Studies indicate patients with type 1 diabetes are more than twice as likely to have co-occurring anorexia. This may sound surprising to some. Many people know that those with type 1 diabetes are at a greater risk for several medical complications, including nerve damage, eye disease, and kidney disease. But, many are unaware of the frequency in which diabetes co-occurs with eating disorders. 

Unfortunately, science has yet to uncover the reason or reasons why a dual diagnosis of diabetes and eating disorders is so common. Some believe it may be because people with diabetes are taught to focus on what and how they eat. This pattern can lead someone to develop rigid (and misguided) ideas about “bad food” and “good food,” which can lead to an increased risk of developing an eating disorder.

What is Anorexia? 

Anorexia is a type of eating disorder that leads to excessive weight loss due to self-starvation. A person with anorexia will intentionally consume a very low-calorie diet to maintain a body weight that is often well below average for their body size and shape. They may also engage in excessive physical activity to “burn off” calories. 

What are the Types of Anorexia? 

There are two categories or “types” of anorexia. The first is the restricting type. Restricting type anorexia occurs when someone places severe restrictions on their food intake. They will limit the kind of food and quantity of food they eat. Depending on the person, they may skip meals, count calories, follow obsessive rules about food and avoid specific food groups or categories (such as sugar or carbs). 

The second category or type of anorexia is the binge-eating and purging type. This diagnosis is not to be confused with Bulimia, a separate eating disorder that shares some similarities in symptoms. This type of anorexia can be very dangerous and life-threatening. Someone with the binge and purging type of anorexia will eat and then actively purge what they have eaten from their body. Purging may be accomplished by diuretics, enemas, misuse of laxatives, or forced vomiting.

What is Diabetes? 

Diabetes is a chronic health condition that affects how your body uses food to create energy. Usually, your body breaks down most of the food you eat, turning it into glucose (sugar). It then releases the glucose into your bloodstream. When your blood sugar levels increase, it triggers your pancreas to release insulin. Insulin is a crucial chemical required to allow your cells to use blood sugar for energy.

When you have diabetes, your body doesn’t make enough insulin or can’t use it as well as it should. As a result, too much blood sugar remains in your bloodstream when there isn’t enough insulin or cells stop responding to insulin. Over time, this can lead to serious health problems like heart disease, vision loss, and kidney disease.

A note about diabetes types

Diabetes is broken down into two main types. The most common is Type 2 diabetes. 

• Type 1 Diabetes- type 1 diabetes is thought to be related to an autoimmune disorder that causes your body to stop producing insulin. Type 1 diabetes is typically diagnosed in younger people and requires daily insulin. Approximately 5-10% of people with diabetes have type 1.
• Type 2 Diabetes- In type 2 diabetes, your body does not produce enough insulin to maintain healthy blood sugar levels. Approximately 90 to 95% of people diagnosed with diabetes have type 2 diabetes. Type 2 diabetes is usually diagnosed in adults, but it can be prevented or delayed with a healthy diet and lifestyle changes. In many cases, diet and exercise are enough to manage type 2 diabetes symptoms effectively, but some may require diabetes medications or insulin therapy

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Science has not shown a direct link between anorexia nervosa and diabetes. However, anorexia may increase your risk of developing diabetes. Someone with anorexia may eat sugar sporadically. They may label foods as good or bad, and they might eat unhealthy meals or snacks with high or low amounts of sugar on an irregular basis. Additionally, someone with anorexia may replace certain foods with sweets or avoid sugar altogether. In either case, blood sugar levels in the body can fluctuate dramatically.

With time, inconsistent blood sugar levels and an unbalanced diet can contribute to the development of type 1 diabetes. In some cases, the eating habits of someone with anorexia may affect the functioning of the pancreas, which produces insulin. A healthy pancreas is essential to regulating blood sugar levels. 

A note about diabetes types cont.

While anorexia may be a risk factor for diabetes, the opposite is common, too. According to the American Diabetes Association, women with diabetes are more likely to have an eating disorder like anorexia than women who don’t have diabetes. Additionally, people with type 1 diabetes are twice as likely to struggle with disordered eating as people who do not have diabetes.

