Summary

The essay explores why the vegan movement has struggled to gain traction in America despite widespread moral concern for factory farming. One major reason for this lack of progress is the high vegan dropout rate, which is caused in large part by health related challenges. While scientific studies affirm that a properly planned vegan diet can be nutritionally adequate, many ex-vegans—ranging from celebrities to public intellectuals—have reported facing health problems on vegan diets.

Two key reasons are identified for why some vegans experience health problems:

1. Misinformation – Many people transition to unhealthy or restrictive versions of veganism, such as raw veganism, which lacks sufficient calories and nutrients. The internet is also flooded with conflicting dietary advice, making it difficult for new vegans to discern reliable nutritional guidance.
2. The Challenge of Transitioning – Successfully adopting a vegan diet requires learning new recipes, adjusting portion sizes, and taking supplements (e.g., B12), which many people fail to do. Some new vegans don’t consume enough calories or protein, leading to health issues that drive them back to an omnivorous diet.

Note: This essay is a cross-post from my blog. It was originally titled "Veganism has a Serious Retention Problem"

Introduction

Why has the vegan movement struggled to make progress in America? Looking at the survey data, one might expect the country to at least be moving towards banning factory farming. A 2022 poll by Data for Progress, for instance, showed that nearly 80% of Americans considered the suffering of farm animals “a matter of moral concern”, with nearly the same percentage agreeing that it was either “somewhat or very important” for companies to only offer cruelty-free animal products.^[1]

Even conservatives, who as a group tend to be more hostile to veganism, have shown a surprising degree of support for the movement. Fox News hosts Tucker Carlson and Greg Gutfeld have both publicly expressed sympathy with vegan activists, and articles voicing opposition to factory farming can be found in major conservative publications.

Yet despite widespread agreement on the cruelty of factory farming, this consensus has not produced a shift in the daily habits of Americans. Gallup found that the percentage of Americans who identified as vegetarian or vegan has remained basically unchanged since 1999.^[2]

Nor has meat consumption decreased. In fact according to the USDA, per capita meat consumption in the United States has been consistently rising for decades, hitting an all-time high in 2021.^[3] While there have been legislative victories such as California’s Prop 12, the condition of the vast majority of farm animals sadly remains the same: the USDA estimates that (literally) 99% of the country’s animals are still being raised in factory-farmed conditions.^[4]

There are many factors which could help explain this absence of progress, but undoubtedly one of the most important is the vegan dropout rate. Faunalytics, a data analytics group dedicated to advancing animal advocacy, found that over 84% of Americans who adopted veganism or vegetarianism eventually reverted back to eating animal products.^[5] Had they all continued with their diet, nearly ⅙ of Americans today would be vegan or vegetarian. My controversial opinion (at least amongst vegans) is that this high attrition rate is in significant part due to people experiencing health issues on a vegan diet. To win over the general public, vegans need to take more proactive steps to ensure that new and current vegans are able to stay healthy.

Veganism is Healthy, Vegans Aren’t Always

Most vegans I’ve encountered typically deny the existence of this problem. When questioned, they tend to downplay the issue by referencing a scientific study supportive of veganism or listing out famous vegan athletes.

As a practicing vegan myself, I certainly don’t disagree with the idea that a vegan diet can be healthy if done right, but I think those responses miss the point. Yes, it is true that reputable dietetic organizations agree that vegan diets are nutritionally adequate.^[6] And yes it’s also true that there are many famous vegan pro athletes at the highest level of their sport (Ex: Lewis Hamilton, Novak Djokovic, and Scott Jurek).^[7] But these facts are not incompatible with the idea that a significant portion of the dropout rate is due to people facing genuine health challenges.

