Common Health Issues

Diabetes Binge Eating Disorders

• By Rich Health Editorial Team
• November 12, 2021

If you have diabetes, it is not unusual to be preoccupied with what you eat and worry about whether you are eating too much or gaining too much weight. This shows that you are doing your part to keep your diabetes under control. Even people who don’t have diabetes often fuss over their weight and diet. However, if you are excessively concerned over your weight to a point that threatens your health, you may have an eating disorder. You may also have an eating disorder if you seek psychological comfort in food and are unable to control what you eat.

 

There are three major types of eating disorders, all of which can seriously affect people with diabetes. Anorexia nervosa often affects teens and young women. If you have anorexia nervosa, you eat very little food and probably exercise to excess. Bulimia nervosa is also common in young women. If you have bulimia nervosa, you tend to binge eat and then purge. Purging is usually accomplished by vomiting, taking laxatives, or over-exercising. A binge eating disorder usually affects older people who are obese. If you have this condition, you are prone to binge eating without purging. Because all of these conditions involve uncontrolled patterns of eating, they can make diabetes extremely difficult to manage.

 

Anorexia Nervosa

Anorexia affects mostly young women. In fact, 95% of those who have anorexia are women. It seems to be more common among people from middle and upper socioeconomic classes. It can be a mild, transient phenomenon that some women go through and outgrow. Or it can be part of a lifelong pattern that is severe and life-threatening. There are multiple causes of anorexia, but it is important to remember all eating disorder behaviors are symptoms of other psychological problems. Treat those problems, and the food-related symptoms will improve. Half of all people with anorexia also have bulimia.

 

Anorexia Nervosa Symptoms

If you are anorexic, you probably weigh less than 85% of normal body weight. You have an intense fear of gaining weight even though you are thin and probably consider yourself too fat. You may exercise to excess and may even resort to bingeing and purging. You are probably preoccupied with food, even though you tend to eat far less than you should. You may hoard, conceal, or even waste food. You may cook elaborate meals for others, but refuse to eat anything yourself. It is likely that you frequently miss at least three consecutive menstrual cycles. When confronted by others, you probably deny that you have an eating problem.

If you have diabetes and are anorexic, you may frequently take part in a very dangerous practice. You may deliberately take less insulin than you know you should. The intent here is to keep from gaining weight by passing excess glucose into the urine. By excreting glucose, you thus absorb less calories. This practice is extremely dangerous. It can lead to emergency situations requiring hospitalization and can even lead to coma and death. It can also worsen the complications of diabetes.

 

What You Should Do About Diabetes Eating Disorders

As with any psychiatric disorder, you cannot be successfully treated until you recognize the problem and agree to seek treatment. Treatment of anorexia usually focuses first on restoring normal body weight and second on psychotherapy. Sometimes antidepressant medication is needed. 

 

If weight loss is severe, it can be life-threatening. If you have lost more than 25% of your ideal body weight, you will most likely be treated in a hospital setting. Usually you will be encouraged to eat solid food. Only rarely will you be fed intravenously. Once you have gained enough weight, psychotherapy—in an individual, group or family setting—can begin.

Your doctor may also suggest that you meet with your dietitian and diabetes educator. Your dietitian can work with you to develop an eating plan that encourages you to eat sensibly and nutritiously. You can learn to eat the right foods without gaining excessive amounts of weight. If you are taking insulin, talk to your educator about finding out how to devise a schedule that fits in with your eating plan.

Bulimia Nervosa

Bulimia also affects mostly young women. In fact, if you are bulimic, you may also be anorexic. Like people with anorexia, bulimics are also of upper socioeconomic classes and are excessively preoccupied with weight. This preoccupation is only a symptom of a deeper problem. 

 

Bulimia Nervosa Symptoms

You may have bulimia if you binge eat and then purge to eliminate the food or over-exercise to rid yourself of the calories. This means you eat very large amounts of food in a single setting at least twice a week. Usually this behavior has gone on for 3 months or more. You may feel that you can’t stop eating or have a hard time controlling how much or what you eat. If food is there, you eat it, whether you are hungry or not. 

 

Once you binge, you will try to get rid of the food you have eaten by vomiting, using laxatives, or taking other medications to lose weight or prevent weight gain. You may also resort to using less insulin than you need to get rid of excess calories as glucose in the urine. If you are bulimic, you are less likely to deny your eating problem than someone with anorexia, and you are more likely to feel guilty about it.

What You Should Do

If you have bulimia or suspect you have bulimia, talk to your doctor right away. You will be referred to a psychotherapist for counseling in a group or individual setting. You should try to find someone who specializes in eating disorders. Often, antidepressant drugs are helpful in treating bulimia, even if you are not diagnosed with depression. However, the symptoms can recur when the drug is discontinued.

 

You should also meet with your dietitian and diabetes educator. Your dietitian can work with you to develop an eating plan that encourages you to eat sensibly and nutritiously. Your eating plan should incorporate foods you like and should help you maintain a healthy weight. If you are taking insulin, talk to your educator about devising a schedule that fits in with your eating plan.

 

Diabetes Binge Eating Disorder

Unlike anorexia and bulimia, binge eating disorders affect both men and women. Almost half of all binge eaters are male. Binge eaters tend to be older than those with anorexia and are frequently obese. Binge eating involves consuming excessive amounts of food without purging. As with other eating disorders, binge eating can make diabetes difficult to control. Excessive amounts of food can send blood glucose levels skyrocketing. Also, the eating pattern is often erratic and unpredictable, and it is difficult to maintain any regular diabetes care schedule. Binge eaters usually continue to gain weight as the bingeing continues, which makes insulin resistance even worse.

 

Diabetes Binge Eating Disorder Symptoms

If you are a binge eater, you eat large amounts of food and feel that you have no control over what you eat. You are probably distressed about your pattern of eating. Often binge eaters try to lose weight, but cannot control their behavior. About half of all binge eaters also suffer from depression

What You Should Do

If you suspect that you are a binge eater, talk to your doctor right away. You may be referred to a psychotherapist and may benefit from group or individual counseling. You may also find relief with antidepressant or appetite suppressant therapy. Drug therapy will be more successful if prescribed along with counseling.

 

Sources and References

The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

Eating Disorders and Diabetes by A Winston

Eating Disorders in Adolescents with Type 2 and Type 1 Diabetes O Hamiel and Y Shraga 

Early Diagnosis and Management of Bulimia Nervosa in Type 1 Diabetes by Ahmed Yahya, Jude Chukwuma et al