Eating disorders are common, but despite the serious health consequences associated with them, people are reluctant to discuss them. It is no surprise that those with diabetes are more susceptible to developing eating disorders because managing diabetes requires patients to be vigilant about dietary management. Thankfully, efforts are being made to raise awareness, educate patients, and support those in need.
Diabetes Advocates is partnering with National Eating Disorders Association for National Eating Disorders Awareness Week, February 24th – March 2nd, promoting this year’s theme, Everybody Knows Somebody. Diabetes Advocates is proud to broaden and amplify the conversation on diabetes-related eating disorders by offering information and resources to the diabetes community, including those at risk and those in need of support, and encouraging participation in NEDAwareness Week through social media outlets.
How common are eating disorders with diabetes?
A report published in Diabetes Spectrum showed that having type 1 diabetes doubles the chance of developing an eating disorder1, and multiple studies have shown that eating disorders can lead to significantly higher rates of diabetic complications and mortality rates.2,3 Even more alarming is that one study indicated that 35% of 15–30 year olds manipulate or omit their insulin in order to lose weight, a practice known as diabulimia.4 For patients with type 2 diabetes, some research has suggested higher rates of binge eating disorder5, which is associated with poorer metabolic outcomes.6
Less severe, but still clinically significant, patients are at risk of developing disturbed eating behaviors, which are also associated with poorer metabolic outcomes, higher rates of diabetic complications and mortality.7 This is not surprising since behaviors that characterize eating disorders are often behaviors encouraged and praised by doctors with patients who have diabetes.Such behaviors include:8
- Weighing, measuring and counting food portions
- Keeping records of food consumed and exercise
- Increased focus on body weight, weight management and BMI
- Monitoring certain food components, i.e. carbohydrates, fiber and fat
National Eating Disorders Association is promoting dialogue and information sharing about eating disorders, and Diabetes Advocates is encouraging the Diabetes Online Community to engage in this important conversation. By highlighting the blog posts and projects of its members, Diabetes Advocates illustrates that disordered eating in the diabetes community affects people of all ages and genders. Michael Hoskins writes on Diabetes Mine about using emotional eating as a coping mechanism for feelings, and how it is not considered “manly” to struggle with such issues. Natalie Sera shares her story on Diabulimia Helpline about discovering she had a “young person’s” disease at the age of 64. Ginger Vieira has written a new book titled Emotional Eating with Diabetes that helps people with diabetes cope with the conflicted feelings about food that they often experience.
Lee Ann Thill, art therapist and founder of Diabetes Art Day, introduces VIAL Project: Voice-Insulin-Art-Life, a social network for people with type 1 diabetes and food and body issues to share creative expression and connect. VIAL project is a doctoral research project investigating the experience of living with diabetes and food and body issues, and participants’ experiences using creative expression and social networking. Erin Akers is CEO of Diabulimia Helpline, the only non-profit in the U.S. devoted solely to supporting diabetics with eating disorders, and their families. Diabulimia Helpline runs a support group on Facebook, where people with diabetes and eating disorders can share their struggles with recovery, and offers a 24-hour hotline to those in need.
The goal of National Eating Disorders Awareness Week is to promote public and media attention to the seriousness of eating disorders, their biological as well as environmental triggers, and to combat the pressures, attitudes and behaviors that can contribute to them. In a culture saturated with unrealistic body-image messages, most people know somebody struggling with an eating disorder. Education can lead to earlier detection, and intervention to help those who are struggling, ultimately improving the likelihood of full recovery.
Diabetes Advocates offers these suggestions to the Diabetes Online Community for participating in NEDAwareness Week:
- Bloggers can share their personal experience managing food and body issues
- Read, comment and share links to blog posts
- Share links to the projects and organizations listed in this post: Diabulimia Helpline, VIAL Project, Emotional Eating with Diabetes, and NEDA (Additional links are listed below)
- Participate in related discussions on diabetes social networking websites, Facebook and Twitter
By taking these actions during NEDAwareness Week, the Diabetes Online Community can raise awareness, educate others, and promote ongoing dialogue in support of those struggling and those at risk.
