Eating Disorders and Co-Occurring Diabetes Treated with ACT

Woman in straw hat

Type 1 (T1) diabetes is a medical condition that affects someone’s endocrine system [1]. Diabetes causes someone’s immune system to attack some of the cells in someone’s pancreas. This then impacts their ability to produce insulin [1].

If diabetes is left untreated, it can be deadly [1]. To keep themselves alive and healthy, people with T1 diabetes have to monitor their blood sugar levels multiple times a day. People with diabetes have to give themselves insulin several times each day to control their blood sugar [1].

Diabetics have to carefully plan out what they eat and how much they exercise. People with diabetes are at increased risk of severe physical harm from disordered eating behaviors [1]. Unfortunately, people with T1 diabetes are more at risk for developing eating disorders [1].

Diabetes and Eating Disorders Issues

Sometimes people with these co-occurring conditions manipulate how much insulin they take in order to control their weight [1]. While this can result in someone losing weight, this isn’t the only physical consequence that can happen as a result.

Without the right amount of insulin, someone’s body is forced to get rid of calories through urination. This damages the kidneys [1]. Similarly, if someone with diabetes isn’t eating enough, then their body will release something called ketones into the bloodstream. This can lead to immediate death [1].

These behaviors are so dangerous that people with diabetes who manipulate their insulin intake are three times more likely to die than people who don’t [1]. This behavior is scarily common. In fact, 30% of women diagnosed with diabetes restrict how much insulin they take so they can lose weight [2].

Woman Struggling with eating disordersEven though there are a lot of people struggling with diabetes and an eating disorder at the same time, this population has been mostly underserved. Researchers have been looking into ways to support the unique needs of this group of people.

One approach is Acceptance Commitment Therapy (ACT). ACT is a therapy model that aims to help people respond differently to upsetting thoughts or feelings. This could be helpful for people struggling with an eating disorder.

For example, someone may feel negatively towards their appearance before going to a job interview. They might cope with this insecurity by restricting their meals or not giving themselves the right amount of insulin.

ACT could help someone figure out a different way of dealing with this insecurity. ACT helps people reach a place of acceptance and increases their ability to be mindful when dealing with their feelings. This approach is designed to help people act in a way that is in line with their values, goals, and long-term well-being [1].

A recent study was done to use this therapy approach and tailor it to fit the unique needs of people with diabetes and eating disorders. The study showed that this approach was effective and made steps towards recovery [1].

While this is promising, there is still a lot of research that needs to be done in order to best serve this population. The research shows that this population is extremely high-risk [1]. Finding ways to best serve and treat these people will improve and save lives.


Resources:

[1] Merwin, R.M., Moskovich, A.A., Babyak, M., Feinglos, M., Honeycutt, L.K., Mooney, J., Freeman, S.P., Batchelder, H., & Sangval, D. (2021). An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes. Journal of Eating Disorders, 9(6), 1-13. https://doi.org/10.1186/s40337-020-00357-6

[2] National Eating Disorders Association. (2018). Statistics and research on eating disorders. https://www.nationaleatingdisorders.org/statistics-research-eating-disorders


About the Author:

Samantha Bothwell PhotoSamantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.


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 February 26, 2021, on EatingDisorderHope.com
Reviewed & Approved on February 26, 2021, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.