Can diabetes cause eating disorders?

Living with diabetes requires a daily focus on food, blood sugar levels, medications, and weight. For many people, this attention helps support healthy habits. But for some, the constant monitoring of food and numbers can create an unhealthy relationship with eating. This has raised an important question: Can diabetes cause eating disorders?

The answer is complex. Diabetes does not directly cause eating disorders, but the demands of managing the condition can increase the risk for disordered eating behaviours. Here are some common questions and answers to help explain the connection.

Highlights

• People with diabetes may have a higher risk of eating disorders or disordered eating behaviours.
• The intense focus on food, weight, and blood glucose levels can sometimes contribute to unhealthy patterns.
• “Diabulimia” refers to intentionally skipping insulin to lose weight in people with type 1 diabetes.
• Early recognition and support can help prevent serious health complications.

Can people with diabetes develop eating disorders?

Yes. People living with diabetes can develop eating disorders just like anyone else. In fact, research suggests that eating disorders and disordered eating behaviours may be more common among people with diabetes, particularly among adolescents and young adults.

This risk appears to be higher for people with type 1 diabetes, but it can also occur in those with type 2 diabetes.

Why might diabetes increase the risk?

Managing diabetes often requires people to think about food more than the average person. They may need to count carbohydrates, track blood glucose readings, plan meals, and adjust medication doses.

For some individuals, this intense focus can lead to stress or anxiety around food. Over time, that pressure may contribute to unhealthy behaviours such as skipping meals, overeating, or feeling overly concerned about body weight.

Several factors can increase the risk:

• Constant attention to food choices and portion sizes
• Concerns about weight gain after starting insulin
• Pressure to maintain “perfect” blood sugar numbers
• Emotional stress or burnout from diabetes management

For teens and young adults who are already navigating body image concerns, diabetes management can add another layer of complexity.

What types of eating disorders are associated with diabetes?

There are two main types of eating disorders associated with diabetes:

1. Bulimia is a serious condition in which people eat excessively large amounts of food, and then try to get rid of the extra calories in unhealthy ways. Some of the ways people with bulimia try to shed the extra calories include self-induced vomiting, misuse of laxatives, diuretics or enemas, as well as fasting, strict dieting or excessive exercise.
2. Binge eating disorder (BED) is also a serious condition, and occurs when people frequently eat large quantities of food (often very quickly, and to the point where they experience discomfort).

What are some common warning signs of bulimia and BED?

Some of the frequent warns signs of an eating disorder such as bulimia or BED include:

• Extremely high A1C test results
• Frequent bouts of poor blood sugar control
• Anxiety about or avoidance of being weighed
• Frequent requests to switch meal-planning approaches
• Frequent and severe low or high blood sugar levels 
• Widely fluctuating blood sugar levels, with no obvious explanation
• Bingeing with food or alcohol at least twice a week
• Exercising more than necessary to stay fit
• Severe family stress

What are the medical risks associated with bulimia and BED?

Both physical and psychological complications can result from bulimia and BED.

Potential complications include:

Diabulimia – an eating disorder unique to people with type 1 diabetes

The term ‘diabulimia’ is most commonly seen in young women with type 1 diabetes who withhold or restrict insulin for the purpose of weight loss. Without insulin, blood glucose levels will increase significantly as well as the risk of diabetic ketoacidosis, a potentially life-threatening condition. Speak to your doctor or someone from the diabetes healthcare team if you suspect that you or someone you know may be suffering from diabulimia.

How can people with diabetes maintain a healthy relationship with food?

Managing diabetes does not have to mean living with constant food anxiety. A balanced approach to eating and diabetes care can help reduce the risk of disordered eating.

Helpful strategies include:

• Focusing on overall patterns of healthy eating, rather than perfection
• Working with a registered dietitian familiar with diabetes
• Discussing emotional challenges with a healthcare professional
• Avoiding overly restrictive diets unless medically necessary
• Practicing self-compassion when blood sugar numbers are not perfect

Learning to see food as fuel and nourishment, rather than something to fear or control, is an important step toward long-term wellbeing.

When should someone seek help?

If concerns about food, weight, or insulin use are affecting diabetes management or emotional health, it is important to seek help early. Eating disorders are medical conditions that benefit from professional support.

Treatment may involve a team that includes a physician, dietitian, and mental health professional experienced in diabetes care.

With the right support, people living with diabetes can develop healthier relationships with food and feel more confident managing their condition.