Eating disorders are relatively common in the diabetic population. In people with Type 1 diabetes, up to 11 percent of cases have an overt eating disorder. In Type 2 diabetics, the binge eating disorder (compulsive overeating) usually goes hand in hand with overweight and obesity. The term "eating disorder" is used to describe a group of psychiatric problems. The most common of these include:
anorexia nervosa, the excessive urge to lose weight by self-starvation,bulimia nervosa, the cycle of binge eating followed by purging through vomiting and over-exercising, andbinge eating disorder, the compulsion to consume large amount of calories in a specific time frame.In people with diabetes, insulin omission is the usual manifestation of purging and it is seen in 11 to 15 percent of diabetics during the teenage years. In early adulthood, 30 to 39 percent also have this problem. Mortality rates in people with diabetes and anorexia nervosa at the same time, are much higher compared to either condition alone. Added to this, complications such as diabetic neuropathy, ketoacidosis, and retinopathy are higher in people who have co-existing Type 1 diabetes together with one of these eating disorders.
What are the risk factors? The most common risk factors include:
being a teenaged girl or young woman, (rarely seen in boys and men),having a strong family history of eating problems,having a history of aggressive dieting,an increased body mass index (BMI) value,a diagnosis of depression and anxiety,having a diagnosed personality disorders.How are eating disorders diagnosed? In most cases, eating disorders are well hidden. However, often the intentional omission of insulin injections can be seen, though most diabetics will deny this.
The criteria for anorexia often includes:
a refusal to maintain a normal body weight,an absolute fear of gaining weight,intense feelings of being fat,a loss of menstrual periods,extreme concern with body shape and weight.The characteristics of bulimia nervosa are:
repeated episodes of binge eating,over and over, there is compensatory behavior to avoid weight gain (such as self-induced vomiting and excessive exercise),extreme concern or satisfaction with both body shape and weight.Binge eating can be described as:
feeling out of control when around food, either trying to resist it or gorging on it,eating even when not feeling hungry,spending a lot of time thinking or worrying about food and weight,experiencing guilt feelings after eating too much,always being desperate to try another diet that promises results.Treatment options include: Eating disorders, especially alongside Type 1 or Type 2 diabetes, should never be ignored...
diabetics with severely increased or decreased blood sugar in association with an eating disorder should be hospitalized immediately to prevent possible complications.family support is definitely necessary in order to achieve management of "ideal" blood sugar levels.psychological and group intervention therapy to help improve self-esteem and body acceptance is needed to help overcome the diabetic's eating disorder.diabetics with more severe forms of the various eating disorders often require the administration of medications to eliminate the symptoms.Why do diabetics and non-diabetics do this? The two most common of these disorders involve starvation. These are anorexia nervosa ("loss of appetite due to mental disorder"), and bingeing followed by purging, known as bulimia nervosa ("hunger like an ox due to mental disorder"). These are diseases of control that primarily affect females, although men have become more vulnerable in recent years. Bulimics and anorexics are usually overachievers in various aspects of their lives: they view excess weight as an announcement to the world they are "out of control".
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