Can Eating Disorders Cause Diabetes?

Diabetes, regardless of the type, means that the person who has it needs to pay close attention to their diet. The restriction involved has to be carefully done so they get all the nutrients they need while keeping diabetes under control.

It’s not a surprise that those restrictions can lead to a diabetic developing eating disorders. But does it work the same way in reverse? Does someone with an eating disorder have an increased risk of developing diabetes? Read more to learn about the connection between eating disorders and diabetes.

Types of Eating Disorders

An eating disorder is a mental condition that involves abnormal eating habits. They involve using food to deal with difficult feelings and other problems. [1]

Different patterns of food intake mark different eating disorders. Some are based on restricting the type and/or quantity of food eaten. Others are based on eating large amounts of food in a short period of time (called binging). Some involve making sure food is not digested (called purging) through vomiting, exercise, or the use of laxatives. Many eating disorders are a combination of these symptoms. [2]

Anorexia nervosa, often called simply anorexia, is one of those conditions that is based on either restricting food or purging it after it is eaten. Anorexics usually think they weigh much more than they actually do and try to keep their weight as low as possible. [3]

Orthorexia is another eating disorder that involves the restriction of food. Unlike with anorexia, where the sufferer tries to consume as little food as possible, orthorexics restrict their diet to those foods they consider “pure” or “safe.” This may mean that whole food groups may be cut out, and someone with orthorexia may have a fear of consuming a portion of food not considered safe. [4]

Bulimia is an eating disorder where someone eats large quantities of food over a short period of time and then purges them. Binging is typically done when the bulimic is alone. This can be accompanied by prolonged periods of fasting. Most bulimics are a normal weight instead of underweight like most anorexics, but they can suffer a variety of physical problems from purging. [5]

Binge eating disorder is an eating disorder like bulimia, but while it involves binging on large amounts of food, it does not involve purging it later on. Binge eaters may eat normal amounts at times when they are not bingeing, or they may only eat when they binge in private. [6]

Both men and women can have eating disorders, but anorexia and bulimia are more common in women. [7]

The Relation between Eating Disorders and Diabetes

There are two possible relationships between eating disorders and diabetes: whether diabetics are more likely to have an eating disorder and whether eating disorders can lead to someone developing diabetes. Let’s look at both.

Are diabetics more likely to develop an eating disorder? Some of the methods used to control diabetes are similar to those in many eating disorders, like food restriction. While those measures are taken for the well-being of the diabetic and not out of an irrational fear of gaining weight, it’s possible that the two can eventually overlap. [8]

Some research has found that women with type 1 diabetes are twice as likely to develop eating disorders as opposed to women who do not have diabetes. And while many of those with eating disorders use the same techniques as non-diabetics, there are ways unique to diabetics to get the same effect. [9]

Type 1 diabetics do not produce insulin on their own. Without insulin, the body is unable to use glucose to get energy. If diabetics do not get insulin from another source, the glucose leaves the body via urine. This leaves them unable to gain weight and lose weight rapidly. Insulin lets the body use that glucose, but if the diabetic does not take enough insulin to manage their glucose levels, they will still lose weight.

Some diabetics deliberately take less insulin than they need, which leads to weight loss. [10] Unfortunately, this also leads to other complications that occur in untreated diabetics and eventually lead to coma and death. It’s estimated that up to a third of women with diabetes have tried this. It’s common enough to have a nickname: “Diabulimia.” [11]

Can Eating Disorder Cause Diabetes?

Can eating disorders lead to someone developing diabetes as a result? This isn’t a question with a simple yes or no answer because eating disorders are so different.

One meta-analysis of studies related to type 2 diabetes and eating disorders found that bulimia and binge eating disorder increased the risk of someone would develop diabetes, while anorexia reduced that risk. This is possible because of increased fat deposits in bulimics and binge eaters and lesser amounts of fat deposits in anorexics. [12]

Common Treatment of Bulimia and Binge Eating Disorder

If you think someone you know has an eating disorder or someone who knows you thinks you have an eating disorder, the first step is to see a doctor. They will be able to guide the person toward treatment.

The treatments for bulimia and binge eating disorder are somewhat similar, as with many eating disorders. The first step is often a self-help guide. The guide can teach the person to do several things to fight the disorder.

