Young People with Diabetes at Risk for Disordered Eating Behaviors

A recent study presented at the American Diabetes Association’s 77th Scientific Sessions in San Diego found that youth and young adults with type 1 diabetes or type 2 diabetes are at risk for developing disordered eating behaviors. Disordered eating behaviors are defined as “a wide range of irregular eating behaviors that do not warrant a diagnosis of a specific eating disorder.” While eating disorders like anorexia or bulimia are defined by certain criteria, disordered eating behaviors are more subtle. However, disordered eating can significantly impact an individual’s physical and emotional health, and for young people with diabetes, there are greater health implications.1,2

The study evaluated data on 2,156 youth with type 1 diabetes and type 2 diabetes from five sites in the United States. The average age of the young people with type 1 diabetes was 17.7 years, while the average age of the young people with type 2 diabetes was 21.8 years. Disordered eating was defined by characteristics including age, body mass index (BMI), and health outcomes. All the participants included in the analysis had been diagnosed with diabetes between 2002 and 2008.1

Disordered eating behaviors were observed in 52.2% of participants with type 2 diabetes and 21.2% of study participants with type 1 diabetes. Researchers believe that the intense focus on diet and weight control that is critical to managing diabetes may predispose young people with diabetes to disordered eating behaviors. Disordered eating behaviors were more common in females and in those who were overweight. More than 20% of the young people in the study admitted they faced challenges in maintaining a healthy weight while managing their diabetes. And a desire to be thin was more important that good diabetes control in 34.2% of those with type 2 diabetes and 12.4% of those with type 1 diabetes.1

The young people with disordered eating behaviors had poorer health outcomes, including higher A1C levels, more symptoms of depression, and poorer quality of life. Other studies have shown that depression occurs in higher rates in people with diabetes and has negative impacts for physical and mental health.1

What are disordered eating behaviors?

Disordered eating behaviors may include:

  • Food restriction
  • Binge eating
  • Purging by self-induced vomiting, laxative use, or excessive exercise
  • Chronic yo-yo dieting
  • Excessive exercise regimens
  • Obsessive calorie counting
  • Self-esteem based mostly or only on body shape and weight
  • Preoccupation with food, body shape, and/or exercise that has a negative impact on the individual’s quality of life
  • Extremely rigid and inflexible approach to eating and/or exercise
  • Guilt or shame that occurs when unable to maintain strict food and exercise habits

While many of the behaviors are similar to eating disorders, the behaviors are generally experienced to a lesser degree or less frequently in someone with disordered eating behaviors. Although they may not be as severe as someone with an eating disorder, these behaviors should be taken seriously.2,3

What are complications and treatment of disordered eating behaviors

As the study researchers noted, disordered eating behaviors can complicate diabetes management, glucose control, and overall general health, and it’s important for families and healthcare professionals to be aware of the risks of disordered eating behaviors among young people with diabetes and to get appropriate treatment if necessary. Treatment for disordered eating behaviors may include psychological therapy and working with a nutritionist.1-3

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