; Trautman et al., 2008), as significant associations between disordered eating and vegetarianism may have simply been artifacts of a larger number of semi‐vegetarians in the study sample. Future research should therefore differentiate between semi‐vegetarians, true‐vegetarians, and vegans when looking at the association between disordered eating and vegetarianism.

The picture that emerges from both previous studies and the present study is that an individual's diet choice and disordered eating behavior appear to be intertwined. The joint link, however, can only be speculated. It is possible that the increased focus on food when an individual commences a semi‐vegetarian diet turns a seemingly innocent diet choice into an obsession and disorder (Lindeman, Stark & Latvala, 2000). However, by this logic, the vegan group, who would require the highest focus on food due to the amount of excluded food groups, should display the highest levels of disordered eating rather than the lowest levels. A more fitting explanation is that the less restrictive levels of vegetarianism, for instance, semi‐vegetarianism, may act as a mask for disordered eating behavior for individuals already suffering from disordered eating, whereas true‐vegetarianism and veganism may represent a lifestyle choice that goes beyond weight and diet preoccupations (Bardone‐Cone et al., 2012; Heiss et al., 2017). However, future research is required for etiological clarification.

4.2. Selflessness and disordered eating

In support of the hypothesis, selflessness was found to significantly predict disordered eating. This finding is consistent with previous studies (Bachar et al., 2002, 2010; Pinus et al., 2017) that found selflessness to not only predict disordered eating, but also be a predisposing factor in disordered eating. Another novel finding was that when selflessness was examined by diet subgroup, only the vegan group had a significant positive correlation between selflessness and disordered eating. Moreover, vegans displayed significantly higher selflessness levels than semi‐vegetarians and non‐vegetarians, despite vegans having the lowest levels of disordered eating.

Theory proposes that individuals with EDs derive their sense of self through food and thereby act as a selfless person, always striving to fulfill the needs of others rather than their own (Bachar 1998). From this standpoint, we could reason that vegans have high levels of selflessness as they indirectly derive their sense of self through food by adopting a vegan diet to minimize harm to animals and nature. An alternative explanation could be that when individuals adopt a vegan diet, their levels of selflessness increase as they are exposed to material portraying animal cruelty and environmental impact (Christopher, Bartkowski, & Haverda, 2018), and as selflessness levels increase so does their risk of disordered eating (Bachar et al., 2002).

Yet the question remains, why do vegans who have the highest levels of selflessness also have the lowest levels of disordered eating? As Sarner‐Levin et al. (2018) point out, standing up for one's own beliefs and views may protect individuals against the development of disordered eating, even if they may be predisposed to dysfunctional eating (such as individuals high in selflessness). Additionally, Kessler et al. (2016) found that vegans scored higher on self‐determination than vegetarians and were also less influenced by their social environment than vegetarians. Vegans may then present as a unique group where although they have high levels of selflessness, they also possess strong self‐determination and beliefs, thereby creating a protective factor from disordered eating. However, future research should further investigate the potential protective factors that may be linked to the vegan diet by seeing if the relationship between the vegan diet and disordered eating is mediated by a measure of self‐determination.

4.3. The mediating effect of selflessness

Contrary to expectations, the vegan group (compared to non‐vegetarians) was the only group where selflessness acted as an inconsistent mediator by partially suppressing the relationship between diet and disordered eating. This implies that when selflessness was controlled for, vegans displayed substantially less disordered eating pathology than non‐vegetarians. Previous studies have found that a self‐psychological approach (targeting selflessness) significantly reduced ED symptoms in ED patients when compared to cognitive orientation treatment and control/nutritional counseling (Bachar, 2018).

The results from the current study thereby raise the possibility that with targeted intervention on selflessness traits, disordered eating symptoms in vegans may be substantially reduced. Due to the lack of prior research, it remains unclear why no significant associations were found between selflessness and disordered eating in the non‐vegetarian, semi‐vegetarian, or true‐vegetarian group.

