Eating Disorders in Teens with Type 1 Diabetes

Eating disorders affect approximately 10 percent of American adolescents and young adults. Results of a study conducted at the University of Toronto and the Hospital for Sick Children showed that eating disorders are twice as likely to occur in teenage girls with type 1 diabetes than in girls who do not have diabetes.

Teens with Type 1 sometimes exhibit another symptom of disordered eating that is unique to diabetes: deliberately changing their insulin dose to achieve weight control or weight loss. Shortchanging or skipping their insulin dose seems like an easy method of weight control, because not taking enough insulin brings on hyperglycemia which causes excessive urination and weight loss.

This is very dangerous in many ways. Teens who use insulin dose manipulation to achieve weight loss suffer serious consequences to their health.

• Higher A1c levels due to poor metabolic control.
• Early onset of diabetes complications, especially retinopathy. In fact, the highest percentage of teens with detectable damage were the ones with the most severe eating disorders, 86 percent had evidence of retina damage, compared with 24 percent for teens who did not have eating disorders.
• Hypoglycemia due to not eating or not eating enough.
• Diabetic ketoacidosis (DKA), brought on by deliberately short-changing the insulin dose or skipping doses altogether.

Sometimes it's hard to tell when there is disordered eating or intentional insulin manipulation going on. Eating disorders are very secretive in nature and teens will attempt to hide it from their families and friends.

• Warning Signs to Look For and What Parents Can Do

Early treatment is important because the longer an eating disorder continues, the harder it is to treat. Also, for kids with diabetes, the longer they are not in good metabolic control, the more long-term damage they might suffer from the complications of uncontrolled blood glucose.

More information on eating disorders in general from our Eating Disorders Guide, Matthew Tiemeyer MA

• Identifying Anorexia Nervosa
• Symptoms of Bulimia Nervosa
• Eating Disorder Triggers

Photo by Marinka van Holten