'I've struggled for years': How diabetes can trigger eating disorder risk

It's estimated that almost a third of people with type 1 Diabetes will also develop some form of disordered eating. Credit: ITV News

Type 1 diabetes is a condition which requires monitoring of what you eat and numerous weight-related checkups.These requirements can be particularly problematic for anyone who may be prone to developing an eating disorder.

Living with type 1 diabetes can be life-changing and challenging enough. But it's now thought that almost a third of people with the condition will also develop some form of disordered eating.

T1DE (type 1 diabetes and disordered eating) is used to describe when those on diabetes medication choose to restrict or stop taking their insulin in a bid to prevent them from putting on weight - and it can have deadly consequences.

Ariella Thompson tells ITV News she 'struggled on and off for years'

Ariella Thompson was diagnosed with type 1 diabetes seven years ago when she was 21.

She had spent several years battling bulimia as a teenager and the way her body reacted after she started taking insulin to control her blood sugars triggered long-standing anxieties about her body image.

"Most people lose an awful lot of weight and I'd lost some weight”, explains Ariella. “When you're diagnosed and you start taking insulin, your body suddenly goes, 'oh, my God, I have food'. And it stores everything as fat and it stores water.”

“I did put on a lot of weight quite quickly after diagnosis and that was something that I then struggled with on and off for years”

“When you go through eating disorder therapy... I was taught to not fixate on food, and there I was three months later with a lifelong health condition that forces me to fixate on food, and that's a really difficult thing to balance, I think”, she adds. Ariella is now in a place where she's in a healthier relationship with food and insulin treatment, but there are major concerns over many others falling below the radar.

Why is restricting or stopping insulin dangerous?

Insulin is a hormone produced in the pancreas that helps the body to use glucose for energy and prevent blood sugar levels from being too high (hyperglycaemia).

If the pancreas stops producing insulin the hormone normally has to be injected to keep blood sugars at a healthy level.

If insulin is not injected and blood glucose levels remain high for a prolonged period of time it can lead to:

  • Permanent damage to the nerves in hands and feet (peripheral neuropathy)

  • Permanent damage to eyes and sight loss (diabetic retinopathy)

  • Life-threatening conditions such as organ damage and diabetic ketoacidosis

When insulin is restricted or reduced it can have drastic long-term consequences

"The most severe form of eating disorder for people with type one is when insulin is emitted”, explains Hillary Nathan from the diabetes charity JDRF UK.

“That reduction or the emission of the correct levels of insulin over time can also lead to a lot of organ damage, site loss, limb loss, kidney failure.”

“So the consequences can be both in the moment and they can be lifelong", she adds.

NHS T1DE clinical expert Sarah Alicia says 'there is work to be done' when it comes to diabetes and eating disorders

A number of NHS England T1DE pilot services - which combine diabetes and mental health services - are being rolled out across the country in a bid to address the issue and provide better support.

"At the moment. There is a whole sort of spectrum of disordered eating and type one diabetes, and I don't think we're picking up all the different presentations that we could be”, says Sarah Alicea from NHS England.

“So I think there's some work to be done in that area to really find out how many people actually do experience this and how we can best support them”, she adds.

A parliamentary inquiry is underway to assess the scale of type-1 diabetes and eating disorders and better understand the relationship.

It’s hoped it will help to set a national consensus on support and treatment so those like Ariella, who cannot escape strict monitoring of their diets, can be better supported.

Eating disorder charity Beat says there's an 'increased risk' in people with type 1 diabetes

"For people with type 1 diabetes there can be an increased risk", explains Umairah Malik from the eating disorder charity, Beat.

"That can be for the need to frequently monitor weight and glucose levels, needing to read food labels carefully, things like the focus on food and weight and intake during medical appointments. All of which leads to an increased focus on those things - your body, your food, your weight."

"Alongside that, things like the negative stigma and the misconceptions people have around diabetes can contribute to why someone might develop T1DE", adds Umairah.

'You deserve the right support'

Umairah says the key to kick-starting recovery is being aware that anyone can be affected by an eating disorder and, regardless of what behaviours someone might be struggling with, they deserve the correct support.

If you're feeling anxiety about weight or eating habits and think you might have an eating disorder:

  • Contact your local GP or eating disorder service. Preparing for this initial appointment can be daunting but charities such as Beat can offer guidance.

  • Beat also suggests speaking to someone about how you're feeling and bringing someone to the appointment with you if you can.

  • Once you’ve been referred you can then be assessed and a treatment plan can be decided. There are many different treatment pathways - the same one won't work for all.

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