5. LIMITATIONS

There are several limitations to the current study that should guide the interpretation of results. Firstly, despite ample efforts to recruit semi‐vegetarians, lacto‐vegetarians, ovo‐vegetarians, lacto–ovo‐vegetarians, and pesco‐vegetarians the sample size in these categories was less than optimal, therefore making a comprehensive comparison of all the different levels of vegetarianism unsuitable. Future research should aim to ensure they have adequate sample sizes in each of the diet subgroups to ensure a more detailed comparison can be carried out.

Secondly, the current study is the first study to use the SS in an Australian population. The current study's Cronbach's α for the SS was below the satisfactory level of reliability as suggested by Nunnally (1978). This study highlights the requirement for further validation and testing of the SS cross‐culturally. Further research should aim to either validate the scale using an Australian population or seek to create a scale of selflessness which is suitable for use in a sample of Australian women.

A further concern of the current study was the increased possibility of Type Ⅰ error due to the number of comparisons undertaken to compare non‐vegetarian, semi‐vegetarian, true‐vegetarian, and vegan diet groups. However, even with the increased possibility of Type Ⅰ error, the evident differences in disordered eating between diet groups warrant further investigation. Future researchers should seek to replicate the current study's results using planned comparisons ensuring they had a larger sample of semi‐vegetarians.

6. THEORETICAL IMPLICATIONS

The results of the current study raise both theoretical and clinical implications in this field of research. Although the present study indicates that selflessness may be associated with disordered eating; when selflessness is broken down across diet groups, the only group to display a significant association between selflessness and disordered eating was the vegan diet group. The fact that vegans displayed the lowest levels of disordered eating suggests that there may be limitations to be explored in the context of the self‐psychology theoretical framework of EDs (individuals deriving their sense of self through food) when reviewing selflessness across diet groups.

7. IMPLICATIONS FOR FUTURE RESEARCH

Inconsistent mediation, as seen in this study, raises concerns for future studies and the possibility of increased Type II error. Inconsistent mediation is characterized by opposing signs on direct effects and indirect effects (negative versus positive) which tend to cancel each other out. Therefore, mediation may be difficult to identify as most models require a significant association between the independent and dependent variables (Baron & Kenny, 1986) which may not appear in a simple regression if the direct effect and indirect effect are canceling each other out. If the current study's findings can be replicated by future research, it may hold implications for future research methodology when exploring the relationship between selflessness and disordered eating.

8. CONCLUSION

The aim of this study was to explore the relationship between diet groups, selflessness, and disordered eating. Results showed support of the hypothesis that selflessness is a significant predictor in disordered eating. However, when these relationships were viewed across the different levels of vegetarianism, the results showed that different diet groups displayed unique associations between selflessness and disordered eating. This highlights the need for further research on disordered eating to take into account an individual's diet preference as this may have a significant impact on future findings. Overall, the current study's findings make several contributions to the growing body of literature on disordered eating and serve as a base for future studies exploring the relationship between diet, selflessness, and disordered eating.

CONFLICT OF INTEREST

The authors declare there is no conflict of interest.

AUTHOR CONTRIBUTION

M.C conceived and designed the study, collected the cases; analyzed and interpreted the data; and wrote the manuscript. S.Q conceived and designed the study, supervised the project, and edited and contributed to the manuscript. All authors provided revisions and approved the final version of the paper for submission.

Peer Review

The peer review history for this article is available at https://publons.com/publon/10.1002/brb3.1774.

ACKNOWLEDGMENTS

Financial support: This research was supported by Charles Sturt University.

