Eating disorders occur among people with diabetes just as they do in the general population. Some researchers believe that individuals with diabetes may have an increased risk for eating disorders because they have to pay more attention to what they are eating. Unfortunately, in our society, the self-worth of many people comes from having a “perfect” body. Some people resort to extreme measures to get or stay thin.

There are two main eating disorders: anorexia nervosa and bulimia. Each has a distinct set of warning signs. People with anorexia refrain from eating in order to stay thin. Their perception of their body is often out of tune with reality. Even very thin women sometimes perceive themselves as being overweight.

People with bulimia will often eat normal or even excessive amounts of food and then purge the food by inducing vomiting or taking laxatives. Over time, bulimia can cause problems with the esophagus, as well as many dental problems. Both disorders stress the body and deny it the necessary nutrients.

People with diabetes and eating disorders are likely to have more episodes of ketoacidosis (type 1 diabetes)  and hypoglycemia, and their A1C levels tend to be higher. And because their blood glucose is often out of range, the risk for diabetes complications is also greater.

A disorder similar to these eating disorders has been found in people with diabetes who use insulin. They intentionally reduce or omit insulin doses in an attempt to lose glucose and calories in the urine. As in other eating disorders, people who omit insulin for weight loss have more episodes of ketoacidosis and problems managing their glucose levels.

If you have an eating disorder or are omitting insulin for weight control, professional help is available. Eating disorders are serious and can lead to acute complications and even death.

Please talk to someone with whom you feel comfortable discussing your feelings. Ask your provider to recommend a mental health counselor who can work with the other members of your health care team. Your entire team will work with you and your family to help you understand your disorder and how to treat it. It may help you to join a support group. Talking to others who have similar problems can help you feel understood.

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Martha M. Funnell, MS, RN, CDE
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Robert M. Anderson, EdD
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Shereen Arent, JD
National Director of Legal Advocacy
American Diabetes Association

American Diabetes Association Complete Guide to Diabetes