It’s completely possible that veganism is a nutritionally adequate diet when properly planned and that a substantial number of people who go vegan experience real health problems. Consider the following:

• Amongst celebrities who have quit veganism, the large majority cite poor health as the main cause. Angelina Jolie states that she “was vegan for a long time and it nearly killed [her]”. Ashley Tisdale says that she “couldn’t stay vegan” due to health issues. These two anecdotes are not isolated incidents. I found an article on VeganFoodandLiving titled “15 ex-vegan celebrities who quit being vegan and the reasons why”. In that article, 9/15 celebrities mentioned health as the primary reason for giving up the diet. Reasons included not getting enough calories, feeling dizzy, and not being able to build enough muscle. Interestingly, some of these celebrities used to speak highly of veganism before they quit. Zac Efron, for instance, praised the vegan diet for being “great for my exercise, and great for my routine” before later quitting for health reasons.
• Anna’s Analysis (herself a vegan) created an excellent video analyzing 23 different Youtubers who went vegan and ended up quitting. The overwhelming majority of these Youtubers who quit cited poor health. Common reasons included bad skin, dizziness, low energy, and muscle loss. Most also mentioned that their health improved once they reintroduced animal products into their diet.
• When vegans talk to ex-vegan family members, friends, or acquaintances, health problems are often mentioned as the main reason for giving up. Ed Winters, a prominent vegan activist, has previously expressed dismay over several of his vegan friends abandoning the diet, almost all due to alleged health-related issues. This sentiment is echoed on r/vegan, where you can find many vegans who share similar anecdotes as Ed. Personally, most of the ex-vegans or ex-vegetarians I know returned to eating meat because they were feeling anemic or had a doctor diagnose them with nutrient deficiencies.
• Even some well-known public intellectuals who adopted plant-based diets for ethical reasons have ultimately abandoned them due to health concerns. Sam Harris was inspired by the philosopher Peter Singer into adopting vegetarianism, but claimed that his diet made him to feel anemic, causing him to revert back to an omnivore diet. Alex O’ Connor was once a highly prominent, if not the most prominent, vegan advocate on YouTube. He has since quit after admitting that he was “struggling privately to maintain a healthy plant-based diet”.

Connor Jennings, a writer on Substack, published an article challenging the notion that health issues are a major contributor to the high vegan dropout rate. He points out that the Faunalytics study I referenced earlier shows that only 26% of former vegans and vegetarians mentioned health concerns as the reason for quitting. Further, he notes that amongst that 26%, many cited reasons which were not necessarily indicative of bad health such as “pregnancy” or “begin to doubt health benefits”. Because of this, he argues that the percentage of people who actually quit for health reasons is likely quite low (~12.5%).

I find it difficult to reconcile Jennings’s view with the numerous testimonies I cited earlier. If it was just a small number of anecdotes of celebrities and Youtube influencers experiencing poor health, I would be inclined to agree with his analysis. However, given the sheer quantity of testimonies and the fact that some of them come from highly intelligent and morally sensitive people (Sam Harris and Alex O’ Connor), it’s hard to dismiss this as an exaggerated concern.

Contrary to Jennings, I would guess that the percentage of people who quit for health reasons is likely higher than 26% due to social desirability bias. A widely replicated finding in psychology is that people tend to significantly overreport behaviors linked to good health, like exercise, and underreport those associated with poor health, such as alcohol consumption. In light of this, it’s reasonable to suspect that many former vegans may underreport health struggles as a reason for quitting, instead attributing their decision to other, less stigmatized factors.

Root Causes

A reasonable observer reading all these testimonies might justifiably question the expert consensus on veganism. It seems implausible that a diet which is not only nutritionally sufficient, but supposedly even healthier, could consistently cause fatigue, muscle loss, and dizziness, amongst other symptoms to its adherents. Providing an answer to these doubts is crucial not only to win over skeptics, but also to help increase retention amongst vegans. In my opinion, this gulf between the scientific evidence and the experiences of ex-vegans has two main causes: online misinformation and the high adjustment cost of transitioning to veganism.

