Advertisement

Eating Disorders in Type 1 and Type 2 Diabetes

  • Ann E. Goebel-Fabbri
Chapter

Abstract

While the risk of developing an eating disorder or subclinical disordered eating behaviors is heightened in both type 1 and type 2 diabetes, these phenomena remain relatively little understood. Eating disorders of all types occur in type 1 diabetes; however the use of insulin restriction for intentional calorie purging is the subject of the most research. Insulin restriction is associated with heightened risk of diabetic ketoacidosis, earlier onset of long-term diabetes complications, and an increased risk of mortality. Binge eating disorder is the more commonly studied eating disorder in type 2 diabetes; however less is known about its medical sequelae. Less research has been done on eating disorders in type 2 diabetes. This chapter provides a comprehensive review of the research on the extent of these problems and what is known about their medical consequences. It describes well-known risk factors common to classic eating disorders and those that occur in diabetes and proposes additional risk factors unique to both forms of diabetes. Screening tools for disordered eating in type 1 diabetes are described and recommended for use in research and general clinical practice. Finally, while there is a dearth of treatment research in this area, suggestions for treatment approaches are made based on both the research and clinical experience.

Keywords

Diabetes Adults Eating disorders Insulin restriction Diabulimia 

References

  1. Bryden, K. S., Neil, A., Mayou, R. A., Peveler, R. C., Fairburn, C. G., & Dunger, D. B. (1999). Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care, 22, 1956–1960.PubMedCrossRefGoogle Scholar
  2. Cerrelli, F., Manini, R., Forlani, G., Baraldi, L., Melchionda, N., & Marchesini, G. (2005). Eating behavior affects quality of life in type 2 diabetes mellitus. Eating and Weight Disorders, 10(4), 251–257.PubMedCrossRefGoogle Scholar
  3. Colton, P., Olmsted, M., Daneman, D., Rydall, A., & Rodin, G. (2004). Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes: A case-controlled study. Diabetes Care, 27, 1654–1659.PubMedCrossRefGoogle Scholar
  4. Colton, P. A., Olmsted, M. P., Daneman, D., Farquhar, J. C., Wong, H., Muskat, S., & Rodin, G. M. (2015). Eating disorders in girls and women with type 1 diabetes: A longitudinal study of prevalence, onset, remission, and recurrence. Diabetes Care, 38(7), 1212–1217.CrossRefGoogle Scholar
  5. Colton, P. A., Olmsted, M. P., Daneman, D., Rydall, A. C., & Rodin, G. M. (2007). Natural history and predictors of disturbed eating behaviour in girls with type 1 diabetes. Diabetic Medicine, 24, 424–429.PubMedCrossRefGoogle Scholar
  6. Crow, S., Kendall, D., Praus, B., & Thuras, P. (2001). Binge eating and other psychopathology in patients with type II diabetes mellitus. International Journal of Eating Disorders, 30(2), 222–226.PubMedCrossRefGoogle Scholar
  7. Custal, N., Arcelus, J., Aguera, Z., Bove, F. I., Wales, J., Granero, R., … Fernandez-Aranda, F. (2014). Treatment outcome of patients with comorbid type 1 diabetes and eating disorders. BMC Psychiatry, 14, 140.PubMedPubMedCentralCrossRefGoogle Scholar
  8. d’Emden, H., Holden, L., McDermott, B., Harris, M., Gibbons, K., Gledhill, A., & Cotterill, A. (2012). Concurrent validity of self-report measures of eating disorders in adolescents with type 1 diabetes. Acta Paediatrica, 101(9), 973–978.PubMedCrossRefGoogle Scholar
  9. d’Emden, H., McDermott, B., Gibbons, K., Harris, M., & Cotterill, A. (2015). Choosing a screening tool to assess disordered eating in adolescents with type 1 diabetes mellitus. The Journal of Diabetic Complications, 29(1), 2–4.CrossRefGoogle Scholar