Collins M, Quinton S. The inter‐relationship between diet, selflessness, and disordered eating in Australian women. Brain Behav. 2020;10:e01774 10.1002/brb3.1774

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

REFERENCES

  1. Albery, I. , Michalska, M. , Moss, A. , & Spada, M. (2019). Selective attentional bias to food‐related stimuli in healthy individuals with characteristics towards orthorexia nervosa. Eating and Weight Disorders ‐ Studies on Anorexia, Bulimia and Obesity, 1–9, 10.1007/s40519-019-00755-z [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Alvaro, C. (2017). Ethical veganism, virtue, and greatness of the soul. Journal of Agricultural and Environmental Ethics, 30(6), 765–781. 10.1007/s10806-017-9698-z [DOI] [Google Scholar]
  3. Arcelus, J. , Mitchell, A. , Wales, J. , & Neilsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders. Archives of General Psychiatry, 68(7), 724 10.1001/archgenpsychiatry.2011.74 [DOI] [PubMed] [Google Scholar]
  4. Armstrong, R. (2014). When to use the Bonferroni correction. Ophthalmic and Physiological Optics, 34(5), 502–508. 10.1111/opo.12131 [DOI] [PubMed] [Google Scholar]
  5. Bachar, E. (1998). The contributions of self‐psychology to the treatment of anorexia and bulimia. American Journal of Psychotherapy, 52(2), 147–165. 10.1176/appi.psychotherapy.1998.52.2.147 [DOI] [PubMed] [Google Scholar]
  6. Bachar, E. (2018). Evidence basis for psychodynamic self‐psychology in eating disorders ‐ A review paper. Israel Journal of Psychiatry, 55(1), 19–24. [PubMed] [Google Scholar]
  7. Bachar, E. , Gur, E. , Canetti, L. , Berry, E. , & Stein, D. (2010). Selflessness and perfectionism as predictors of pathological eating attitudes and disorders: A longitudinal study. European Eating Disorders Review, 18(6), 496–506. 10.1002/erv.984 [DOI] [PubMed] [Google Scholar]
  8. Bachar, E. , Latzer, Y. , Canetti, L. , Gur, E. , Berry, E. , & Bonne, O. (2002). Rejection of life in anorexic and bulimic patients. International Journal of Eating Disorders, 31(1), 43–48. 10.1002/eat.10003 [DOI] [PubMed] [Google Scholar]
  9. Bachar, E. , Latzer, Y. , Kreitler, S. , & Berry, E. M. (1999). Empirical comparison of two psychological therapies: Self psychology and cognitive orientation in the treatment of anorexia and bulimia. The Journal of Psychotherapy Practice and Research, 8(2), 115. [PMC free article] [PubMed] [Google Scholar]
  10. Bardone‐Cone, A. , Fitzsimmons‐Craft, E. , Harney, M. , Maldonado, C. , Lawson, M. , Smith, R. , … Robinson, D. (2012). The inter‐relationships between vegetarianism and eating disorders among females. Journal of The Academy of Nutrition and Dietetics, 112(8), 1247–1252. 10.1016/j.jand.2012.05.007 [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Baron, R. , & Kenny, D. (1986). The moderator‐mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. 10.1037//0022-3514.51.6.1173 [DOI] [PubMed] [Google Scholar]
  12. Barr, S. , & Chapman, G. (2002). Perceptions and practices of self‐defined current vegetarian, former vegetarian, and nonvegetarian women. Journal of the American Dietetic Association, 102(3), 354–360. 10.1016/s00028223(02)90083-0 [DOI] [PubMed] [Google Scholar]
  13. Beardsworth, A. , & Bryman, A. (1999). Meat consumption and vegetarianism among young adults in the UK. British Food Journal, 101(4), 289–300. 10.1108/00070709910272169 [DOI] [Google Scholar]
  14. Boisseau, C. , Thompson‐Brenner, H. , Caldwell‐Harris, C. , Pratt, E. , Farchione, T. , & Harrison Barlow, D. (2012). Behavioral and cognitive impulsivity in obsessive– compulsive disorder and eating disorders. Psychiatry Research, 200(2–3), 1062–1066. 10.1016/j.psychres.2012.06.010 [DOI] [PubMed] [Google Scholar]
