Diabetes & Eating Disorders in Youth

Research shows that individuals (especially young women) with type 1 diabetes (T1D) are at an increased risk of developing eating disorders (ED) and disordered eating behaviors (DEB) [1]. Unfortunately, co-occurring diabetes and eating disorders in youth can create severe and sometimes irreversible health complications.

The Connection Between Diabetes and Eating Disorders in Youth

In a study published by the medical research journal, The BMJ, researchers found that eating disorders were nearly twice as prevalent in adolescent females (aged 12-19) with type 1 diabetes than in non-diabetic adolescent females [2].

Another study published in the American Diabetes Association journal revealed that binge eating, subthreshold eating disorders, and excessive exercise for weight loss/control were more common in young females with type 1 diabetes than in non-diabetic young females [3].

Other research reveals that problematic behaviors like mild to extreme dieting, binge eating episodes, skipping meals, caloric restriction, and the use of purging behaviors (e.g., vomiting, use of laxatives, etc.) for weight control are reported more in youths with type 1 diabetes than in their non-diabetic peers. Specific rates of EDs/DEBs are approximately 39.9%/7% in youth with type 1 diabetes compared to 32.5%/2.8% in youth without diabetes [4].

While the specific cause for increased rates of EDs and DEB among youth with T1D is unknown, experts assume that certain aspects of diabetes and its treatment (e.g., counting carbohydrates, dietary restrictions, preoccupation with food and food intake, weight fluctuations, meal planning, etc.) may make diabetic youth more vulnerable to developing an ED [5].

Complications in Youth

Although eating disorders and disordered eating behaviors pose serious (often life-threatening) health complications to all individuals, diabetic youth who develop an ED or engage in DEB are especially at risk of suffering severe health complications. One study shares that individuals with comorbid diabetes and eating disorders often restrict or stop using insulin as a way to reduce calories and encourage weight loss [6].

This behavior, along with food restriction, bingeing episodes, and purging, lead to poor glycemic control and prolonged elevated blood sugar levels, which in turn can create a myriad of severe and irreversible health problems.

Some of the complications associated with comorbid diabetes and eating disorders in youth include:

• Severe dehydration

• Electrolyte imbalance

• Increased susceptibility to bacterial and yeast infections

• Menstrual disruption

• Muscle atrophy

• Slow wound healing

• Diabetic Ketoacidosis

• Kidney disease

• Heart disease

• Liver disease

• Peripheral Neuropathy

• Chronic diarrhea

• Coma

COVID-19 Impact

In light of the evidence that youth with type 1 diabetes are more susceptible to developing an ED or DEB than their non-diabetic peers, health practitioners should begin regular ED and DEB screening and prevention programs when treating preteens and youth with T1D. This is especially important during times of increased stress, like the current COVID-19 pandemic.

While a recent study on Italian youth with type 1 diabetes did not find evidence that youth with T1D are developing EDs or DEB at a higher rate during the COVID-19 pandemic, research is still limited [7].

And given that adverse psychological conditions (anxiety, stress, depression, etc.) are considered a trigger for the development, maintenance, and relapse of DEB and EDs in high-risk individuals, extra attention (i.e., parental and practitioner screening and prevention measures) should be given to youth with T1D during this time.

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Resources:

[1] Troncone, A., Chianese, A., Zanfardino, A., Cascella, C., Piscopo, A., Iafusco, D., … Borriello, A. (2020). Disordered eating behaviors in youths with type 1 diabetes during COVID-19 lockdown: an exploratory study. Journal of Eating Disorders. https://jeatdisord.biomedcentral.com/track/pdf/10.1186/s40337-020-00353-w.pdf.

[2] Jones, J. M., Lawson, M. L., Daneman, D., Olmsted, M. P., & Rodin, G. (2000, June 10). Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study. The BMJ. https://www.bmj.com/content/320/7249/1563.short.

[3] Colton, P., Olmsted, M., Daneman, D., Rydall, A., & Rodin, G. (2004, July 1). Disturbed Eating Behavior and Eating Disorders in Preteen and Early Teenage Girls With Type 1 Diabetes. Diabetes Care. https://care.diabetesjournals.org/content/27/7/1654.short.

[4] Troncone, A., Chianese, A., Zanfardino, A., Cascella, C., Piscopo, A., Iafusco, D., … Borriello, A. (2020). Disordered eating behaviors in youths with type 1 diabetes during COVID-19 lockdown: an exploratory study. Journal of Eating Disorders. https://jeatdisord.biomedcentral.com/track/pdf/10.1186/s40337-020-00353-w.pdf.

[5] ibid.

[6] ibid.

[7] ibid.

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About the Author:

Sarah Musick is a freelance writer who specializes in eating disorder awareness and education. After battling with a 4-years long eating disorder, she made it her mission to help others find hope and healing in recovery.

Her work has been featured on numerous eating disorder blogs and websites. When she’s not writing, Sarah is off traveling the world with her husband.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published January 7, 2021, on EatingDisorderHope.com
Reviewed & Approved on January 7, 2021, by Jacquelyn Ekern MS, LPC