02/12/2026
Folks spend so much time/ resources "fighting" diabetes, we don't realize that the lifetime prevalence of eating disorders (ED) is actually higher than diabetes (DM). And so many of the behaviors encouraged in DM contribute to ED risk.
When people think of eating disorders in diabetes, most folks think it only applies to those with type 1. The reality is that the rate of EDs are far higher in those with type 2 diabetes. Due to providers not knowing what questions to ask, making assumptions, and encouraging restriction, EDs get missed and even promoted. Binge eating, night eating, atypical anorexia, and EDNOS are common!
--> Binge eating is not due to "lack of control." It is fueled by dietary restriction, excessive cognitive restraint (guilt / shame), emotion dysregulation / coping response, and elevated insulin levels (in folks with insulin resistance). Encouraging restriction exacerbates condition (and makes people feel like crap about themselves).
--> Atypical anorexia is not someone with "great control." It is a mental health condition not dependent on BMI, fueled by fear, guilt, and shame related to food, body, and movement. It shows up as fear of weight gain / obsession with weight loss, dietary restriction, and sometimes compulsive movement.
As professionals, please ask questions before you "congratulate" or make assumptions:
* How do you feel about your body?
* Have you experienced any weight changes? Has anything changed in your life? (I can't tell you how many clients have been "congratulated" for weight loss secondary to depression, anxiety, grief, anorexia)
* How do you feel about movement?
* How often are you eating?
* How often do you ever feel "out of control" when you eat?
* How often do you feel guilt or shame for what or how you eat?
* How often do you feel like you are unable to eat what you want or need due to financial concerns or transportation challenges?
* How do you feel about hunger?
Folks, if you work in diabetes, you are seeing folks with eating disorders, whether or not you realize it. Please learn the signs, symptoms, and how to support so you can help, not harm.
End rant. References in comments :)