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Binge Eating Disorder & Diabetes: What Is the Link?
Binge eating disorder (BED) and Type 2 diabetes are two of the most prevalent conditions affecting our modern society, and that may not be a coincidence. The connection between the two might be closer than many people think.
Studies show that individuals with Type 2 diabetes are more likely to have BED when compared to the general population. [1] And it’s possible that in a number of cases, BED comes before the development of Type 2 diabetes, as the disordered eating behaviors associated with BED can affect blood sugar levels and play a role in the development of insulin resistance. [1]
Regardless, treatment can help with either condition, especially in programs that combine diabetes treatment with binge eating disorder therapy.
What is Type 2 Diabetes?
To better understand the relationship between binge eating disorder and Type 2 diabetes, it’s helpful to consider how each condition develops in the body.
Type 2 diabetes is a disease in which the body develops an insulin resistance. Insulin is a hormone that allows the body to convert glucose (sugar) into energy. It also helps to regulate the amount of glucose in the blood.
Establishing a blood sugar balance is important. Too much sugar in the blood can result in hyperglycemia, which can lead to thirst, fatigue, headaches, confusion, and other unpleasant symptoms. Too little sugar in the blood results in hypoglycemia, which can result in trembling, sweating, anxiety, irritability, heart palpitations, and dizziness, among other issues.
While scientists are still meting out all the reasons behind insulin resistance, it’s generally accepted that extra weight and additional body fat, especially body fat found around the abdomen and organs, can lead to this condition.
When the body begins to develop an insulin resistance, it will lean on the pancreas to make extra insulin. However, this is not a sustainable solution. Eventually, the body cannot produce enough insulin to maintain blood glucose at normal levels, which can lead to whole body insulin sensitivity. [2]
What is Binge Eating Disorder?
Binge eating disorder is one of the most recent additions to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the list of all officially recognized mental health disorders. But it is already considered the most common eating disorder in America, and, by some estimates, the world. [1]
The condition manifests as recurrent binge eating episodes, which are defined as periods during which someone eats an amount of food that is much larger than what would be considered normal to eat during that time. The official definition is loose, but to determine a binge eating disorder diagnosis, researchers generally look at a two-hour window, and how much someone eats during that time.
Binge eating behaviors are often unmanageable. These episodes are colored by a number of characteristics, including eating to the point of feeling uncomfortable, and a loss of sense of control over how much—or what—is eaten.
Individuals with BED often report feelings of shame and guilt following an episode. And, as there are no compensatory behaviors connected to the condition, weight gain is also a frequent effect of binge eating disorder.
Connections Between Binge Eating and Diabetes
Once someone develops both binge eating disorder and Type 2 diabetes, it may be more difficult to understand the relationship between the two conditions and how they impact each other.
But there are aspects of binge eating disorder that may make someone more vulnerable to developing Type 2 diabetes.
Weight Gain
The specific disordered eating behaviors associated with BED frequently lead to the type of weight gain that can put someone at a greater risk for Type 2 diabetes.
During a binge eating episode, it’s not uncommon for someone to consume between 5,000 and 15,000 calories in one sitting. [3] People with BED may also snack throughout the day, in addition to eating regular meals.
After a period of time, these behaviors frequently lead to weight gain, and the accumulation of the kind of body fat which has been tied to diabetes. [4] One study found that people who were later diagnosed with binge eating disorder gained up to 53 pounds in the year before they entered treatment for the condition. [5]
Dietary Choices
It’s not just the weight gain connected to BED which may put someone at a higher risk of developing Type 2 diabetes, but the types of foods people consume during their binge eating episodes.
Some research has found that people with BED have excessive dietary fat intake, or receive a disproportionate amount of their daily calories from fat, as well as carbohydrates. [1] Other research suggests that those who have a greater preference for sweet food are more likely to binge eat. [1]
Eating a high-fat diet for even one day can change how your body processes glucose. [6] When this becomes a frequent occurrence, it can contribute to whole body insulin sensitivity.
Metabolic Syndrome
Many people with binge eating disorder will frequently participate in diets, or attempt to severely limit their food intake during the day, but experience binge eating episodes later on, as part of BED or possibly the closely-related night eating syndrome.
In these cases, the severe swing between restriction and indulgence can make an even larger, more immediate impact on blood sugar levels, taking the body from extremely low to extremely high in a short period of time. This essentially causes the pancreas to work overtime and, if repeated frequently enough, could potentially contribute to the development of metabolic syndrome. [6]
Also called insulin resistance syndrome, metabolic syndrome develops from a number of combined conditions, including high blood sugar levels, high cholesterol levels, and high levels of fat in the blood, called triglycerides. And the condition is often a precursor for Type 2 diabetes. [7]
Body Mass Index
Body mass index (BMI) is a number that represents the ratio between someone’s weight and height. The calculation is used to place people in relative categories, ranging from normal to below normal, above normal, and obese.
And while increasingly considered an imperfect diagnostic tool, BMI has frequently been used in previous research on diabetes, weight gain, and a number of eating disorders.
Some studies have shown that people with a high body mass index have a higher amount of substances in their blood linked to insulin resistance. [8] And these elements can alter how well the pancreas works, leading to added sugars in the blood, which can, in turn, go on to harm the pancreas even more.
