Over 30 million Americans suffer from type 2 diabetes mellitus (T2D), comprising the seventh leading cause of death in the United States.1 In recent years, researchers have observed a relationship between eating disorders, most commonly binge eating disorder (BED), and T2D, with up to 40% of T2D patients reporting disordered eating behaviors.2 

Binge eating has been found to have a complex relationship with T2D, with research suggesting that it can act as both a risk factor for the development of T2D and a potential challenge to T2D management. Studies have shown that individuals who suffer from BED have a higher risk of acquiring a T2D diagnosis later in life.1 This may be due to several factors, including increased insulin resistance, hormonal imbalance, and changes in appetite regulation. Moreover, binge eating is associated with metabolic syndrome, increased Body Mass Index, and poor blood glucose control.1 Consequently, participants with binge eating behaviors were observed to have T2D at a younger age and higher risk of developing cardiovascular diseases1.  

BED can also present challenges to T2D management due to its impact on dietary intake and other negative health outcomes. Studies have shown that patients with BED tend to consume a disproportionate amount of fat and carbohydrates during binge episodes, including sweets, bread, and pasta.1 Since carbohydrates break down into glucose and foods that are high in refined carbohydrates can cause a rapid increase in blood sugar levels, binge eating episodes might lead to insulin resistance over time.1 Further, binge eating behaviors are often accompanied by weight gain.4 Since a key component in the treatment of T2D is adherence to a prescribed dietary regimen, patients with T2D are often urged to lose weight for medical purposes, which makes it extremely difficult for patients struggling with binge eating behaviors. Additionally, Herpertz and colleagues found that overweight T2D patients with BED revealed more psychopathologic symptomatology than patients without an eating disorder.3 In addition to their struggles with eating habits and weight-related health issues, individuals with BED experienced more depressive symptoms and lower self-esteem, further complicating T2D management. 

How can you find balance while managing BED and T2D? 5

  • Talk to someone you trust. It can be scary to discuss challenges with binge eating behaviors. However, finding someone you feel safe sharing experiences with can help reduce feelings of guilt and improve diabetes self-care. 
  • Eat an adequate amount. It can be challenging to reduce binge behaviors when you’re hungry. Eating an appropriate amount throughout the day can help enhance blood glucose management and eliminate high blood sugar excursions following a binge. 
  • Take note of your blood glucose response. Everyone responds to food differently. It is important to keep track of your individual blood glucose response in connection to the timing and composition of the meals you consume.   

Resources: 

  1. Chevinsky, J. D., Wadden, T. A., & Chao, A. M. (2020). Binge Eating Disorder in Patients with Type 2 Diabetes: Diagnostic and Management Challenges. Diabetes, metabolic syndrome and obesity : targets and therapy, 13, 1117–1131. https://doi.org/10.2147/DMSO.S213379 
  1. García-Mayor, R. V., & García-Soidán, F. J. (2017). Eating disoders in type 2 diabetic people: Brief review. Diabetes & metabolic syndrome, 11(3), 221–224. https://doi.org/10.1016/j.dsx.2016.08.004 
  1. Herpertz, S., Albus, C., Lichtblau, K., Kohle, K., Mann, K., & Senf, W. (2000). Relationship of weight and eating disorders in type 2 diabetic patients: A multicenter study. International Journal of Eating Disorders, 28(1), 68–77. https://doi.org/10.1002/(sici)1098-108x(200007)28:1<68::aid-eat8>3.0.co;2-r 
  1. Nieto-Martínez, R., González-Rivas, J. P., Medina-Inojosa, J. R., & Florez, H. (2017). Are eating disorders risk factors for type 2 diabetes? A systematic review and meta-analysis. Current Diabetes Reports, 17(12). https://doi.org/10.1007/s11892-017-0949-1 
  1. 5 tips to balancing binge eating disorder & type 2 diabetes. Walden Eating Disorders. (2022, October 28). Retrieved March 28, 2023, from https://www.waldeneatingdisorders.com/blog/5-tips-to-balancing-binge-eating-disorder-type-2-diabetes/ 

By Yiwen Xu

Yiwen is a senior at UNC-Chapel Hill, and she joined the Living F.R.E.E. Lab last summer.

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