  10. Daneman, D., Olmsted, M., Rydall, A., Maharaj, S., & Rodin, G. (1998). Eating disorders in young women with type 1 diabetes. Prevalence, problems and prevention. Hormone Research, 50, 79–86.PubMedCrossRefGoogle Scholar
  11. De Groot, M., Anderson, R., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). Association of depression and diabetes complications: A meta-analysis. Psychosomatic Medicine, 63, 619–630.PubMedCrossRefGoogle Scholar
  12. De Groot, M., Golden, S. H., & Wagner, J. (2016). Psychological conditions in adults with diabetes. American Psychologist, 71(7), 552–562.PubMedCrossRefGoogle Scholar
  13. Dickens, Y. L., Haynos, A. F., Nunnemaker, S., Platka-Bird, L., & Dolores, J. (2015). Multidisciplinary residential treatment of type 1 diabetes mellitus and co-occurring eating disorders. Eating Disorders, 23(2), 134–143.CrossRefGoogle Scholar
  14. Domargard, A., Sarnblad, S., Kroon, M., Karlsson, I., Skeppner, G., & Aman, J. (1999). Increased prevalence of overweight in adolescent girls with type 1 diabetes mellitus. Acta Paediatrica, 88, 1223–1228.PubMedCrossRefGoogle Scholar
  15. Fairburn, C. G. (2013). Overcoming binge eating (2nd ed.). New York: Guilford Press.Google Scholar
  16. Gagnon, C., Aimé, A., Bélanger, C., & Markowitz, J. T. (2010). Comorbid diabetes and eating disorders in adult patients: Assessment and considerations for treatment. Diabetes Educator, 38(4), 537–542.CrossRefGoogle Scholar
  17. Garcia-Mayor, R. V., & Garcia Soidan, F. J. (2016). Eating disorders in type 2 diabetic people: Brief review. Diabetes and Metabolic Syndrome, 16, S1871–S4021.Google Scholar
  18. Gibbons, C. H., & Freeman, R. (2014). Treatment-induced neuropathy of diabetes: An acute, iatrogenic complication of diabetes. Brain, 138, 43–52.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Goebel-Fabbri, A. (2017). Prevention and recovery from eating disorders in type 1 diabetes: Injecting Hope. New York: Routledge Press.CrossRefGoogle Scholar
  20. Goebel-Fabbri, A. E., Anderson, B., Fikkan, J., Franko, D. L., Pearson, K., & Weinger, K. (2011). Improvement and emergence of insulin restriction in women with type 1 diabetes. Diabetes Care, 34, 545–550.PubMedPubMedCentralCrossRefGoogle Scholar
  21. Goebel-Fabbri, A. E., Fikkan, J., Connell, A., Vangsness, L., & Anderson, B. J. (2002). Identification and treatment of eating disorders in women with type 1 diabetes mellitus. Treatments in Endocrinology, 1, 155–162.PubMedCrossRefGoogle Scholar
  22. Goebel-Fabbri, A. E., Fikkan, J., Franko, D. L., Pearson, K., Anderson, B. J., & Weinger, K. (2008). Insulin restriction and associated morbidity and mortality in women with type 1 diabetes. Diabetes Care, 31, 415–419.PubMedCrossRefGoogle Scholar
  23. Goebel-Fabbri, A. E., Polonsky, W., Uplinger, N., Gerkin, S., Mangham, D., Moxness, R., … Parkin, C. (2009). Outpatient management of eating disorders in type 1 diabetes. Diabetes Spectrum, 22(3), 147–152.CrossRefGoogle Scholar
  24. Gorin, A. A., Niemeier, H. M., Hogan, P., Coday, M., Davis, C., DiLillo, V. G., Gluck, M. E., Wadden, T. A., West, D. S., Williamson, D., & Yanovski, S. Z. (2008) Look AHEAD Research Group. Binge eating and weight loss outcomes in overweight and obese individuals with type 2 diabetes: results from the Look AHEAD trial. Archives of General Psychiatry, 65(12), 1447–1455.Google Scholar
  25. Hamdy, O., & Carver, C. (2008). The why WAIT program: Improving clinical outcomes through weight management in type 2 diabetes. Current Diabetes Reports, 8(5), 413–420.PubMedCrossRefGoogle Scholar
  26. Herbozo, S., Flynn, P. M., Stevens, S. D., & Betancourt, H. (2015). Dietary adherence, glycemic control, and psychological factors associated with binge eating among indigenous and non-indigenous Chileans with type 2 diabetes. International Journal of Behavioral Medicine, 22(6), 792–798.PubMedCrossRefGoogle Scholar
