The Silent Struggle – Unmasking Eating disorders in type 1 diabetes

The Silent Struggle – Unmasking Eating Disorders in Type 1 Diabetes

Disordered eating in people with type 1 diabetes represents a complex and often overlooked comorbidity with far-reaching implications. Recent studies reveal that up to 30% of adolescents with type 1 diabetes exhibit disordered eating behaviours (DEBs), such as insulin omission, rigid dietary control, bingeing and purging. These behaviours are associated with increased HbA1c, worse glycaemic management and enhance the risk for the developing long-term complications. Emerging evidence highlights the dual burden of managing diabetes and body image during adolescence, a developmental phase already vulnerable to psychosocial stressors.

Two recent investigations offer crucial insights. Propper-Lewinsohn et al. (2023) show how rapid post-diagnosis weight gain and higher BMI at diagnosis are significant predictors of DEBs. Abild et al. (2024) delve into the lived experiences of adolescents, revealing the psychological toll of constant surveillance, body judgment and the internalisation of guilt and shame—constructs intensified by diabetes care itself. A biopsychosocial understanding of these mechanisms is critical for prevention and early intervention.

Our live session will challenge us to reflect on how our clinical practices—however well-intentioned—may inadvertently reinforce harmful eating patterns. We aim to promote more sensitive, developmentally appropriate and psychologically informed diabetes care.