  15. Brytek‐Matera, A. , Czepczor‐Bernat, K. , Jurzak, H. , Kornacka, M. , & Kołodziejczyk, N. (2018). Strict health‐oriented eating patterns (orthorexic eating behaviours) and their connection with a vegetarian and vegan diet. Eating and Weight Disorders ‐ Studies on Anorexia, Bulimia and Obesity, 24(3), 441–452. 10.1007/s40519-018-0563-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Carraça, E. , Silva, M. , Markland, D. , Vieira, P. , Minderico, C. , Sardinha, L. , & Teixeira, P. (2011). Body image change and improved eating self‐regulation in a weight management intervention in women. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 75 10.1186/1479-5868-8-75 [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Christopher, A. , Bartkowski, J. , & Haverda, T. (2018). Portraits of veganism: A comparative discourse analysis of a second‐order subculture. Societies, 8(3), 55 10.3390/soc8030055 [DOI] [Google Scholar]
  18. Curtis, M. , & Comer, L. (2006). Vegetarianism, dietary restraint and feminist identity. Eating Behaviors, 7(2), 91–104. 10.1016/j.eatbeh.2005.08.002 [DOI] [PubMed] [Google Scholar]
  19. Fairburn, C. , Cooper, Z. , & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509–528. 10.1016/s0005-7967(02)00088-8 [DOI] [PubMed] [Google Scholar]
  20. Fatima, W. , Fatima, R. , & Anwar, N. (2018). Subclinical eating disorders and association with vegetarianism in female students of Saudi Arabia: A crosssectional study. Journal of Nursing and Health Science, 7(2), 62–67. 10.9790/1959-0702026267 [DOI] [Google Scholar]
  21. Fisak, B. , Peterson, R. , Tantleff‐Dunn, S. , & Molnar, J. (2006). Challenging previous conceptions of vegetarianism and eating disorders. Eating and Weight Disorders ‐ Studies on Anorexia, Bulimia and Obesity, 11(4), 195–200. 10.1007/bf03327571 [DOI] [PubMed] [Google Scholar]
  22. Forestell, C. (2018). Flexitarian diet and weight control: Healthy or risky eating behavior?. Frontiers in Nutrition, 5(59). 10.3389/fnut.2018.00059 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Fraser, G. , Welch, A. , Luben, R. , Bingham, S. , & Day, N. (2000). The effect of age, sex, and education on food consumption of a middle‐aged English cohort—EPIC in East Anglia. Preventive Medicine, 30(1), 26–34. 10.1006/pmed.1999.0598 [DOI] [PubMed] [Google Scholar]
  24. Garfinkel, P. , & Newman, A. (2001). The Eating Attitudes Test: Twenty‐five years later. Eating and Weight Disorders ‐ Studies on Anorexia, Bulimia and Obesity, 6(1), 1–21. 10.1007/bf03339747 [DOI] [PubMed] [Google Scholar]
  25. Garner, D. , & Garfinkel, P. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9(02), 273 10.1017/s0033291700030762 [DOI] [PubMed] [Google Scholar]
  26. Garner, D. , Olmsted, M. , Bohr, Y. , & Garfinkel, P. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12(04), 871 10.1017/s0033291700049163 [DOI] [PubMed] [Google Scholar]
  27. Geist, R. (1989). Self‐psychological reflections on the origins of eating disorders. Journal of the American Academy of Psychoanalysis, 17(1), 5–27. 10.1521/jaap.1.1989.17.1.5. [DOI] [PubMed] [Google Scholar]
  28. Ghasemi, A. , & Zahediasl, S. (2012). Normality tests for statistical analysis: A guide for non‐statisticians. International Journal of Endocrinology and Metabolism, 10(2), 486–489. 10.5812/ijem.3505 [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Goodsitt, A. (1997). Eating disorders: A self‐psychological perspective In Garner D. M., & Garfinkel P. E. (Eds.), Handbook of psychotherapy for eating disorders, 2nd ed. (pp. 205–228). New York, NY: Guilford. [Google Scholar]