  27. Jones, J. M., Lawson, M. L., Daneman, D., Olmsted, M. P., & Rodin, G. (2000). Eating disorders in adolescent females with and without type 1 diabetes: Cross sectional study. BMJ, 320, 1563–1566.PubMedPubMedCentralCrossRefGoogle Scholar
  28. Kenardy, J., Mensch, M., Bowen, K., Green, B., Walton, J., & Dalton, M. (2001). Disordered eating behaviours in women with type 2 diabetes mellitus. Eating Behaviors, 2(2), 183–192.PubMedCrossRefGoogle Scholar
  29. Mannucci, E. L., Tesi, F., Ricca, V., Pierazzuoli, E., Barciulli, E., Moretti, S., Di Bernardo, M., Travaglini, R., Carrara, S., Zucchi, T., Placidi, G. F., & Rotella, C. M. (2002). Eating behavior in obese patients with and without type 2 diabetes mellitus. International Journal of Obesity and Related Metabolic Disorders, 26(6), 848–853.Google Scholar
  30. Markowitz, J. T., Butler, D. A., Volkening, L. K., Antisdel, J. E., Anderson, B., & Laffel, L. M. (2010). Brief screening tool for disordered eating in diabetes. Diabetes Care, 33, 495–500.CrossRefGoogle Scholar
  31. Markowitz, J. T., Lowe, M. R., Volkening, L. K., & Laffel, L. M. B. (2009). Self-reported history of overweight and its relationship to disordered eating in adolescent girls with type 1 diabetes. Diabetic Medicine, 26, 1165–1171.PubMedPubMedCentralCrossRefGoogle Scholar
  32. Merwin, R. M., Dmitrieva, N. O., Honeycutt, L. K., Moskovich, A. A., Lane, J. D., Zucker, N. L., … Kuo, J. (2015). Momentary predictors of insulin restriction among adults with type 1 diabetes and eating disorder symptomatology. Diabetes Care, 38(11), 2025–2032.PubMedPubMedCentralCrossRefGoogle Scholar
  33. Merwin, R. M., Moskovich, A. A., Dmitrieva, N. O., Pieper, C. F., Honeycutt, L. K., Zucker, N. L., … Buhi, L. (2014). Disinhibited eating and weight-related insulin mismanagement among individuals with type 1 diabetes. Appetite, 81, 123–130.PubMedPubMedCentralCrossRefGoogle Scholar
  34. Nicolau, J., & Masmiquel, L. (2015). Eating disorders and diabetes mellitus. Endocrinology Nutrition, 62(7), 297–299.CrossRefGoogle Scholar
  35. Nielsen, S., Emborg, C., & Molbak, A. G. (2002). Mortality in concurrent type 1 diabetes and anorexia nervosa. Diabetes Care, 25, 309–312.PubMedCrossRefGoogle Scholar
  36. Olmsted, M. P., Colton, P. A., Daneman, D., Rydall, A. C., & Rodin, G. M. (2008). Prediction of the onset of disturbed eating behavior in adolescent girls with type 1 diabetes. Diabetes Care, 31, 1978–1982.PubMedPubMedCentralCrossRefGoogle Scholar
  37. Peveler, R. C., Bryden, K. S., Neil, H. A., Fairburn, C. G., Mayou, R. A., Dunger, D. B., & Turner, H. M. (2005). The relationship of disordered eating habits and attitudes to clinical outcomes in young adult females with type 1 diabetes. Diabetes Care, 28, 84–88.PubMedCrossRefPubMedCentralGoogle Scholar
  38. Peveler, R. C., & Fairburn, C. G. (1989). Anorexia nervosa in association with diabetes mellitus--a cognitive-behavioural approach to treatment. Behavior Research and Therapy, 27(1), 95–99.CrossRefGoogle Scholar
  39. Peveler, R. C., Fairburn, C. G., Boller, I., & Dunger, D. (1992). Eating disorders in adolescents with IDDM. A controlled study. Diabetes Care, 15(10), 1356–1360.PubMedCrossRefPubMedCentralGoogle Scholar
  40. Pinhas-Hamiel, O., Hamiel, U., Greenfield, Y., Boyko, V., Graph-Barel, C., Rachmiel, M., … Reichman, B. (2013). Detecting intentional insulin omission for weight loss in girls with type 1 diabetes mellitus. International Journal of Eating Disorders, 46(8), 819–825.PubMedCrossRefGoogle Scholar
  41. Polonsky, W. H., Anderson, B. J., Lohrer, P. A., Aponte, J. E., Jacobson, A. M., & Cole, C. F. (1994). Insulin omission in women with IDDM. Diabetes Care, 17, 1178–1185.PubMedCrossRefPubMedCentralGoogle Scholar