Misinformation

Searching online for nutrition guidance is often a dizzying experience. Seemingly every other article or video has a completely different opinion from the last. Red wine is good for you in moderation or it’s actually not. Oatmeal is the best breakfast food or it’s something you should avoid. Veganism does wonders for your health or it’s actually a nutritionally deficient diet. In this kind of environment, it’s extremely hard to tell what is true and what is false, allowing bad health advice to proliferate.

One relevant example of this is raw veganism. Raw veganism is a diet consisting of only plant-based foods which have not been processed or heated above 40°C.^[8] This diet gained popularity through YouTubers such as Freelee the Banana Girl and FullyRawKristina, whose videos promoting raw veganism have amassed tens of millions of views. They, like most proponents of raw veganism, claim that a raw vegan diet offers a host of amazing health benefits ranging from weight loss to better skin, to even changes in eye color.

Most of the common arguments in favor of the raw vegan diet are either completely false or highly exaggerated. There is no evidence, for instance, that eating raw foods detoxifies the body better than cooked foods or that humans are somehow naturally suited to only eating raw plants.^[9] There are, however, serious health concerns with raw veganism. Even doctors who promote vegan diets tend to strongly discourage their patients from adopting a raw vegan one. For instance, Caldwell Esselstyn, the doctor who convinced Bill Clinton to adopt a plant-based diet, has warned that raw vegan diets are far too limited in terms of energy foods.^[10]

The popularity of raw veganism likely accounts for a significant number of vegans who quit due to health reasons. In her video on ex-vegan YouTubers, Anna’s Analysis notes that the overwhelming majority had adopted a raw vegan diet. One YouTuber, for example, subsisted on a daily diet of only papayas, bananas, and salads, while another ate three cantaloupes for breakfast each morning. I would not be surprised if raw veganism also explained the low retention rate amongst celebrities quit given that Gwyneth Paltrow, Sting, and Megan Fox were once avid promoters of this diet.^[11]

Transition Process

The second key factor behind vegans quitting for health reasons is the challenge of the transition process. In a predominantly meat-eating culture, the switch to veganism can be difficult, as it requires adopting many new habits and breaking old ones. Failing to establish the right habits can potentially lead to health issues.

One major difference between vegan and omnivore diets is that maintaining health on a vegan diet requires taking supplements. Vitamin B12, for instance, is an important nutrient for supporting proper red blood cell formation and nerve function found only in animal products.^[12] Vegans must take B12 vitamins or consume B12 fortified products on a frequent basis in order to stay healthy.

The problem is that they often don’t. A literature review published in the journal Nutrition Reviews reveals that 32% of vegetarians and 43% of vegan young adults were B12 deficient. Amongst raw vegans, it was 47%.^[13]

I couldn’t find any studies which determined the cause of this phenomenon, but my guess is that a lot of vegans didn’t take vitamins before they transitioned and forgot to adjust accordingly once they switched. According to the CDC, about 60% of the population between 20 and 39 takes 0 supplements a day, likely because most omnivores in that age range can live a relatively healthy life without any.^[14] This need for supplements can be a stumbling block for many new vegans and can often be a cause for failing the diet.

Secondly, eliminating animal products requires obtaining essential nutrients from alternative sources, which comes with its own challenges. One problem is that many of the foods which do provide these nutrients are relatively unknown to the average American. Given that most Americans eat meat two or three times a day, they don’t usually have a good point of reference for plant-based foods.

Take a look at the excerpt above from Tufts Medicine, especially the bullet point regarding protein. When it comes to plant-based protein sources, foods like lentils, tofu, buckwheat, quinoa, and hemp seeds are basically unknown to many Americans. Meanwhile, the more commonly recognized options like beans, oatmeal, and nuts are not typically eaten as main dishes.

Successfully making the shift to veganism requires serious effort in researching and learning new recipes as well as a willingness to break their decade-long eating habits. Most people are unfortunately quite change-averse. What often happens is that instead of replacing animal products with proper substitutes like tofu and lentils, they’ll sometimes just go cold turkey or start eating tons of vegan junk food. This meme from Reddit unfortunately describes a person I know who went vegan pretty accurately and judging by the number of upvotes on the post (60,000 as of writing), I’m definitely not alone in this.

