Disordered eating with type 1 and the way ahead

If you live with type 1 diabetes and struggle with disordered eating or an eating disorder, you are not alone.

In the past 30 years there has been growing awareness that people living with type 1 diabetes have higher rates of disordered eating and eating disorders.

What is disordered eating?

Disordered Eating is problematic eating behaviour that occurs with varying severity. It includes restricting food, skipping meals, excessive or compulsive eating or exercise, binge eating, laxative/diuretic abuse, vomiting and/or reducing or omitting insulin doses for the purpose of weight control.

In more recent times we have learnt more about why people with type 1 diabetes are at increased risk of disordered eating.

Health professionals working in this area are also being upskilled as to how they can better support individuals with or at risk of disordered eating.

Address early

The health consequences of disordered eating can be serious, especially when reduction or omission of insulin is involved. This is why the problems are best addressed at an early stage so the behaviours don’t become entrenched.

A helpful resource – Injecting hope

The book ”Prevention and Recovery from Eating Disorders in Type 1 Diabetes – Injecting Hope”, written by psychologist Dr Ann Goebel-Fabbri, tells the story of 25 women aged 18-50 years who live with type 1 diabetes and have recovered from an eating disorder.

The average duration among the women of type 1 diabetes was 19 years. The duration of the eating disorder was eight years. Only two of the 25 women believed the eating disorder was not preventable.

There are many learnings that have come from this book for both health professionals and for those with type 1 diabetes who are struggling with their eating. For those with diabetes, it is important to find a collaborative health care team who understand both type 1 diabetes and disordered eating.

Look for HPs who will talk it through with you

If you’re struggling with disordered eating and eating disorders it’s important to find a supportive and knowledgeable health care team.

It’s important to have a good relationship with your health care team. One that is trusting and respectful so you can speak openly and honestly with them.

Depending on your needs, additional education and assistance from the psychologist, dietitian or diabetes educator can help. Regardless the most important thing to do is to find a healthcare professional you trust and share your thoughts and feelings with them.

Weight concerns are valid

The treatment goals of type 1 diabetes are not to make you overweight. If you are concerned about your weight this is a very valid issue and you should talk to your healthcare team about it.

Risks of insulin omission

Don’t stop taking your insulin. If you’re struggling with your eating, you need to know there are very serious risks associated with insulin not taking the required dosage. You could develop diabetes ketoacidosis (DKA).

DKA is extremely serious and can be life threatening. Know the signs and symptoms of DKA, but best of all manage your diabetes to avoid this serious complication.

Dealing with disordered eating 

Be prepared to tackle your concerns in small manageable steps. Discuss with your loved ones how they can best support you, too.

Be assured, you are not alone, and this problem is now recognised.

Life can be better. With the right care and support there is an easier way forward with better health outcomes for you.

By Helen d’Emden
Adv Accredited Practising Dietitian, 
Credentialled Diabetes Educator

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