Eating disorders and diabetes: Why your relationship with food matters


by Alessandra Stasnopolis, RDN, LDN

Sep 1, 2021

Did you know eating disorders are more common among people living with Type 1 or Type 2 diabetes? When you think about the weight loss and diet obsessed world we live in, it’s no wonder.

From societal pressure to lose weight, to fears around certain foods and the emotional burden of living with diabetes, there are a lot of contributing factors that can cause someone with diabetes to develop an unhealthy view of food. The consequences can be severe, especially if that unhealthy view of food leads to an eating disorder.

But here’s the good news—you don’t have to live that way. It’s possible to thrive with a healthy mindset toward food AND your diabetes management.

The dangers of eating disorders in diabetes management

First, let’s talk about eating disorders. Eating disorders are ranked as the second deadliest mental health condition, claiming approximately 10,200 deaths each year in the U.S. Research shows that chronic dieting may increase your risk for developing an eating disorder, among other health issues.

Diabetes and eating disorders currently aren’t well-studied in research, but the work that has been done shows that those who suffer from diabetes have a higher risk of suffering from disordered eating and eating disorders than their non-diabetic peers.

So, why is that the case? Here are just a handful of the factors that can lead someone with diabetes to develop disordered eating habits.

  • Anti-carb or low carb rhetoric
  • Dieting or goals to “reverse” diabetes
  • Pushing “weight loss only” methods to improve numbers
  • Weight stigma in healthcare and society
  • Assumptions about how one develops diabetes
  • Constantly having to think and plan around food
  • Financial impact of diabetes
  • Dealing with blood sugar highs and lows
  • Dealing with diabetic-induced or other chronic conditions
  • Checking blood sugar and taking medication
  • The pressure to have perfect numbers
  • Threats used as motivation in treatment
  • Having an unpredictable body (a lack of control can increase risk for eating disorders)
  • Mental health impact of having a chronic condition (leading to diabetic burnout)

Disordered eating and diabetes

Disordered eating, which is different from an eating disorder, is more common than you might think. Many of these habits or thoughts happen without you realizing, and some may even seem to be “healthy”—but going against your bodily cues is not healthy.

Disordered eating can look like…

  • Constant dieting or yo-yo dieting
  • Cutting out entire food groups
  • Labeling foods as “good” or “bad”
  • Avoidance of certain foods or restaurants
  • Not keeping certain foods in the house
  • Constant thoughts about foods you can’t have
  • Feeling guilty after eating certain foods
  • Feeling stressed out about eating foods that you feel negatively impact your health or chronic condition management
  • Skipping meals on purpose

Disordered eating in diabetics can lead to other conditions like hypothalamic amenorrhea (loss of menstruation), extreme hypoglycemia, nutritional deficiencies, injury and eating disorder development.

Related: Your essential diabetes checklist

Eating disorders and diabetes

Disordered eating habits can easily slip into eating disorder territory. Type 1 diabetics tend to be at a higher risk for bulimia or diabulimia. Diabulimia refers to an eating disorder in a person with diabetes, typically Type 1 diabetes, wherein the person purposefully restricts insulin in order to lose weight. Type 2 diabetics tend to be at a higher risk of binge eating disorder.

Eating disorders in diabetics can lead to:

  • Infection and healing issues
  • Diabetic ketoacidosis
  • Dehydration
  • Muscle wasting
  • Eye conditions
  • Neuropathy
  • Digestive disorders
  • Organ damage
  • Coma
  • Stroke
  • In severe cases, death

How to build a healthier relationship with food

Now, for the good stuff—what you can do today to start building a healthier mindset toward food.

Find the right support.

Work with a dietitian and a therapist trained in eating disorders or disordered eating. It’s important to have a team to help you manage your conditions—especially those who understand eating disorders and disordered eating.

Incorporate a variety of foods, including carbs.

Carbs are essential for every human to live and thrive. This is because the body’s and brain’s main and preferred fuel source is carbs. Just because you are diabetic, doesn’t mean you shouldn’t eat carbs. In fact, you should focus on eating carbs at every meal.

What is most important is that you are eating consistently throughout the day, pairing carbs with proteins and fats, and eating a variety of carbs (with and without fiber). Also, having tools to manage your blood sugar (medication, checking blood sugar, talking a walk, drinking enough water, increasing protein, fat and fiber intake when blood sugar is high, etc.) can be helpful so you can enjoy a variety of foods.

Understand all the things that can impact blood sugar.

Did you know sleep, stress, lack of movement, medications, allergies, illness, weather, altitude, caffeine, skipping meals, dieting, alcohol intake, gut microbiome, sunburns, dehydration, expired medication, lack of diabetes medication/not taking medication properly, social determinants of health and lack of support can all impact your blood sugar? It’s not just based on what we eat.

A dietitian or certified diabetes care and education specialist can help you figure out how to manage these fluctuations so you can feel well and enjoy life.

Join a support group or online community.

It’s important to talk to people who know what you are going through, which is where a support group or online community can be so helpful. Your family and friends are an important part of your support system, but only someone living with diabetes can truly understand. Find diabetes support and education near you.

Looking for help improving your relationship with food and diabetes? Connect with a dietitian or diabetes care and education specialist today.

About the Author

Alessandra Stasnopolis, RDN, LDN, is a clinical dietitian and wellness coordinator in the Baylor Scott & White Health wellness department.

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