Disordered Eating

Living with diabetes places a lot of focus on food, healthy eating and body weight. This can sometimes lead to an unhealthy relationship with food

The term ‘disordered eating’ refers to a wide range of abnormal eating behaviours. Many of these behaviours are also commonly seen in diagnosed eating disorders, such as anorexia and bulimia. The main difference between disordered eating and an eating disorder is how severe and how regular that behaviour occurs.

Regardless, disordered eating is a serious medical and mental health issue that requires professional attention.

Common disordered eating behaviours include:

Binge eating
Regular dieting
Obsession with ‘clean eating’ (orthorexia)
Fasting or skipping meals regularly
Obsessive calorie counting
Self-induced vomiting
Limited self-worth based on body shape and weight
Misusing laxatives

The relationship between disordered eating and diabetes

Living with diabetes places a lot of focus on food, healthy eating and body weight. With so much attention on when, what, and how much to eat, this can sometimes lead to an unhealthy relationship with food. It can also lead to body image issues and poor self-esteem.

Research shows that anyone with diabetes is at a higher risk of disordered eating. However, the risk is even higher for those with type 1 and type 2 diabetes requiring insulin. People with diabetes who use insulin often need to manage their diabetes more intensively. This can include weighing and measuring foods to calculate the amount of carbohydrate they consume and to adjust their inulin dose, which may lead to an obsession around food, the skipping of meals, or the potential misuse of insulin to lose weight. This, in turn, can affect the way a person manages their diabetes and their physical health. For instance:

Severe hypos (low blood glucose levels) can occur if food is being restricted.
It may lead to an increased risk of diabetic ketoacidosis (DKA) in people with type 1 diabetes, along with unhealthy weight loss.
Poor long-term blood glucose control increases the risk of diabetes-related complications, such as eye, nerve and kidney damage.

What is ‘normal eating’?

Given that everybody is different and needs different amounts and types of food, ‘normal eating’ can vary a lot from person to person. Normal eating generally refers to the positive attitude a person holds towards food, as opposed to the type or amount of food they eat.
When it comes to food, it’s normal to:

Eat more on some days, less on other
Eat some foods simply because they taste good
Not categorise foods as "good", "bad", or "clean"
Over-eat or under-eat occasionally
Crave certain foods at different times
Treat food and eating as a small part of a balanced life

What is mindful eating?

Mindful eating is about focusing on how you eat to become more in-tune with your level of hunger and fullness, helping you respond appropriately to your body’s needs. Mindful eating can ensure a healthy relationship with food and is not a diet. It’s about the way we eat, not what we eat, and it allows people to break free from food rules.

Sunday 6 May 2018 was International No Diet Day, an annual celebration of body acceptance and body shape diversity. With today’s society being obsessed with size and appearance, this event can help us refocus on what’s truly important – a healthy lifestyle and self-worth.
So instead of trying the next ‘diet of the month’, have a go at some mindful eating techniques that can be found at the Eating Disorders Victoria website.

What can you do to help yourself, or someone who has disordered eating?

If someone you know is at risk of disordered eating, check out Eating Disorders Victoria’s What should I say? fact sheet, featuring useful tips on how to best share your concerns.

If you’re worried about yourself, start with your diabetes healthcare team, who are there to help you with all aspects of your diabetes. Your general practitioner (GP), diabetes nurse educator, dietitian or endocrinologist can provide you with non-judgemental support and advice. You’ll probably feel relieved after sharing your feelings, and it will help your health professional understand how you’re feeling.

Please contact the Eating Disorders Victoria Helpline on 1300 550 236 for more advice or information, or download our Eating Disorders and Diabetes Fact Sheet.

What is a mental health care plan?

As eating disorders are a mental health condition, a mental health care plan may be available to you. Your doctor will use a care plan to determine what services and treatment options best fit your needs. It entitles you to 10 individual or 10 group appointments per year. Medicare will cover some or all costs involved with some mental health services.

Ask your GP if you’re eligible to reduce the costs involved in seeing a psychologist or psychiatrist.