  30. Greer, S. , & Cooper, M. (2016). Do female dieters have an “eating disorder” selfschema? Journal of Eating Disorders, 4(1), 1–8. 10.1186/s40337-016-0103-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Hayes, A. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76(4), 408–420. 10.1080/03637750903310360 [DOI] [Google Scholar]
  32. Hayes, A. (2017). Introduction to mediation, moderation, and conditional process analysis, Second Edition: A regression‐based approach. New York; London: Guilford Publications; Retrieved from https://ebookcentral-proquestcom.ezproxy.csu.edu.au [Google Scholar]
  33. Heiss, S. , Coffino, J. , & Hormes, J. (2017). Eating and health behaviors in vegans compared to omnivores: Dispelling common myths. Appetite, 118, 129–135. 10.1016/j.appet.2017.08.001 [DOI] [PubMed] [Google Scholar]
  34. IBM (2017). SPSS Statistics Package, Version 25.0. Armonk, NY: IMB Corp. [Google Scholar]
  35. Kadambari, R. , Gowers, S. , & Crisp, A. (1986). Some correlates of vegetarianism in anorexia nervosa. International Journal of Eating Disorders, 5(3), 539–544. [DOI] [Google Scholar]
  36. Kessler, C. , Holler, S. , Joy, S. , Dhruva, A. , Michalsen, A. , Dobos, G. , & Cramer, H. (2016). Personality profiles, values and empathy: Differences between lacto‐ovovegetarians and vegans. Complementary Medicine Research, 23(2), 95–102. 10.1159/000445369 [DOI] [PubMed] [Google Scholar]
  37. Klopp, S. , Heiss, C. , & Smith, H. (2003). Self‐reported vegetarianism may be a marker for college women at risk for disordered eating. Journal of the American Dietetic Association, 103(6), 745–747. 10.1053/jada.2003.50139 [DOI] [PubMed] [Google Scholar]
  38. Krug, I. , Pinheiro, A. P. , Bulik, C. , Jiménez‐Murcia, S. , Granero, R. , Penelo, E. , … Fernández‐Aranda, F. (2009). Lifetime substance abuse, family history of alcohol abuse/dependence and novelty seeking in eating disorders: Comparison study of eating disorder subgroups. Psychiatry and Clinical Neurosciences, 63(1), 82–87. 10.1111/j.1440-1819.2008.01908.x [DOI] [PubMed] [Google Scholar]
  39. Lindeman, L. , Stark, K. , & Latvala, K. (2000). Vegetarianism and eating-disordered thinking. Eating Disorders, 8(2), 157–165. 10.1080/10640260008251222 [DOI] [Google Scholar]
  40. Martins, Y. , Pliner, P. , & O'Conner, R. (1999). Restrained eating among vegetarians: Does a vegetarian eating style mask concerns about weight? Appetite, 32(1), 145–154. 10.1006/appe.1998.0185 [DOI] [PubMed] [Google Scholar]
  41. McLean, J. , & Barr, S. (2003). Cognitive dietary restraint is associated with eating behaviors, lifestyle practices, personality characteristics and menstrual irregularity in college women. Appetite, 40(2), 185–192. 10.1016/s01956663(02)00125-3 [DOI] [PubMed] [Google Scholar]
  42. Mulders‐Jones, B. , Mitchison, D. , Girosi, F. , & Hay, P. (2017). Socioeconomic correlates of eating disorder symptoms in an Australian population‐based sample. PLoS One, 12(1), e0170603 10.1371/journal.pone.0170603 [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. National Eating Disorders Collaboration . (2012). An Integrated Response to Complexity: National Eating Disorders Framework. Report for the Department of Health and Ageing. [Google Scholar]
  44. Nunnally, J. (1978). Psychometric theory (pp. 245–246). New York, NY: McGraw‐Hill Book. [Google Scholar]
