created: 30.09.2004
last modified: 30.09.2004
The problem of eating disorders was and is very present in the media. Little wonder, if you take a look at the current beauty ideal and the diet boom.
The "slim-o-mania" starts earlier and earlier. According to the doctors' chamber of Niedersachsen, almost 2/3 of all female adolescents have already dieted at least once before their 18th birthday. In Germany alone 220.000 people of the age between 15 and 24 suffer from anorexia or bulimia. The unknown cases are estimated to be a lot more.
But what mostly remains left aside in the overall discussion is the close connection between eating disorders and diabetes.
Eating disorder and Diabetes - often there's a connection
To adjust and medicate their disease successfully diabetics need to follow a strict self-control of their eating habits. Constant diets and weight fluctuation, due to the injection of insulin, support the drifting into pathological eating habits.
According to studies of the universities of Cologne and Essen, 10-14% of all type-1 diabetics come down with an eating disorder at some point of time. And it is similar for type-2 diabetics. Most of the diseased are younger than 45 and female.
Differences between Type-1 and Type-2
On the topic of eating disorders we need to make a difference between the two types of diabetes. Whereas in case of a type-1 the disordered eating habit results from the diabetes, it is the cause for type-2 diabetes. To be more precise: eating disorders like bulimia or anorexia are reactions towards the restrictions and outgrowth of a type-1 diabetes.
Overweight and obesity can cause type-2 diabetes.
All in all, the symptoms and behaviour of diabetics with eating disorders don't differ very much from people without diabetes. They hunger or regurgitate, have eating flashes and a misled perception of their own figure. But what comes along with diabetes is the so-called insulin purging. This means to provoke a loss of calories by deliberately missing out an insulin dose and excreting sugar by urinating frequently. The huge consequences of interference like that won't be realised by most of the diabetics at this stage of their eating disorder.
Consequences of the dangerous double disease
In case of such a double disease, a diabetic can no longer coordinate his nutrition and his insulin therapy successfully. The needed diet is being changed and reduced too much after his own obsessive ideas; in addition the insulin injections become irregular. The consequences of such a manipulation of the diabetes treatment are massive metabolic fluctuations. The treatment is "overridden" by the eating disorder, hypoglycaemia becomes frequent and even a glucose coma can occur. The patient's mortality increases many times over for diabetics with an eating disorder:
Possible Therapies
The therapy of a patient who has diabetes as well as an eating disorder demands close co-operation of Diabetologists, Nutrition Trainers and Psychologists as well as intensive medical care.
It is important for the therapy to keep an eye on the connection between the eating disorder and the diabetes. On top of the list is the prevention of a metabolic crash. Before it is possible to work on the patients psyche the prime dangers of the blood glucose disease have to be isolated. A radical control of the insulin injections and monitoring the food ingestion are the first priority. Once the diabetes is under control, the tedious and difficult psychological care for the eating disorder can begin.
At the moment there aren't too many Psychologists who are well versed in diabetes. Such a specialisation is highly needed due to the rising figure of combined diabetes and eating disorders. The German Diabetes Society (DDG) has realized that and is offering professional education for Psychologists, who are especially dealing with diabetes.
