Diabetes & Eating Disorders

Because both disorders involve the control of food, diabetes, and eating disorders can run hand-in-hand. Diabetes is a disorder that is a result of the pancreas not producing enough insulin or the body not being able to effectively use the insulin produced. The prevalence of eating disorders among insulin-dependent diabetics is estimated to be two to six times higher than in the general population. Up to 25% of females with insulin-dependent diabetes may have a diagnosable eating disorder. Although diabetes has not been shown to cause eating disorders, the condition may increase the risk of developing them.

The connection between eating disorders and diabetes may be a result of both disorders sharing some common traits and paths. To begin with, for many diabetics, the onset of diabetes is accompanied by an initial weight loss, which is often how the disorder is first recognized. This initial weight loss can be perceived as rewarding and become something the diabetic does not want to give up. Following diagnosis, the individual is started on insulin treatment, which often causes weight gain for the diabetic. This resultant weight gain may exacerbate any concerns about body image and cause anxiety for the newly diagnosed diabetic. Also complicating the situation are the dietary constraints imposed on diabetics. Both eating disorders and diabetes encourage individuals to pay accentuated attention to what they eat and weigh. Foods for individuals with an eating disorder and diabetes are no longer viewed as just for nutrition, but often gain the monikers of “forbidden” or “dangerous”. The obsessive pursuit of gaining control of food can become central for both diabetics and eating-disordered individuals. This struggle to maintain control can become the introduction to developing an eating disorder for a diabetic. The issue of control is of special importance for adolescent diabetics. Like all teenagers, adolescent diabetics strive for independence but besides the regular teen issues, adolescent diabetics must also grapple with someone or something else posing control over their food intake. Through the practice of an eating disorder, eating-disordered diabetics may feel they have regained some of the lost control.

When a diabetic has an eating disorder, they often fall into the dangerous behaviors of dieting, restricting, and bingeing. The most dangerous practice is the misuse of their insulin. To avoid weight gain, some diabetics with eating disorders underuse their insulin, causing their blood sugar to rise and spill into their urine. The accompanied weight loss is the result of the body’s tissues being dissolved. Medical complications as a result of improper use of insulin or bingeing for diabetics with eating disorders include kidney failure, heart disease, blood circulation difficulties, and eyesight damage. Diabetics with eating disorders have a threefold risk of retinopathy (permanent damage to the retina of the eye). Diagnosing an eating disorder in a diabetic can be extremely difficult, even for professionals. The dietary concerns of diabetes can easily mask eating-disordered behavior. It is often hard to tell if the behaviors are symptoms of an eating disorder or just careful dietary management of diabetes. When confronted, eating-disordered diabetics often claim that they are just practicing good dietary control. One tale-tell sign of trouble is poorly controlled blood sugars for unexplained reasons.

WD Recovery and Wellness Center understands the nuances and difficulties of diabetes complicated with an eating disorder and has put together a program that can address an eating-disordered diabetic’s specific needs. In the past, the course of treatment for a diabetic was one of a prescribed restrictive diet and a rigid approach to regulation and management. WD Recovery and Wellness Center understands this approach can be counterproductive and even lead a diabetic towards bingeing, restricting, and even misuse of insulin. Instead, we work with eating disorder diabetic individuals towards normalizing their eating and tailoring their insulin to their food plan. It is not uncommon for a diabetic individual to lower the amount of insulin or move from injections to oral medication, once they are in recovery from their eating disorder.