• Keep a food diary. Note what foods can form the basis of a healthy eating plan and which foods are not as nutritious. Use healthy foods to help plan meals.
• Try to watch for triggers that cause binging or purging. See what can be done to avoid them.
• The guide will also contain information on dealing with food and weight gain/loss in a healthier manner. [13][14]

Treatment for eating disorders typically also involves seeing a therapist. With therapy, the person can deal with whatever life issues lead to the eating disorder and ways of dealing with painful feelings that do not involve food. Therapists can also work on the underlying thoughts that drive most eating disorders and show the person how they are not accurate. [15]

In addition to all the above, it is important to mention to anyone that is providing treatment or guidance for an eating disorder that the person in question is diabetic, so that can be worked into any food plans.

FAQ

What Is Diabulimia?

Diabulimia is a term used for those with diabetes who lower or stop their insulin intake so they can lose weight.

What to do if I have Eating Disorders with Diabetes?

If you have diabetes and are engaging in behaviors related to eating disorders, see either your doctor or a doctor who specializes in one or the other and tell them what you have been doing.

When to Visit My Doctor?

If you or someone you know with diabetes is starting to show signs of an eating disorder, that person should get medical help immediately.

Final Thoughts

Eating disorders, like diabetes, are not conditions to be managed once but rather ones that must be dealt with over a lifetime. If the two of them overlap, managing both can be even harder. Thankfully with proper treatment, both can become something that can be dealt with over daily life.

References

1. February 25, & Member, 2019 R. E. T. L. | A. F. (2019, February 25). Types of Eating Disorders: Symptoms, Causes and Effects. Www.snhu.edu. https://www.snhu.edu/about-us/newsroom/health/types-of-eating-disorders
2. Beat Eating Disorders. (2022). Types of eating disorder. Beat. https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/
3. Types of eating disorders. (n.d.). Mental Health UK. https://mentalhealth-uk.org/help-and-information/conditions/eating-disorders/types-of-eating-disorders/
4. Orthorexia. (n.d.). Beat. https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/other-eating-feeding-problems/orthorexia/
5. Types of Eating Disorders. (n.d.). Nyulangone.org. Retrieved January 18, 2023, from https://nyulangone.org/conditions/eating-disorders/types
6. Beat Eating disorders. (n.d.). Binge Eating Disorder. Beat. https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/binge-eating-disorder/
7. Nagl, M., Jacobi, C., Paul, M., Beesdo-Baum, K., Höfler, M., Lieb, R., & Wittchen, H.-U. (2016). Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults. European Child & Adolescent Psychiatry, 25(8), 903–918. https://doi.org/10.1007/s00787-015-0808-z
8. Types of Eating Disorders | ADA. (n.d.). Diabetes.org. https://diabetes.org/healthy-living/mental-health/eating-disorders
9. Diabetes and Eating Disorders. (2002). Diabetes Spectrum, 15(2), 106–106. https://doi.org/10.2337/diaspect.15.2.106
10. The Uniquely Dangerous Eating Disorder Symptom in Type 1 Diabetes. (2017, March 14). National Eating Disorders Association. https://www.nationaleatingdisorders.org/blog/eating-disorders-type-1-diabetes
11. Types of Eating Disorders | ADA. (n.d.). Diabetes.org. https://diabetes.org/healthy-living/mental-health/eating-disorders
12. Nieto-Martínez, R., González-Rivas, J. P., Medina-Inojosa, J. R., & Florez, H. (2017). Are Eating Disorders Risk Factors for Type 2 Diabetes? A Systematic Review and Meta-analysis. Current Diabetes Reports, 17(12). https://doi.org/10.1007/s11892-017-0949-1
13. NHS. (2021, February 12). Treatment – Binge eating disorder. Nhs.uk. https://www.nhs.uk/mental-health/conditions/binge-eating/treatment/
14. NHS. (2021, February 15). Treatment – Bulimia. Nhs.uk. https://www.nhs.uk/mental-health/conditions/bulimia/treatment/
15. Types of Psychotherapy. (2020, November 16). National Eating Disorders Association. https://www.nationaleatingdisorders.org/treatment/types-psychotherapy