Diabetes and Eating Disorders: Why the Risk Is Higher and What Can Help

22 July

Living with diabetes can require constant attention to food, carbohydrates, blood glucose, medication, exercise and body changes. While these tasks are important for diabetes management, they can also make it difficult to develop a relaxed and flexible relationship with eating.

Research suggests that people with diabetes, particularly type 1 diabetes, have an increased risk of developing disordered eating and eating disorders. Binge eating and other distressing eating patterns can also occur alongside type 2 diabetes.

Why can diabetes increase eating disorder risk?

Diabetes management can make food feel highly monitored. People may need to count carbohydrates, plan meals, interpret glucose readings and think carefully about how food affects their body.

Over time, this can contribute to:

Feeling preoccupied with food, weight or numbers
Dividing food into “good” and “bad” categories
Anxiety about blood glucose changes after eating
Restricting carbohydrates or skipping meals
Feeling ashamed when glucose levels are outside the target range
Binge eating after periods of restriction
Exercising rigidly to influence glucose levels or weight
Feeling disconnected from natural hunger and fullness cues

Changes in weight following diagnosis or the commencement of insulin may also affect body image. Diabetes Australia notes that diabetes can influence how people experience food and their bodies, and that disordered eating behaviours should be taken seriously even when they do not meet the criteria for a diagnosed eating disorder.

Importantly, this is not caused by a lack of motivation or poor diabetes management. It can develop when understandable attempts to manage health become increasingly rigid, stressful or driven by fear.

Type 1 diabetes and insulin restriction

Some people with type 1 diabetes may reduce or omit insulin in an attempt to influence their weight. This is sometimes informally called “diabulimia,” although it is not a formal diagnosis.

Insulin restriction or omission is medically dangerous and can lead to severe hyperglycaemia, diabetic ketoacidosis and longer-term diabetes complications. Diabetic ketoacidosis is a potentially life-threatening emergency requiring urgent medical care.

People experiencing insulin-related disordered eating deserve compassionate, specialised support, not criticism or shame.

What can help?

Recovery usually works best when eating disorder treatment and diabetes care are provided together.

Helpful support may include:

A coordinated treatment team

A GP or endocrinologist, diabetes educator, eating disorder-informed dietitian and psychologist may need to communicate and develop a shared plan. Treatment should recognise that diabetes cannot simply be separated from the person’s relationship with food.

Weight-inclusive and non-judgemental care

An excessive focus on weight loss, food rules or “perfect” glucose readings can unintentionally increase shame and disordered eating. Care should focus on health, safety, regular nourishment and sustainable diabetes management rather than blame.

Regular and adequate eating

Consistent meals and snacks can reduce physiological deprivation, extreme hunger and binge eating. A dietitian who understands both diabetes and eating disorders can support flexible carbohydrate intake while keeping diabetes management safe.

Psychological support

Therapy can help address body-image distress, perfectionism, shame, anxiety, trauma and fears about food or glucose levels. It can also support a more compassionate response to diabetes-related numbers and reduce all-or-nothing thinking.

Diabetes-specific eating disorder screening

Traditional eating disorder screening tools may miss diabetes-specific behaviours, including insulin manipulation. Diabetes-specific assessment tools and direct, sensitive conversations can support earlier identification.

When should I seek support?

Consider reaching out when you notice:

Increasing fear or avoidance of particular foods
Frequent binge eating or feelings of losing control
Skipping meals or restricting carbohydrates
Delaying, reducing or omitting insulin
Intense distress around weight, food or glucose readings
Avoiding diabetes appointments because of shame
Exercising compulsively
Feeling that diabetes management is taking over your life

You do not need to wait until your symptoms become severe. Early support can protect both your physical health and your relationship with food. Never change or omit prescribed insulin without urgent guidance from your diabetes treatment team.

At recoverED clinic, we understand that managing diabetes alongside an eating disorder can feel complex and exhausting. Support should help you feel safer, more understood and less alone, not judged for finding diabetes difficult. Contact us to learn more about how we may be able to help.

Disclaimer

This blog is for general educational purposes only and does not constitute medical, psychological, diagnostic, or therapeutic advice. It should not be relied upon as a substitute for personalised care from a qualified health professional.

Reading this blog does not create a psychologist–client relationship with recoverED Clinic or its clinicians. If you have concerns about your mental health, eating behaviours, physical health, or safety, please seek professional support. In an emergency, call 000 or attend your nearest emergency department. You can access a list of Australian crisis Helpines here.

This blog was created with the support of AI tools for clarity and structure and has been reviewed and edited by our team.