Those living with type 2 diabetes mellitus (T2DM) may have a higher risk of developing an eating disorder. This may be due to stringent management behaviors relating to T2DM.

T2DM is a chronic condition where a person has high blood glucose levels. This is because their bodies cannot produce enough insulin or are unable to use it effectively.

An eating disorder refers to conditions that affect both mental and physical health. A person living with an eating disorder will engage in less healthy eating patterns as a means to cope with feelings or situations.

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Research suggests that those living with T2DM may have a higher risk of developing an eating disorder compared to the general population. While some evidence suggests eating disorders may be more common in individuals living with type 1 diabetes, they can also occur in those with T2DM.

A possible reason for this link may be due to some treatment strategies for T2DM. For example, managing T2DM may involve being vigilant and mindful of specific dietary guidelines. This, in combination with monitoring blood glucose levels and managing drug administration, can result in negative attitudes toward food and body image.

Several eating disorders may affect a person with T2DM.

The most common eating disorder that people with T2DM experience is binge eating disorder. This is where a person frequently consumes large amounts of food within a short period and feels unable to stop.

Other eating disorders that a person with T2DM may experience include:

  • Anorexia nervosa: This centers around an obsessive fear of weight gain and involves a person severely restricting their food intake and undergoing excessive weight loss.
  • Bulimia nervosa: The main characteristic of this condition is recurrent binge eating. A person will typically follow this with purging, such as self-induced vomiting or consuming laxatives.
  • Diabulimia: This involves someone intentionally misusing insulin to manipulate body weight. This practice jeopardizes blood glucose control and can lead to severe health complications.
  • Eating disorders not otherwise specified: This includes a range of serious disordered eating patterns that do not fit into the above types or do not meet the full criteria. For example, they may display patterns of chewing food and spitting it out without swallowing.

There are several signs of disordered eating in people with T2DM to be mindful of. This may include:

  • increases in HbA1c, or blood glucose levels
  • frequently fluctuating glucose levels
  • going into diabetic ketoacidosis (DKA) or near DKA episodes
  • severe food restriction
  • eating a large amount of food very often and not feeling in control
  • being secretive about diabetes management
  • restricting insulin
  • attempting to make oneself sick
  • fear of weight gain
  • concerns about body image
  • increasing exercise without consuming food to make up for it

From a healthcare perspective, identifying eating disorders in people with T2DM requires an understanding of both conditions. Healthcare professionals should be mindful of the signs above and monitor a person’s psychological well-being, particularly in the context of diabetes management.

Family and friends can also play an important role in recognizing signs and offering nonjudgmental support. This can help create a safe environment for those having difficulties discussing their feelings and any issues they are experiencing.

Read on to learn more about the signs of an eating disorder.

The combination of T2DM and eating disorders poses significant health risks. Proper diabetes management requires a consistent and balanced approach to nutrition, medication, and lifestyle. Engaging in disordered eating behaviors can disrupt this delicate balance, leading to uncontrolled blood glucose levels.

Evidence suggests that eating disorders and T2DM may cause early and severe diabetes-related complications. For example, these complications may include nephropathy and retinopathy.

Treatment for those living with T2DM and an eating disorder likely involves a combination of psychological interventions and practical management support. However, there is a lack of research exploring optimal treatments to support someone with both conditions.

Cognitive behavioral therapy (CBT) and psychoeducation programs are effective in helping individuals with eating disorders without diabetes. While more research is still necessary, evidence notes that CBT can help individuals with T2DM improve glycemic control by reducing the frequency of binge eating episodes.

Other avenues of support available include support groups and peer counseling. Both can provide a valuable sense of community and understanding and reduce the isolation that people managing complex health issues often experience.

People living with type 2 diabetes are more likely to experience eating disorders. Identifying and addressing eating disorders in individuals with T2DM is crucial for preventing severe health complications and promoting overall well-being.

Family members, friends, and healthcare professionals should be mindful of the signs of disordered eating in those with T2DM and foster open, nonjudgmental communication to support someone with T2DM.