Most studies on diabetes-related eating disorders have been focused on disordered behavior and adult women with Type 1 diabetes; such behavior includes skipping meals, skipping insulin to lose weight, binge eating, and vomiting. Eating disorder researchers know, however, that a dysfunctional relationship with food and body perception often begins well before adulthood, and includes both genders.
A team of researchers led by Dr. Angel Siu Ying Nip, a pediatric endocrinology fellow at the University of Washington, has provided a study to help fill the void of information about children with Type 1 and diabetes-related eating disorders. She and her colleagues questioned 2,156 young participants with Type 1 diabetes and 161 participants with Type 2 diabetes using a 16-question survey; the average age of the survey participants was 17 years old. What they found backs up the assertion that screening and treatment for diabetes-related eating disorders should begin in the pediatric population.
“Disordered eating behavior is common in youth or young adults with both Type 1 and Type 2 diabetes,” said Dr. Nip in a press conference at the ADA Scientific Sessions in San Diego.
Researchers found that some 21 percent of participants with Type 1 diabetes and 52 percent of participants with Type 2 diabetes were identified with a diabetes-related eating disorder through the survey. The survey also found that 20 percent of respondents with Type 1 diabetes endorsed skipping insulin as a way to lose weight; 30 percent of respondents with Type 1 also showed some signs of binge-eating behavior, although not all of these two groups registered a high enough score on the survey to be labeled with a diabetes-related eating disorder.
The survey was coupled with a larger study, the SEARCH for Diabetes in Youth Study Group. Researchers then examined medical outcomes of survey respondents using the data collected in the larger study. They found that survey participants with a diabetes-related eating disorder had higher A1C scores and reported higher levels of depression and lower levels of quality of life. One of the highest predictors of mortality among the survey participants was the question, “Do you ever manipulate your insulin to lose weight?”
Dr. Nip encouraged the medical community to screen actively for diabetes-related eating disorders in adolescents.
“It is paramount to raise the awareness among health providers, as well as among families and patients, to identify at-risk patients early, and to offer appropriate counseling and treatment if necessary. Providers should educate patients and families to make sustainable healthful lifestyle choices rather than focus on a specific weight-loss goal,” she stated in a follow-up press release.
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