What types of eating disorders are associated with diabetes?
There are two main types of eating disorders associated with diabetes:
- Bulimia is a serious condition in which people eat excessively large amounts of food, and then try to get rid of the extra calories in unhealthy ways. Some of the ways people with bulimia try to shed the extra calories include self-induced vomiting, misuse of laxatives, diuretics or enemas, as well as fasting, strict dieting or excessive exercise.
- Binge eating disorder (BED) is also a serious condition, and occurs when people frequently eat large quantities of food (often very quickly, and to the point where they experience discomfort).
Why are eating disorders associated with diabetes?
Eating disorders are associated with type 2 diabetes because people with bulimia or BED tend to binge on foods that are high in sugar and fat, and low in protein. Even though bulimics purge food, some food and nutrients will remain in the body, which can cause high blood sugar levels. While unhealthy eating habits are not one of the main causes of type 2 diabetes, they can be a significant contributing factor.
A recent study of more than 2,300 patients who were being treated at an eating disorder clinic in Finland showed that bulimia and BED were associated with diabetes, both in increased incidence (the rate of newly diagnosed cases of the disease) and prevalence (the actual number of people who were reported to have the disease).
When compared with a control group (people who did not have an eating disorder), the lifetime prevalence rate of diabetes among people with either bulimia or BED was 5.2% vs. 1.7% among the control group. At the end of the 16-year study, 33% of patients treated for BED had type 2 diabetes and 4% of those with bulimia had type 2 diabetes.
The researchers concluded: “Our findings provide strong support for the association between type 2 diabetes and clinically significant binge eating.”
What are some common warning signs of bulimia and BED?
Some of the frequent warns signs of an eating disorder such as bulimia or BED include:
- Extremely high A1C test results
- Frequent bouts of poor blood sugar control
- Anxiety about or avoidance of being weighed
- Frequent requests to switch meal-planning approaches
- Frequent and severe low or high blood sugar levels
- Widely fluctuating blood sugar levels, with no obvious explanation
- Bingeing with food or alcohol at least twice a week
- Exercising more than necessary to stay fit
- Severe family stress
What are the medical risks associated with bulimia and BED?
Both physical and psychological complications can result from bulimia and BED. Physical complications include:
- Higher risk of developing type 2 diabetes
- Worsening diabetes control, and an increased risk of complications, in those who already have the disease
- Joint problems
- Gastroesophageal reflux disease
- Sleep-related breathing disorders, such as sleep apnea
Psychological and psychiatric complications include:
- Poor quality of life
- Problems functioning at work, in family life, or in social situation
- Bipolar disorder
- Substance use disorders
Diabulimia – an eating disorder unique to people with type 1 diabetes
The term ‘diabulimia’ is most commonly seen in young women with type 1 diabetes who withhold or restrict insulin for the purpose of weight loss. Without insulin, blood glucose levels will increase significantly as well as the risk of diabetic ketoacidosis, a potentially life-threatening condition. Speak to your doctor or someone from the diabetes healthcare team if you suspect that you or someone you know may be suffering from diabulimia.