What are Eating Disorders in Diabetes Mellitus?
National Diabetes Awareness Month: What are Eating Disorders in Diabetes Mellitus? by Monte Nido
November was National Diabetes Awareness Month, and an opportunity to bring awareness to the intersection of diabetes and eating disorders. In this blog we recognize the strength of all individuals who are living with diabetes and eating disorders in diabetes mellitus (EDDM). We recognize the necessity to spark conversations about EDDM as it is often missing from the greater conversation about eating disorders.
Understanding Eating Disorders in Diabetes Mellitus: A Path to Recovery
EDDM is a serious and potentially life-threatening condition that affects individuals with both Type 1 and Type 2 diabetes. Incorrectly referred to as “diabulimia,” this disorder involves the deliberate manipulation of insulin doses or other prescribed treatments to lose weight or control body shape. The complexities of managing both diabetes and an eating disorder can create a unique set of challenges for those affected.
The Challenges of EDDM
Clients dealing with EDDM often encounter significant hurdles in treatment. Many eating disorder providers lack the expertise required for diabetes care, while diabetes management teams frequently have limited experience with eating disorders. This gap in knowledge can hinder effective treatment, making it crucial for individuals to seek specialized care.
Key Characteristics of EDDM
Some common signs and symptoms of EDDM include:
- Unmanaged or Uncontrolled Glucose Levels: Individuals may experience persistently elevated blood glucose levels (hyperglycemia).
- Insulin Misuse: This can manifest as omitting or underusing insulin doses.
- Frequent Hospitalizations: Many clients may face repeated hospital visits for diabetic ketoacidosis (DKA).
- Restrictive Eating: Some may avoid certain foods in an attempt to control blood sugar levels.
- Unexplained Weight Loss: Fluctuating or maintaining an unhealthy body weight.
- Emotional Distress: Distorted body image, anxiety, depression, and low self-esteem.
- Diabetes-Related Complications: Poor blood sugar control can lead to significant health issues
Eating Disorders in Type 1 Diabetes Mellitus (EDDMT1)
Research shows that eating disorders are particularly prevalent among individuals with Type 1 diabetes. Studies indicate that 30-40% of young women with Type 1 diabetes also struggle with an eating disorder (National Institute of Diabetes and Digestive and Kidney Diseases, 2021). Common behaviors in EDDMT1 include insulin misuse, food restriction, and binge/purge cycles. Those affected face a significantly higher risk of adverse outcomes compared to their peers without EDDMT1.
Eating Disorders in Type 2 Diabetes Mellitus (EDDMT2)
Individuals with Type 2 diabetes are also at risk for developing eating disorders. While some may misuse insulin, others engage in restrictive eating or binge-purge behaviors. This combination can lead to severe complications for both their eating disorder and diabetes management.
Understanding Risk Factors
While not everyone with diabetes will develop EDDM, several risk factors may increase the likelihood:
- Genetics and History: A family history of eating disorders or mental health issues can play a role.
- Gender: EDDM is more commonly reported among females, though it can affect any gender.
- Body Image Concerns: Dissatisfaction with body image can lead to unhealthy eating behaviors.
- Mental Health Factors: A history of anxiety or depression may heighten susceptibility to EDDM.
- Lack of Education and Support: Limited understanding of diabetes management and its implications can contribute to harmful behaviors.
The Path to Recovery
We recognize the urgent need for specialized care that addresses both diabetes management and eating disorder treatment. It is important to know that you are not alone and that help is available, through specialized treatment programs, which can be found at multiple Monte Nido program locations. When it comes to treating EDDM, multidisciplinary team is needed. This can include certified diabetes education specialists (CDCES) who work collaboratively with clients to bridge communication with their healthcare teams. This approach ensures sensitivity to the unique needs of individuals with EDDM, both during treatment and beyond.
Continuous glucose monitoring is also important in this process, allowing clients to track their progress effectively. Throughout the recovery process it is important to be ready for real-world situations outside of treatment. The skill of self-managing nutrients and insulin doses is a necessity in their journey going forward.
Diagnosis and Treatment Considerations
While no specific diagnostic criteria for EDDM are outlined in the DSM-5, healthcare professionals may diagnose and treat the condition based on a combination of factors. These can include a confirmed diabetes diagnosis, evidence of disordered eating behaviors, unexplained weight fluctuations, and psychological symptoms such as body dissatisfaction and low self-esteem.
We believe that recovery is possible for everyone. Those struggling with EDDM are deserving of a supportive environment with specialized care to help them on their recovery journey.
If you or someone you love is struggling with EDDM, know that you are not alone. Reach out for help, and take the first step toward a more fulfilling life.
