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Home > Knowledge & support > Living with type 1 diabetes > Health and wellbeing > Eating disorders
Getting to this page is an important step. You are not alone and there is support available, from healthcare professionals and other people going through the same thing as you are.
Type 1 and disordered eating, known as T1DE, is an eating disorder in a person with type 1 diabetes. This can be when someone restricts the amount of insulin they take on purpose, to lose weight or stop them from gaining weight, or are experiencing bulimia or anorexia alongside their type 1.
There are many reasons someone with type 1 may experience an eating disorder. Evidence suggests that about 42 per cent of people living with type 1 will experience distress about their diabetes at some point in their life, so if you’re feeling this way, you are not alone.
Diabulimia is a media-coined term that refers to an eating disorder in a person with diabetes, typically type 1 diabetes, where the person doesn’t take the amount of insulin they need, because they are worried about gaining weight or want to lose weight. We explain below how this can affect your type 1 management and wellbeing, and how to find help.
Managing type 1 diabetes is very closely linked with food and the body and can also be stressful. Because of this, the risk of someone developing disordered eating is higher. Here are some of the reasons for this (as outlined by the Wessex ComPASSION Project):
Managing type 1 diabetes means that you have to think about your body a lot of the time. Self-monitoring of glucose levels and weight, and a focus on weight at clinic appointments, may cause people to focus on their bodies more than people who don’t have type 1.
One of the main symptoms of undiagnosed type 1 is weight loss. When people start taking insulin, their body restores the weight they have lost which can cause them to associate taking insulin with putting on weight.
Reaching or maintaining a target weight can be difficult when you’re managing type 1.
If you have type 1, you have to think about food a lot. You need to carefully read food labels and have a constant awareness of the amount of carbohydrates in food so that you can take the right amount of insulin.
The need to eat to treat hypoglycaemia can cause weight gain and can sometimes be counterintuitive (e.g. having to eat when not hungry) and can contribute to feelings of guilt around eating.
Sometimes with type 1, you can feel like you’re not in control of your body. For some people, reducing how much they eat, or restricting or missing insulin doses can give them a sense of control. However, the person can find themselves out of control of these things too.
The language that people use when they talk about type 1 can also have an effect on how you feel. If people use words like ‘control’ when it comes to type 1 management, it implies that it’s completely down to you to get it right every time. Realistically, managing type 1 isn’t like that, which is why using non-judgemental language is so important.
How your friends, family and colleagues see and talk about type 1 can affect how you feel, especially if they have misconceptions about what type 1 is and how it’s treated.
Made by the All Wales Diabetes Implementation Group (AWDIG), NHS Wales Health Collaborative, Cardiff and Vale UHB Psychology department, and funded by Public Health Wales NHS Trust. The project was facilitated by Katja Stiller (Therapeutic Arts Facilitator) and Jane Hubbard (Animation Producer) from Breathe Creative.
Much like eating disorders that aren’t connected to type 1 diabetes, spotting the signs and symptoms can be difficult because the person affected by an eating disorder might keep them hidden.
The signs and symptoms can include:
If you are concerned that any of these issues might be affecting someone close to you, please reach out to their Diabetes Healthcare Team or contact one of the organisations listed below for advice, as soon as possible.
Deliberately and regularly reducing or missing insulin doses with the aim of affecting body shape or reducing or not gaining weight, is known as ‘insulin omission’.
Missing or restricting insulin doses can leave someone at risk of developing short and long-term complications. Many of these complications can be life-changing or life-threatening. Reading the list below may feel scary, but with support and help many of these can be avoided (see below for resources). Find out more about the complications of type 1.
If you would like to speak to a professional about type 1 and eating disorders please contact your Diabetes Healthcare Team as soon as possible, or scroll down to the useful links section for details of organisations that can help.
The T1DE podcast is a series all about type 1 diabetes and disordered eating from the ComPASSION Project team.
We would like to offer our heartfelt thanks to Ariella and Lawrence for sharing their stories with us.
“The long (and continuing) road to recovery began with a visit to my diabetic care team.”
Lawrence talks about his journey with disordered eating and how he found support to help him with his mental health.
“I’m grateful I had the eating disorder therapy when I did.”
Ariella had already had eating disorder therapy when she was diagnosed with type 1. She talks about how the tools she learned in therapy helped her manage her type 1 and disordered eating.
Learn about what technology is available to manage type 1 and how to access it
Get information about dealing with the emotional side of living with type 1
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Managing type 1 diabetes day in and day out can be tough. Find information and support about how to cope with type 1 and manage your emotional wellbeing.