  45. Orbitello, B. , Ciano, R. , Corsaro, M. , Rocco, P. L. , Taboga, C. , Tonutti, L. , … Balestrieri, M. (2006). The EAT‐26 as screening instrument for clinical nutrition unit attenders. International Journal of Obesity, 30(6), 977–981. 10.1038/sj.ijo.0803238 [DOI] [PubMed] [Google Scholar]
  46. Perneger, T. (1998). What's wrong with Bonferroni adjustments. BMJ, 316(7139), 1236–1238. 10.1136/bmj.316.7139.1236 [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Perry, C. , Mcguire, M. , Neumark‐Sztainer, D. , & Story, M. (2001). Characteristics of vegetarian adolescents in a multiethnic urban population. Journal of Adolescent Health, 29(6), 406–416. 10.1016/s1054-139x(01)00258-0 [DOI] [PubMed] [Google Scholar]
  48. Pinus, U. , Canetti, L. , Bonne, O. , & Bachar, E. (2017). Selflessness as a predictor of remission from an eating disorder: 1–4 year outcomes from an adolescent daycare unit. Eating and Weight Disorders ‐ Studies on Anorexia, Bulimia and Obesity, 24, 777–786. 10.1007/s40519-017-0444-3 [DOI] [PubMed] [Google Scholar]
  49. Pollack, L. , & Forbush, K. (2013). Why do eating disorders and obsessive–compulsive disorder co‐occur? Eating Behaviors, 14(2), 211–215. 10.1016/j.eatbeh.2013.01.004 [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Robinson‐O'Brien, R. , Perry, C. , Wall, M. , Story, M. , & Neumark‐Sztainer, D. (2009). Adolescent and young adult vegetarianism: Better dietary intake and weight outcomes but Increased risk of disordered eating behaviors. Journal of the American Dietetic Association, 109(4), 648–655. 10.1016/j.jada.2008.12.014 [DOI] [PubMed] [Google Scholar]
  51. Rothgerber, H. (2013). Real men don’t eat (vegetable) quiche: Masculinity and the justification of meat consumption. Psychology of Men & Masculinity, 14(4), 363–375. 10.1037/a0030379 [DOI] [Google Scholar]
  52. Ruby, M. , & Heine, S. (2011). Meat, morals, and masculinity. Appetite, 56(2), 447–450. 10.1016/j.appet.2011.01.018 [DOI] [PubMed] [Google Scholar]
  53. Sarner‐Levin, K. , Canetti, L. , Latzer, Y. , Bonne, O. , Lerer, B. , & Bachar, E. (2018). Anorexia nervosa, selflessness, and gender‐role identity: A study of daughters and parents. Israel Journal of Psychiatry, 55(1), 25–34. [PubMed] [Google Scholar]
  54. Stein, K. (1996). The self‐schema model: A theoretical approach to the self‐concept in eating disorders. Archives of Psychiatric Nursing, 10(2), 96–109. 10.1016/s0883-9417(96)80072-0 [DOI] [PubMed] [Google Scholar]
  55. Svirko, E. , & Hawton, K. (2007). Self‐Injurious behavior and eating disorders: The extent and nature of the association. Suicide and Life‐Threatening Behavior, 37(4), 409–421. 10.1521/suli.2007.37.4.409 [DOI] [PubMed] [Google Scholar]
  56. Timko, C. , Hormes, J. , & Chubski, J. (2012). Will the real vegetarian please stand up? An investigation of dietary restraint and eating disorder symptoms in vegetarians versus non‐vegetarians. Appetite, 58(3), 982–990. 10.1016/j.appet.2012.02.005 [DOI] [PubMed] [Google Scholar]
  57. Tonstad, S. , Butler, T. , Yan, R. , & Fraser, G. (2009). Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care, 32(5), 791–796. 10.2337/dc08-1886 [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Trautman, J. , Rau, S. , Wilson, M. , & Walters, C. (2008). Vegetarian students in their first year of college. Are they at risk for restrictive or disordered eating behaviour? College Student Journal, 42(2), 340–347. [Google Scholar]
  59. World Health Organization (1997). Obesity: Preventing and managing the global epidemic. Report on a WHO consultation on Obesity. Geneva, Switzerland: WHO. [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Articles from Brain and Behavior are provided here courtesy of Wiley

RESOURCES