Our bodies and life experiences do not exist in a vacuum. As such, it is not uncommon for numerous mental and physical diagnoses to challenge one individual. Research continues to grow regarding the co-occurrence of diabetes and eating disorders, showing that the two seem to be interrelated in some way.
Diabetes and Eating Disorders
One theory regarding the relationship between diabetes and eating disorders is that the shared relationship both have with comorbid mental health diagnoses increases risk.
Individuals with diabetes have twice the risk of clinically significant depression than those without diabetes . Similarly, 33 to 50% of those with anorexia, and nearly half of individuals that struggle with bulimia or binge eating disorder, also struggle with depression.
Life with Diabetes
The nature of the diabetes illness might also contribute to the increased eating disorder diagnoses of sufferers.
On study aptly connected the two in 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. .”
This focus on intake might also “inhibit the patient’s sensations of hunger and fullness .”
There is also a frightening trend of those with Type 1 diabetes engaging in what is being referred to as “diabulimia.” These individuals self-administer insulin because their body does not produce it on its own. When engaging in “diabulimia” behaviors, they reduce or omit the amount of insulin they administer because “intentionally induced glycosuria causes weight loss as calories spill into the urine .”
Those that engage in these dangerous behaviors have “higher rates of hospital and emergency room visits, higher rates of medical complications, and more negative attitudes toward T1DM than women who do not report insulin restriction .” “Diabulimia” has also been shown to increase the risk of mortality .
In relation to the treatment of both eating disorders and diabetes, the increasing information regarding the two shows a need for treatment team members that are educated in both areas.
Unfortunately, this is difficult to come by, and those suffering are being negatively impacted by the lack of effective treatment strategies.
For example, “T1DM patients with eating disorders are more likely to drop out of treatment and also show worse outcomes with conventional outpatient treatment for eating disorders .” Research has shown a few factors that increase the effectiveness of treatment for this population, such as longer residential treatment stays .”
With the risk clearly evident and the need more defined, awareness and knowledge need to be increased for advocates and medical and mental health professionals in both the diabetes community and the eating disorder community.
Sharing this information can mean the difference between an undetected diagnosis or early intervention that saves a life.
References: 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.  Gagnon, C. et al. (2012). Comorbid diabetes and eating disorders in adult patients. The Diabetes Educator, 38:4, 537-542.  Goebel-Fabbri, A. E. (2008). Diabetes and eating disorders. Journal of Diabetes Science and Technology, 2:3, 530-532.
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 November 8, 2019, on EatingDisorderHope.com
Reviewed & Approved on November 8, 2019, by Jacquelyn Ekern MS, LPC