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Diabetes & Disordered Eating
It is not surprising that any physical illness could be associated with disordered eating behaviors such as diabetes and eating disorder practices. After all, much of disordered eating can come from challenges with how one relates to their body as well as a desire for control over that which feels uncontrollable.
One physical disorder that can make one feel out of sync and out of control over their body, and therefore life, is diabetes mellitus, “a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both [1].”
The combination of physical and mental distress that this disease can cause puts people struggling with diabetes at high risk for disordered eating.
Understanding Diabetes
Diabetes diagnoses often fall into one of two categories, Type I or Type II. In Type I diabetes, individuals have a deficiency of insulin because their immune system attacks and destroys insulin-producing cells in the pancreas [2]. Without insulin, sugar builds up in the bloodstream. Individuals with Type I diabetes must
In Type II diabetes, cells become resistant to insulin. Therefore, sugar is still not transferred into cells and builds up in the bloodstream.
Diabetes and Eating Disorder Behaviors and the Connection
An individual’s experience with diabetes depends a great deal on how they nourish themselves, and many believe that this is where the connection to disordered eating comes in.
One study detailed this connection, stating that “The treatment itself (of diabetes) involves paying close attention to refined carbohydrates and to food portions which can parallel the rigid thinking about food, weight, and body image reported by women with eating disorders who do not have diabetes. Such treatment recommendations can lead to feelings of deprivation, resentment, and shame, and to binge eating [3].”
The National Eating Disorders Association also points out the challenges that diabetes treatment can have for body image and possible disordered beliefs and behaviors. It specifically points out the “intense focus on food, labels, numbers (weight, blood glucose, A1c) and control, plus the many disruptions that occur in a person’s metabolic system [4].”
Additionally, both those with disordered eating and/or diabetes both struggle with shape and weight overvaluation, that is, “excessive influence of shape or weight on self-evaluation [1].”
Individuals with diabetes are also at twice the risk of experiencing clinically significant depression than those without, which can also make them more susceptible to disordered eating behaviors as an unhelpful coping skill.
Diabulimia
A lot of pressure is placed on individuals with diabetes to make the necessary adjustments with their daily life, nutrition, and insulin, in order to cope with their disease. In conjunction with the psychological challenges the disease can present, this has led to a new and dangerous disorder.
Individuals struggling with diabetes test and regulate their own insulin, and many are using this process to lose weight. Referred to as “diabulimia,” individuals are reducing or omitting the amount of insulin they administer to themselves, causing their calories to spill into their urine, resulting in weight-loss.
Recent studies show that this results in higher rates of hospital visits, medical complications, as well as an overall higher risk of mortality [3].
The complicated nuances of struggling with a physically challenging disease such as diabetes and eating disorder beliefs and behaviors present overwhelming challenges to overcome.
Both disorders leave individuals vulnerable to physical and mental illness and should be treated simultaneously.
If you are struggling with diabetes and feel concerned about your relationship with your body, your mental health, or your behaviors, you are not alone. You can receive the support to help you repair the relationship you have with your body and yourself.
Resources
[1] Santana, D. D., et al. (2019). Associations between self-reported diabetes mellitus, disordered eating behaviors, weight/shape overvaluation, and health-related quality of life. Journal of Eating Disorders, 7:35. [2] Unknown (2020). Diabetes. The Mayo Clinic, retrieved from https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444. [3] Gabbri-Goebel, A., Copeland, P., Touyz, S., Hay, P. (2019). Editorial: eating disorders in diabetes: discussion on issues relevant to type 1 diabetes and an overview of the journal’s special issue. Journal of Eating Disorders, 7:27. [4] Unknown (2018). Diabulimia. The National Eating Disorders Association, retrieved from https://www.nationaleatingdisorders.org/diabulimia-5.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.
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 January 29, 2020, on EatingDisorderHope.com
Reviewed & Approved on January 29, 2020, by Jacquelyn Ekern MS, LPC
