Disordered eating and type 1 diabetes
Thursday, 25 March 2021
If you live with type 1 diabetes and struggle with disordered eating or an eating disorder, you are not alone.
In the past 30 years there has been growing awareness that people living with type 1 diabetes have higher rates of disordered eating and eating disorders.
Learn more, do better
We have also learnt more about why those with type 1 diabetes are at increased risk of disordered eating. In more recent times, health professionals working in this area are being upskilled as to how they can better support individuals with or at risk of disordered eating.
Disordered Eating is problematic eating behaviour that occurs with varying severity. It includes restricting food, skipping meals, excessive or compulsive eating or exercise, binge eating, laxative/diuretic abuse, vomiting and/or reducing or omitting insulin doses for the purpose of weight control.
The health consequences of disordered eating can be serious, especially when reduction or omission of insulin is involved. This is why the problems are best addressed at an early stage so the behaviours don’t become entrenched.
The book ”Prevention and Recovery from Eating Disorders in Type 1 Diabetes – Injecting Hope”, written by psychologist Dr Ann Goebel-Fabbri, tells the story of 25 women aged 18-50 years who live with type 1 diabetes and have recovered from an eating disorder.
The average duration among the women of type 1 diabetes was 19 years. The duration of the eating disorder was eight years. Only two of the 25 women believed the eating disorder was not preventable.
There are many learnings that have come from this book for both health professionals and for those with type 1 diabetes who are struggling with their eating. For those with diabetes, it is important to find a collaborative health care team who understand both type 1 diabetes and disordered eating.
Look for HPs who will talk it through with you
The health care providers should be alert to the signs and symptoms of disordered eating, and be prepared to discuss this with you. Relationships with health care professionals should be trusting and respectful so open and honest communications result.
Often there may be one particular member of the health care team with whom you establish a very good relationship, and feel comfortable to openly discuss your concerns.
Weight concerns are valid
Health care professionals should clearly advise that the treatment goals of type 1 diabetes are not to make you overweight. Any weight concern should be taken seriously and not dismissed, as your concerns are as valid as for someone without diabetes.
Risks of insulin omission
Those struggling with their eating should be given factual information about the risks of insulin omission, and the signs and symptoms of diabetes ketoacidosis so this life-threatening condition can be avoided.
Keep looking for a supportive team
Depending on the individual needs, additional education and assistance from the psychologist, dietitian or diabetes educator in your team can help.
In summary, if you’re struggling with disordered eating and eating disorders it’s important to find a supportive and knowledgeable health care team.
Problem now recognised
Be prepared to tackle your concerns in small manageable steps. Discuss with your loved ones how they can best support you, too.
Be assured, you are not alone, and this problem is now recognised.
Life can be better, and with the right care and support there is an easier way forward with better health outcomes for you.
By Helen d’Emden
Diabetes Qld Adv Accredited Practising Dietitian, Credentialled Diabetes Educator