Diabetes-related eating disorders are a combination of diabetes and binge eating disorder. Diabetes is a disease that affects the way the body uses blood sugar, and bulimia is an eating disorder in which the person overeats and then removes food by vomiting or taking laxatives to lose weight.
The term “diabetes-related eating disorder” is sometimes used to refer to people with type 1 diabetes who lose weight by reducing their insulin dose.
People with the disease?
The disease mainly affects women.
The disease mainly affects women. Women of all ages with type 1 diabetes are 2 times more likely to have an eating disorder than women without the disease. About 30% of adolescents suspend insulin therapy to lose weight.
There is no clear cause for eating disorders, but the risk is higher if there is a family history of the disease. Sometimes family stress or trauma can also trigger an eating disorder.
What are the dangers?
If you reduce the amount of insulin you need to treat type 1 diabetes in order to lose weight, you can develop an eating disorder related to diabetes. If you have type 1 diabetes, your body can’t make insulin, which means you can’t trade sugar for energy, so your blood sugar rises and appears in large amounts in your urine.
If there is not enough insulin, the body produces ketone bodies as a source of energy, which can lead to anorexia and weight loss, and can also bring on diabetic ketoacidosis, which can lead to coma or death.
Complications of diabetes-related eating disorders are a mix of diabetes and eating disorder complications:
- hyperglycemia;
- Urinary glucose;
- Blurred consciousness;
- dehydration;
- Muscle loss;
- Diabetic ketoacidosis;
- High cholesterol;
- Bacterial skin infections;
- Fungal infections;
- Immenorrhea or abnormal menstruation;
- Staphylococcal infections;
- damage to blood vessels in the eye (retinopathy);
- Nerve damage resulting in numbness in the hands and feet;
- Peripheral arterial disease;
- Thicker arterial walls (atherosclerosis);
- Liver disease;
- Low sodium and potassium levels;
- stroke;
- Coma;
- Death.
Eating disorders have the highest mortality rate of all mental illnesses. Women who do not take insulin to lose weight die on average 10 years earlier than women who do not have an eating disorder.
What are the signs?
The first and most obvious sign of a diabetes-related eating disorder is weight loss without any effort. Other signs include:
- Feeling tired all the time;
- Feeling very thirsty;
- Thinking or talking a lot about body image;
- Glucose records that do not match glycated hemoglobin (HbA1c) measurements;
- Depression or mood swings;
- Confidentiality about blood glucose, insulin, food, or dietary habits;
- Canceled visits;
- Eating regularly, especially sugary foods;
- delayed pubertal development;
- Tension within the family;
- Hair loss;
- Dry skin;
- Aromatic breathing (a sign of ketoacidosis);
- Extensive exercise.
What can be done?
Diabetes-related eating disorders are a mental illness and require professional treatment. If you experience symptoms of a diabetes-related eating disorder, seek nutritional, medical, and psychological help from a health professional, such as:
- endocrinologists;
- Diabetes specialists;
- Nurses;
- dieticians specializing in eating disorders or diabetes treatment;
- Counselors/psychologists.
Treating diabetes-related binge eating disorder is not a quick fix and requires working on changing behavior patterns and learning to manage triggers through different approaches. Counseling is a great way to help, try the following:
- Cognitive behavioral therapy (CBT), which can change the way of thinking and therefore the way of behaving.
- Group therapy, which gets support from people who have successfully cured diabetes-related bulimia.
- Family therapy (FBT), which includes the whole family. This approach can be very helpful to parents in dealing with their child’s eating disorder.