In addition to having to switch to different foods, vegans also have to adjust the volume of food they consume in order to feel satiated. A very common mistake among new vegans, as noted by Rainbow Plant Life and other vegans, is undereating. New vegans sometimes don't realize that most plant-based foods generally contain fewer calories, proteins, and fats on a per gram basis compared to animal products. For example, 100g of ground beef provides over double the amount of fat and over 100 more calories compared to the same quantity of firm tofu.^[15] This is a mistake I personally made when I started being vegan. I often felt hungry just an hour or two after meals because my diet mainly consisted of rice, tofu, and lentil stews with minimal oil or other healthy fats. Once I started incorporating more healthy fats, like sesame seeds, the issue resolved itself.

Acknowledging the Elephant

In my opinion, one of the most concerning tendencies within the vegan community is this contemptuous attitude we have toward ex-vegans. When someone prominent abandons veganism for alleged health reasons, we rarely try to empathize or engage in self-reflection to figure out why they quit. Instead, we label them as frauds who were never truly committed to the cause or dismiss their personal experience as being “just an anecdote”.

This attitude is terribly counterproductive. What reason is there to believe that these people were lying? In fact, as I’ve discussed earlier, there is strong evidence to suggest that the health issues these people faced were real and not fabricated.

Don’t get me wrong, I understand why people feel this way. Factory farming is the moral stain of our time. When people quit for health reasons, it reinforces the perception that vegan diets are unhealthy, which seriously harms our cause. But there’s no need be so rude to these people, if only for pragmatic reasons. Many of us have messed up our diets before, how likely would we be to try again if every vegan we spoke to angrily berated us for our mistakes?

I don’t have any specific solutions for fixing this situation. Ensuring that people don’t fall for fad diets and that they properly transition to veganism is a hard problem. The first step to solving a problem, however, is admitting that there is one. At the moment, we're unfortunately not even doing that. Until our community acknowledges and addresses these challenges, the percentage of vegans in this country will continue to stay in the single digits and the animals will continue to suffer.

1. ^{^}

   https://www.dataforprogress.org/blog/2022/8/2/voters-demand-farm-animal-protections-from-both-politicians-and-companies

2. ^{^}

   https://news.gallup.com/poll/510038/identify-vegetarian-vegan.aspx

3. ^{^}

4. ^{^}

   https://ourworldindata.org/how-many-animals-are-factory-farmed

5. ^{^}

   https://faunalytics.org/a-summary-of-faunalytics-study-of-current-and-former-vegetarians-and-vegans/

6. ^{^}

   https://veganhorizon.substack.com/p/nutritional-adequacy-of-a-vegan-diet

7. ^{^}

   https://www.veganfoodandliving.com/features/vegan-athletes-plant-based-diet/

8. ^{^}

   https://www.healthline.com/nutrition/raw-vegan-diet

9. ^{^}

   https://www.scientificamerican.com/article/reality-check-5-risks-of/

10. ^{^}

    From the Scientific American article: "The problem with the raw food diet is where do you get your energy food?" asked Caldwell Esselstyn of the Cleveland Clinic, the doctor who convinced Bill Clinton to adopt a plant-based diet. "You get it from pouring down nuts," he said, and these are high in fat and not healthful when eaten in excess.

11. ^{^}

    https://web.archive.org/web/20200731182316/https://www.bda.uk.com/resource/top-5-worst-celeb-diets-to-avoid-in-2018.html

12. ^{^}

    https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

13. ^{^}

    https://academic.oup.com/nutritionreviews/article/71/2/110/1940320

14. ^{^}

    https://www.cdc.gov/nchs/products/databriefs/db399.htm#section_2

15. ^{^}

    Ground beef: https://fdc.nal.usda.gov/fdc-app.html#/food-details/174036/nutrients

    Tofu: https://fdc.nal.usda.gov/fdc-app.html#/food-details/172475/nutrients