Eating disorders and type 1 diabetes
Managing type 1 diabetes requires you to think about food and everything you eat every single day.
The pressure is real
Since the moment you were diagnosed with type 1 diabetes (T1D), your entire relationship with food probably changed. Every meal requires careful thought, some math, and the pressure to make the “right” choices.
You’re also probably hearing and reading so many opinions, advice, and lectures from friends and family, the media, and even total strangers. Some of this may not match what you are hearing from your diabetes care team. Combined with the pressure many people feel from society to look a certain way, T1D can easily contribute to disordered eating behaviors, and even eating disorders including anorexia, bulimia, and bingeing.
In fact, research says that people with T1D are more likely to develop eating disorders than those without diabetes. This is especially true for girls and women—but boys and men with T1D can struggle with eating disorders, too.
Concerns about insulin and weight gain
Many people lose quite a bit of weight in the weeks leading up to their T1D diagnosis. That weight loss occurs because without insulin allowing glucose to be used as energy within the cell, the body burns fat and muscle for energy instead.
When you start insulin therapy, you might experience some weight gain. This is okay! For some people, however, it can be startling or frustrating. But it’s important to remember that all human beings need insulin to live. If you are gaining more weight than anticipated in the months following your diagnosis, work with your healthcare team to evaluate your insulin doses and nutrition to manage any unwanted weight gain.
Skipping insulin and risking your life
Skipping insulin to lose weight is extremely dangerous and not an effective way to lose weight. Any weight loss you might experience by restricting your insulin will be temporary. More importantly, restricting your insulin will lead to high blood sugar and put you at risk for complications including:
- Significant risk of hospitalization for diabetic ketoacidosis (DKA)
- Fatigue
- Intense cravings for food
- Damage to blood vessels in your eyes, kidneys, fingers, toes, heart, etc.
- Increased risk of infections that lead to leg/feet amputations
- Loss of menstruation and fertility
- Recurring yeast infections (especially in girls and women)
- Coma or death
If you or someone you love is purposefully restricting or skipping insulin, running dangerously high blood- glucose levels, reach out to your healthcare team for help
Other eating disorders
Not all eating disorders with type 1 diabetes have to do with restricting or omitting insulin. People with T1D can develop other eating disorders just like people without diabetes. The risks and complications of these eating disorders can be more dangerous for people with T1D. Limiting food intake can increase your risk of severe hypoglycemia while repeated vomiting can lead to severe lows, dehydration, and DKA. If you are struggling with disordered eating, talk to your diabetes care team. Getting treatment early is important for both your immediate and long-term health and safety.
Getting support for eating disorders
The American Diabetes Association (ADA) recommends that all people with T1D get screened by their healthcare providers for disordered or disrupted eating. If your healthcare provider doesn’t ask you about your feelings regarding your weight and eating, it is important that you speak up and tell them! Getting treatment early is key for any disordered eating and can help to improve your long-term medical and psychological outcomes.
Treatment for disordered eating requires a multidisciplinary approach and includes endocrinologists, diabetes care, and educational specialists, nurses, dieticians, and mental health providers. In both children and adults, this can include cognitive-behavioral therapy, family therapy, or other evidence-based therapy, as well as diabetes education and nutritional counseling.
If you are struggling with disordered eating or skipping your insulin doses, talk to your diabetes care team. Getting treatment early is important for both your immediate and long-term health and safety.
More food and diet guidance
Learn about nutrition while taking a realistic approach
Paying attention to your relationship with food