Individuals with co-occurring diabetes and an eating disorder often hide poor or dangerous eating habits behind their diabetes. They might limit specific food groups and state it’s due to having diabetes and needing to manage their intake of particular foods when, in reality, food restriction is a symptom of their eating condition. Individuals with diabetes might likewise abuse their insulin as a method to lose weight.

These habits can have harmful health effects.

• Inexplicable increase in A1C levels.
• Recurring episodes of diabetic ketoacidosis.
• Engaging in extreme exercise
• Experiencing Persistent hypoglycemia.

Other signs and symptoms of anorexia

There are other indications of anorexia that aren’t associated with whether somebody has diabetes. These are:

• Missing out on meals or consuming minimal quantities.
• Taking medication to minimize cravings.
• Feeling overloaded or afraid about putting on weight.
• Rigorous food routines, such as cutting food into little pieces or requiring to consume foods in a particular order.
• Bloating, irregularity, or stomach discomfort.
• Headaches. 
• Issues sleeping.
• Feeling cold, lightheaded, or exhausted.
• Poor blood flow in hands or feet.
• Dry skin.
• Reduced libido.

A Word About Diabulimia

Diabulimia is a life-threatening eating disorder that occurs when someone with Type 1 diabetes withholds insulin to lose weight. People with diabulimia may have any number of unhealthy eating behaviors, such as purging, or they may only reduce or withhold their insulin dosages and otherwise have healthy eating patterns.

Getting Treatment for Anorexia at The Meadowglade

Most eating disorder treatment plans involve a combination of psychological therapy (psychotherapy), nutrition education, medical monitoring, and sometimes medications. The duration of treatment and type of therapeutic intervention will depend on the specific disorder and the individual’s personal needs.

Intensive outpatient or outpatient care

An outpatient treatment program may be the most beneficial for patients who are medically stable and do not need daily medical monitoring. For this type of care to work, you must be psychiatrically stable and have your symptoms under sufficient control to be able to function outside of the supervision provided in a residential (inpatient) treatment program. You need to be able to carry out your daily obligations and “function” in your existing social, educational, or vocational situations while still making progress in your recovery. 

In an outpatient eating disorder treatment program, you will still work with a team of providers, including a mental health professional, a nutritionist or dietician, and other medical professionals. Unlike an inpatient plan, these providers would be seen regularly in private office settings or group treatment meetings.

Inpatient or residential programs

Inpatient or residential eating disorder treatment programs are the most intensive treatment option available. These programs are designed for individuals with severe mental health symptoms, leaving them unable to respond successfully to outpatient treatment or a partial hospitalization setting. They may or may not require medical intervention depending on their disorder and the severity of their symptoms. Residential settings may also be used as a form of “step down” treatment for those who have been hospitalized (to achieve medical stability) or who need long-term care setting to allow their mental or physical health to improve before returning home. 

In an inpatient treatment program, a team approach is generally the most effective method for treating eating disorders. Residential treatment provides complete support and supervision from a variety of medical and mental health professionals. Also, in the inpatient environment, you are free from the various triggers and stressors that can lead to eating disorder behaviors. 

The importance of medical treatment before mental health treatment

Suppose you or a loved one has an eating disorder like anorexia. In that case, it is essential to seek medical help if your symptoms include physical complications, including problems with blood glucose levels, blood pressure, abnormal heart rate, malnutrition, and other potential medical complications that can arise from months or years of poor eating habits. Once you are medically stable, it is safe to begin a mental health treatment program to address eating disorder behaviors while continuing to learn how to manage your diabetes. 

Anorexia and diabetes can both cause erratic eating, weight fluctuation, and an unhealthy relationship with food. However, having anorexia does not mean you will develop diabetes or vice versa. Both conditions are treatable, and it is possible to recover from an eating disorder and a co-occurring medical health issue like diabetes. Anorexia is treatable with the proper medical and psychological care, and diabetes is manageable with a doctor’s guidance. 

Seeking professional counseling at a treatment program like The Meadowglade, where a team of caring and compassionate mental health practitioners can help you heal from an eating disorder like anorexia and a medical condition like diabetes. Eating disorder behaviors do not resolve independently, and if left untreated, an eating disorder and co-occurring diabetes can lead to dangerous medical consequences. Let us help you take your first steps on your journey to a future of health and wellness. Contact us today to learn more about treatment at The Meadowglade.