Skip to main content

Type 1 diabetes and eating disorders

If you or someone you know is living with type 1 diabetes and experiencing disordered eating, we have information, shared experiences and links to further support.
Content last reviewed and updated: 26.02.2024

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 diabetes and disordered eating

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 gaining weight, known as insulin omission, or are experiencing another form of disordered eating, like bulimia or anorexia, alongside their type 1.

There are many reasons someone with type 1 may experience an eating disorder. Evidence suggests that up to 40% of girls and women and up to 15% of boys and men with type 1 diabetes experience some form of disordered eating. If you’re feeling this way or experiencing disordered eating, you are not alone.

What is diabulimia?

Diabulimia is a term used in the media rather than a medical term used by Diabetes Healthcare Teams. It refers to an eating disorder in a person with diabetes, usually 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.

Why might someone living with type 1 develop an eating disorder?

There are many reasons someone with type 1 may experience an eating disorder.

Managing type 1 diabetes is very closely linked with food and the body and can be stressful. Because of this, the risk of someone developing disordered eating is higher than in people without type 1.

A focus on food

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.

Having to eat to treat low blood glucose (hypos) can cause weight gain and having to eat when you’re not hungry can sometimes be counterintuitive. This can contribute to feelings of guilt around eating.

A focus on weight and the body

Managing type 1 diabetes means that you have to think about your body a lot of the time. Monitoring your own glucose levels and weight, along with 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.

Feeling in control

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.

Diabetes-related stress

The stress associated with managing diabetes, including daily glucose monitoring and insulin injections, may increase the risk of developing disordered eating behaviours.

Fear of hypos

The fear of hypos, when blood glucose levels drop too low, may lead some people with type 1 to skip insulin doses on purpose or manipulate their blood sugar levels to try to avoid hypos.

How we talk about type 1

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.

Other reasons

There are other reasons someone with type 1 might develop disordered eating, that aren’t related to their type 1. If someone has a history of disordered eating, dieting, or body image concerns, they might be more likely to develop disordered eating behaviours in relation to their type 1. Negative body image or low self-esteem may also be factors in developing disordered eating.

Swimming with the T1DE

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. 

What are the signs and symptoms of T1DE?

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 of T1DE can become apparent medically, like having increased HbA1c or erratic blood glucose levels. Someone with T1DE may also have episodes of diabetic ketoacidosis (DKA) or near DKA.

Someone with T1DE might become secretive about their diabetes management, or not go to their diabetes clinic appointments or engage in services. They may not take enough insulin on purpose, over-exercise or restrict food, or binge-eat and make themselves vomit. They may also use laxatives or diuretics for reasons they’re not intended for.

Emotionally, they may show signs of feeling overwhelmed and frustrated at having to constantly manage their type 1 (known as diabetes distress) and have a fear of hypoglycaemia. They may also show signs of depression and anxiety, have concerns about body image and have dieted or tried to lose weight in the past.

If you are concerned that any of these issues might be affecting you or someone close to you, please reach out to your Diabetes Healthcare Team or contact one of the organisations listed below for advice, as soon as you can.

What can happen if you don’t take the insulin you need?

Missing or restricting insulin doses, known as insulin omission, can leave someone at risk of developing short and long-term complications. Many of these complications can be life-changing or life-threatening. Thinking about complications might feel scary, but with support and help the risks can be reduced.

What to do about eating disorders

If you would like to speak to a professional about type 1 and eating disorders contact your Diabetes Healthcare Team as soon as possible or find more information below.

More resources on T1DE

Read more


Diabulimia, the mental health equivalent of putting a hat on a hat – Lawrence Smith

Read more


Amybetic: Type 1 diabetes, mental health and the highs and lows in between – Amy Stevens

Read more


A series about type 1 diabetes and disordered eating from an NHS pilot project that treats T1DE.

Read more

NHS pilot project

Find out more about the NHS pilot treating T1DE, the Wessex ComPASSION project.

Shared stories

Explore other health and wellbeing topics

Read more


When you get a bug or a virus, you might need to manage your type 1 diabetes a bit differently. Find out what you should do if you become unwell.

Read more


If you have type 1 diabetes, menstrual cycles can affect your type 1 management. Your glucose may rise higher and you may be more resistant to insulin during your period.

Read more


There are many different methods of contraception, and each has pros and cons when it comes to how it can affect your type 1 diabetes.

Read more


If you have type 1 diabetes there’s no reason why you can’t start thinking about pregnancy. Get advice about planning and managing a pregnancy through to giving birth and breastfeeding.

Read more


Learn about how menopause impacts type 1 diabetes, how to tell a hot flush from a hypo, and how to keep blood sugar stable during this challenging time.

Read more

Emotional wellbeing

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.