Other research points to obesity, as understood through BMI and other measurements, as the biggest risk factor for developing diabetes, with one study saying obesity was responsible for up to 85% of the risk of diabetes development. [9]
As BMI is directly tied to weight, and BED can frequently contribute to weight gain, the connection between BMI and diabetes can extend to many people struggling with binge eating disorder.
Can Type 2 Diabetes Cause Binge Eating Disorder?
While this connection is understudied in scientific research, there are some possible links that could be made between a Type 2 diabetes diagnosis and an increased likelihood of binge eating.
People with diabetes must pay close attention to how they eat, and they often follow very strict diets. Each meal can put intense pressure on their mental health.
But this hyper-attention to diet and increased pressure to adhere to strict eating rules could be especially triggering for someone who struggles with or may be at greater risk of developing binge eating disorder.
Indeed, binging episodes are often brought on by both stress and a hyper-focus on diet. [3] The more pressure people feel around their diet, the more likely they may be to experience the sudden loss of control associated with binge eating episodes.
How BED & Diabetes Are Treated
Thankfully, both BED and Type 2 diabetes can be treated. But it’s important for someone experiencing these conditions to look for programs that can address both issues at the same time.
Knowing that these conditions are co-occurring can and should affect the way medical and mental health professionals address these issues, and may impact the tests or treatments they choose to help.
And while many treatments have been developed for both disorders, there are some that are more primed to helping both at once.
Therapy
An array of therapies can help with eating disorders of all kinds, but people with binge eating disorder frequently benefit from cognitive behavioral therapy (CBD).
CBD revolves around the idea that disordered and disruptive behaviors are borne of disordered and disrupted thoughts. During these sessions, therapists help patients first identify, then understand, and finally change these unhelpful thought patterns, with the goal of changing any associated unhelpful behaviors.
This tactic can be extremely effective for binge eating disorder, with CBD helping up to 90% of people with BED experience fewer bingeing episodes, according to one study. [1]
Medications
While medications are generally considered a secondary treatment, or more helpful for active management of a disorder once someone achieves recovery, there are some medications that could help someone better handle their binge eating urges and episodes.
The stimulant lisdexamfetamine is one such option. Helpfully, the drug has been approved by the U.S. Food and Drug Administration to treat binge eating disorder. [1]
Originally developed to help with the management of attention-deficit/hyperactivity disorder, lisdexamfetamine focuses on certain areas of the brain involved in impulse control, which can help people feel and exercise a greater sense of control over their attention and choices.
Diabetes Care
If diabetes is the primary diagnosis, there are other treatments that focus more on helping people proactively manage blood sugar levels and other factors that can lead to issues.
Healthy eating and exercise are often recommended to help the body achieve a healthier level of equilibrium. In some cases, additional medications, such as direct insulin shots, can be used to help someone manage diabetes symptoms.
If signs of binge eating disorder are also present, a doctor may recommend additional psychotherapy treatment to help someone achieve more lasting diet management.
Finding Help for Binge Eating Disorder
If you or a loved one are struggling with binge eating disorder, it’s important to seek out help.
Aside from the development of Type 2 diabetes, this condition can lead to a number of health concerns, including increased cardiovascular and mortality risks.
If you’re unsure where to seek out help, you can speak with your doctor, therapist, or another trusted medical professional. These experts may be able to point you in the direction of programs or treatments that can help.
If you’d rather not speak face-to-face to someone about the situation, you can utilize a number of eating disorder hotlines. These programs allow callers to remain anonymous, while simultaneously offering information and other helpful resources for treatment and recovery.
Overcoming binge eating disorder may seem difficult, but with the right kind of treatment, it’s possible to build a healthier relationship with food, and a healthier and happier future.
References
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- Chevinsky JD, Wadden TA, & Chao AM. (2020). Binge Eating Disorder in Patients with Type 2 Diabetes: Diagnostic and Management Challenges. Diabetes, metabolic syndrome and obesity : targets and therapy; 13:1117-1131.
- Type 2 Diabetes. (2021, December). Centers for Disease Control and Prevention. Accessed September 2022.
- Binge Eating. (2022, March). U.S. Department of Health and Human Services. Accessed September 2022.
- Symptoms & Causes of Diabetes. (2016, December). National Institute of Diabetes and Digestive and Kidney Diseases. Accessed September 2022.
- Blomquist KK, Barnes RD, White MA, Masheb RM, Morgan PT, & Grilo CM. (2011). Exploring weight gain in year before treatment for binge eating disorder: a different context for interpreting limited weight losses in treatment studies. The International Journal of Eating Disorders; 44(5):435-439.
- Banerjee S. (2021). Fad diets on metabolic syndrome among sedentary women — A systemic review. IP Journal of Nutrition, Metabolism and Health Science; 4(1):34-40.
- What Is Metabolic Syndrome? (2022, May 18). National Heart, Lung and Blood Institute. Accessed September 2022.
- Al-Goblan AS, Al-Alfi MA, & Khan MZ. (2014). Mechanism linking diabetes mellitus and obesity. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy; 7:587–591.
- Diabetes and Obesity. (2022, September). Diabetes.co.uk. Accessed September 2022.
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.
Edited on April 24, 2023
Published on EatingDisorderHope.com