Diabetes and Eating Disorders

A surprising new study has reported that more than half of all young people with Type 2 diabetes engage in behaviors related to eating disorders. Among youngsters with Type 1 diabetes, the number was about one in five.

The study was conducted by researchers at the University of Washington, Seattle, and reported at a recent conference of the American Diabetes Association. They used data from a study begun in 2002 that examined the prevalence of diabetes among young people in five states — South Carolina, Ohio, Colorado, Washington, and California. The study is considered the largest and most comprehensive of its kind in the United States.

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The researchers identified about 2300 study participants between the ages of 10 and 20 with diabetes. The subjects had all completed a screening tool called the Diabetes Eating Problem Survey–Revised. Among the questions asked were whether they had ever engaged in any inappropriate behaviors, such as skipping insulin or eating less in an attempt to lose weight. This tool enabled the researchers to give a score to the participants, and a score of higher than 20 indicated disordered eating behaviors. Evidence of eating disorders was found in 21.2% of the subjects with Type 1 diabetes and 52.5% of those with Type 2 diabetes. These subjects also tended to score higher on a depression scale and lower on measures of quality of life.

The researchers speculated that two main factors were behind the high rate of eating disorders among young people with diabetes. First, much of diabetes management is “food-focused,” and an overemphasis on diet can drive young people to inappropriate eating behaviors. Second, many young people with diabetes struggle with self-esteem problems related to having a chronic disease, and these can lead to psychiatric troubles or mood disorders.

According to Angel Siu Ying Nip, MD, the lead author of the study, her team’s research indicates that eating disorders among young diabetes patients is “a common problem, yet underrecognized and underdetermined.” Both physicians and parents, she said, need to be on the alert for inappropriate eating behavior and such signs as excessive weight gain or weight loss. Physicians who treat young people with diabetes might consider using the same Diabetes Eating Problem Survey employed in the study. It consists of 16 questions and can easily be given in the doctor’s office.

Want to learn more about diabetes and eating disorders? Read “Diabulimia” and “Help for Those Dealing With Diabulimia.”