  42. Powers, M. A., Richter, S., Ackard, D., & Craft, C. (2016). Development and validation of the screen for early eating disorder signs (SEEDS) in persons with type 1 diabetes. Eating Disorders, 24(3), 271–288.PubMedCrossRefGoogle Scholar
  43. Raevuori, A., Suokas, J., Haukka, J., Gissler, M., Linna, M., Grainger, M., & Suvisaari, J. (2015). Highly increased risk of type 2 diabetes in patients with binge eating disorder and bulimia nervosa. International Journal of Eating Disorders, 48(6), 555–562.CrossRefGoogle Scholar
  44. Rydall, A. C., Rodin, G. M., Olmsted, M. P., Devenyi, R. G., & Daneman, D. (1997). Disordered eating behavior and microvascular complications in young women with insulin-dependent diabetes mellitus. The New England Journal of Medicine, 336, 1849–1854.PubMedCrossRefGoogle Scholar
  45. Takii, M., Uchigata, Y., Komaki, G., Nozaki, T., Kawai, H., Iwamoto, Y., & Kubo, C. (2003). An integrated inpatient therapy for type 1 diabetic females with bulimia nervosa: A 3-year follow-up study. Journal of Psychosomatic Research, 55(4), 349–356.PubMedCrossRefGoogle Scholar
  46. The Diabetes Control and Complications Trial Research Group. (1988). Weight gain associated with intensive therapy in the diabetes control and complications trial. Diabetes Care, 11, 567–573.CrossRefGoogle Scholar
  47. The Diabetes Control and Complications Trial Research Group. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The New England Journal of Medicine, 329, 977–986.CrossRefGoogle Scholar
  48. The Diabetes Control and Complications Trial Research Group. (2001). Influence of intensive diabetes treatment on body weight and composition of adults with type 1 diabetes in the diabetes control and complications trial. The diabetes control and complications trial research group. Diabetes Care, 24, 1711–1721.PubMedCentralCrossRefPubMedGoogle Scholar
  49. Tierney, S., Deaton, C., & Whitehead, J. (2009). Caring for people with type 1 diabetes mellitus engaging in disturbed eating or weight control: A qualitative study of practitioners’ attitudes and practices. Journal of Clinical Nursing, 18(3), 384–390.PubMedCrossRefGoogle Scholar
  50. Treasure, J., Kan, C., Stephenson, L., Warren, E., Smith, E., Heller, S., & Ismail, K. (2015). Developing a theoretical maintenance model for disordered eating in type 1 diabetes. Diabetic Medicine, 32(12), 1541–1545.PubMedCrossRefGoogle Scholar
  51. Verrotti, A., Catino, M., De Luca, F. A., Morgese, G., & Chiarelli, F. (1999). Eating disorders in adolescents with type 1 diabetes mellitus. Acta Diabetologica, 36, 21–25.PubMedCrossRefGoogle Scholar
  52. Wilfley, D., Berkowitz, R., Goebel-Fabbri, A., Hirst, K., Ievers-Landis, C., Lipman, T. H., … The TODAY Study Group. (2011). Binge eating, mood, and quality of life in youth with type 2 diabetes: Baseline data from the TODAY study. Diabetes Care, 34(4), 858–860.CrossRefGoogle Scholar
  53. Wolpert, H. A., & Anderson, B. J. (2001). Metabolic control matters: Why is the message lost in the translation? The need for realistic goal-setting in diabetes care. Diabetes Care, 24, 1301–1303.PubMedCrossRefGoogle Scholar
  54. Young, V., Eiser, C., Johnson, B., Brierley, S., Epton, T., Elliott, J., & Heller, S. (2013). Eating problems in adolescents with type 1 diabetes: A systematic review with meta-analysis. Diabetic Medicine, 30, 189–198.PubMedCrossRefGoogle Scholar
  55. Zuijdwijk, C. S., Pardy, S. A., Dowden, J. J., Dominic, A. M., Bridger, R., & Newhook, L. A. (2014). The mSCOFF for screening disordered eating in pediatric type 1 diabetes. Diabetes Care, 37(2), e26–e27.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Ann E. Goebel-Fabbri
    • 1
  1. 1.Dr. Goebel-Fabbri, LLCBrooklineUSA

Personalised recommendations