We can all help because Everybody Knows Somebody who needs it.
Erin, Lee Ann, Natalie
1. Daneman, D. Eating Disorders in Adolescent Girls and Young Women with Type I Diabetes. Diabetes Spectrum 2002; 15 : 83-105.
2. Steel JM, Young RJ, Lloyd GG, and Clarke BF. Clinically apparent eating disorders in young diabetic women: associations with painful neuropathy and other complications. British Medical Journal 1987; 294: 859-62.
3. Takii M, Uchigata Y, Tokunaga S, Amemiya N, Kinukawa N, Nozaki T, Iwamoto Y, and Kubo C. The duration of severe insulin omission is the factor most closely associated with the microvascular complications of Type 1 diabetic females with clinical eating disorders. The International Journal Of Eating Disorders, 2008 Apr; Vol. 41 (3), pp. 259-64.
4. *5 Goebel-Fabbri A. Insulin Restriction and Associated Morbidity and Mortality in Women with Type 1 Diabetes. Diabetes Care (2007).
5. Papelbaum M, Appolinário JC, Moreira Rde O, Ellinger VC, Kupfer R, and Coutinho WF. Prevalence of eating disorders and psychiatric comorbidity in a clinical sample of type 2 diabetes mellitus patients. Revista Brasileira De Psiquiatria (São Paulo, Brazil: 1999) [Rev Bras Psiquiatr] 2005 Jun; Vol. 27 (2), pp. 135-8.
6. Mannucci E, Tesi F, Ricca V, Pierazzuoli E, Barciulli E, Moretti S, Di Bernardo M, Travaglini R, Carrara S, Zucchi T, Placidi GF, and Rotella CM. Eating behavior in obese patients with and without type 2 diabetes mellitus. International Journal Of Obesity And Related Metabolic Disorders: Journal Of The International Association For The Study Of Obesity, 2002 Jun; Vol. 26 (6), pp. 848-53.
7. Goebel-Fabbri AE. Disturbed eating behaviors and eating disorders in type 1 diabetes: clinical significance and treatment recommendations. Current Diabetes Reports, 2009 Apr; Vol. 9 (2), pp. 133-9.
8 Affenito, SG, Adams CH. “Are eating disorders more prevalent in females with type 1 diabetes mellitus when the impact of insulin omission is considered?” Nutrition Reviews 2001; 59: 179-82.
About NEDAwareness Week
24-hour hotline (425) 385-3635
We Are Diabetes
Emotional Eating With Daibetes
V.I.A.L project; Voice, Insulin, Art, Life.
Your Diabetes May Vary
Food for the shrink – http://www.ydmv.net/2008/09/food-for-shrink.html
Cheating - http://www.ydmv.net/2013/02/eating-cheating-with-diabetes.html
•Blood Sugar Roller Coaster (over-treating low blood sugars)
•Rules Around Food that Do More Harm Than Good
The Butter Compartment – Previous posts
Peace of Cake: http://www.thebuttercompartment.com/?p=6265
New Year’s Revelation: http://www.thebuttercompartment.com/?p=4763
The Odd Duck Out
Has a very poignant graphic of how diabulimia happens.
Texting My Pancreas – Everybody Knows Someone
The Blue Heel Society – No Body is Perfect
Diabetes Mine - Diabetes and Eating Disorders: Fellow PWD Shares Her Diabulimia Story
DSMA Live ‘Rents – Feb 18 – Lee Ann: http://www.blogtalkradio.com/diabetessocmed/2013/02/19/dsma-live-rents
DSMA en Vivo con – Feb 26 – Lizmari:
The Angry Type 2 Diabetic
Diabetes Forecast - Hope in the World of Eating Disorders and Diabetes
Me and D: You Know Me
Diabetesaliciousness: #NEDAwareness Week: We All Know Someone~
Bitter~Sweet: Disorders and Issues
Strangely Diabetic: I’m One of the Disorderly
My crazy life with my diabetic service dog