Does eating food cause you some anxiety? Does deciding what to eat, when to eat, how much to eat make you depressed or feel ashamed? Do you often find yourself in a battle with food thinking that some are good, while others are bad?

If so, you are not alone! It is estimated that 40% (2 in 5) people living with type 1 or type 2 diabetes experience disordered eating behaviours.

Diabetes can attract extra personal and public attention when it comes to body shape, food and eating. This comes on top of our existing diet and weight centric culture. Therefore many people living with diabetes develop increased concerns around food and how their bodies should look. This can lead to unhealthy relationships with food and may result in disordered eating and or an eating disorder.

 What is disordered eating?

Disordered eating includes a number of eating related behaviours that could harm your health and your diabetes management, and prevent you from enjoying your life. It can include:

• A constant or anxiety-fuelled focus on food
• Overly restrictive or depriving styles of eating
• Binge eating
• Use of vomiting or over exercising to offset food intake
• Restricting insulin in an effort to alter your body shape

While the above behaviours maybe less severe than those experienced by someone living with anorexia nervosa, bulimia nervosa or a binge eating disorder, they should be taken seriously.  So if you are struggling at any level with your eating please reach out for support and guidance from your GP or diabetes healthcare team.

How does disordered eating affect diabetes management?

Managing diabetes takes a multipronged approach which can include lots of trial and error, to get your blood glucose levels (BGLs) within a range that prevents or delays diabetes complications.

Following a nutritious eating plan, looking after your mental health, doing regular exercise, getting good sleep, taking your diabetes medications, monitoring BGLs, and having regular health checks including feet, eye, teeth and kidneys and are all important to managing your diabetes and staying healthy.

If any of these are ignored or not well looked after (eg: not eating well) it can affect your ability to manage your diabetes

What are the possible outcomes of disordered eating?

Disordered eating can affect your diabetes management in a number of ways including:

• BGLs outside of individual targets; too low (hypoglycemia – hypos) or too high (hyperglycemia – hypers)
• Early onset or increased risk of complications such as eye and nerve problems; retinopathy, peripheral neuropathy in feet, hands or gastrointestinal tract to name a few.
• Low energy due to reduced food intake impacting overall wellbeing

Who can help if you feel you have disordered eating behaviours?

Managing diabetes is best done as part of a team. This can include trusted family and friends, your GP,  your Diabetes Educator and Endocrinologist.

Your GP can refer you to a mental health professional who specialises in eating disorders or a diabetes dietitian who can provide advice on managing your weight through weight-neutral, non-diet and mindful eating approaches.

Disordered eating behaviours or an eating disorder won’t go away on their own so please seek help. Talk to someone close to you or a health professional. Because with the right support things will get better.

Looking for more information?

Read:

• Disordered eating and diabetes
• Diabetes distress

Listen to:

• Diabetes NSW and ACT podcast on Diabulimia
• Food Psych Podcasts

Talk to someone over the phone:

• Butterfly foundation 1800 33 4673
• NDSS Helpline 1300 136 588