Eating Disorders and Diabetes: What We Need to Know

Eating disorders do not exist in a vacuum. In fact, they commonly co-occur with many other mental and physical illnesses. One of these that causes great concern is diabetes, a disease that is chronic, lifelong, and where an individual’s diet is a primary focus of treatment. Eating Disorders and Diabetes can commonly co-occur especially since diabetes’ primary focus is diet.

Here is what you need to know:

Diabetes

Let’s start with the most basic low-down of diabetes, as a disease that occurs when an individual’s blood sugar is too high.

We get blood glucose (AKA: blood sugar) from the food we eat, and typically, the hormone insulin transfers the sugar into our cells. Diabetes occurs when the body doesn’t make enough, or any, insulin or doesn’t use the insulin it produces properly.

Type 1 Diabetes occurs when the immune system attacks cells that create insulin, resulting in the body not producing it. This is most often diagnosed in childhood or young adulthood, and these individuals must take insulin every day to stay alive [1].

Type 2 diabetes is the most common form and is often diagnosed in middle-aged or older people [1]. Type 2 diabetes occurs when the body either does not make enough insulin or does not use it correctly.

Type 1 Diabetes and Eating Disorders

Young women with Type 1 diabetes are 2.4 times more likely to develop an eating disorder than those without diabetes of the same age [2].

Additionally, between 12% to 15% of young women with Type 1 Diabetes engage in over-eating and up to 27.5% of adolescents with Type 1 Diabetes meet the diagnostic criteria for an eating disorder [3].

One dangerous form of disordered eating that individuals with only Type 1 Diabetes experience is not formally named but is commonly referred to as “diabulimia.” This term describes the individual reducing or omitting the insulin they take in, as “intentionally induced glycosuria causes weight loss as calories spill into the urine [2].”

The practice of “diabulimia” can be incredibly harmful and can result in serious medical complications. Yet, 31% of women with Type 1 Diabetes report engaging in this act of insulin restriction [2].

Type 2 Diabetes and Eating Disorders

Studies suggest that between 2.5% to 40% of those with Type 2 Diabetes have an eating disorder [3]. The most common disordered eating behavior for these individuals is Binge Eating Disorder.

Studies show that 6.5% to 9% of individuals with Type 2 Diabetes are diagnosed with Binge Eating Disorder [3]. “In fact, one in every five women with Type 2 Diabetes reports having binges, compulsive overeating, or excessive food intake [3].”

What is the Connection?

Many believe that a crucial connection with diabetes and disordered eating comes from the focus of food required to manage symptoms of both Type 1 and Type 2 Diabetes.

One study stated, “it may lead to a rigid and perfectionist attitude toward eating, which in turn may increase the risk of developing an ED through the excessive preoccupation with weight and diet, binge eating, and dysfunctional weight control behaviors [3].”

This study also pointed out that the focus on external food rules “may inhibit the patient’s sensations of hunger and fullness [3].”

Treatment

The treatment of a person struggling with both diabetes and an eating disorder will look a little different than traditional treatment, as these individuals will need more medical monitoring [2].

The treatment team will also look a bit different, as it will need to include “a diabetologist; a diabetes educator; a nutritionist with training in the treatment of eating disorders and diabetes patients; a psychiatrist for psychopharmacologic evaluation and treatment; and a mental health professional to provide individual therapy [2].”

Finding eating disorder professionals also educated in diabetes is incredibly difficult. However, as the incidences of co-morbidity between diabetes and eating disorders continue to increase, eating disorder advocates, medical professionals, and mental health professionals are pushing for more information and awareness.

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Resources:

[1] Unknown. (2019). What is diabetes? National Institute of Diabetes & Digestive Kidney Disease, retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes.

[2] Goebel-Fabbri, A. E. (2008). Diabetes and eating disorders.Journal of Diabetes Science and Technology, 2:3, 530-532.

[3] Gagnon, C. et al. (2012). Comorbid diabetes and eating disorders in adult patients. The Diabetes Educator, 38:4, 537-542.

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About the Author: 

Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on April 30, 2019.
Reviewed & Approved on April 30, 2019, by Jacquelyn Ekern MS, LPC

Published on EatingDisorderHope.com