|Strict diets required for chronic disease management may increase risk of unhealthy eating behaviors
Young women with diseases that require them to adhere to a strict diet may be more vulnerable to a range of eating disturbances that varies depending on the disease, according to the results of a small study.
Eating disturbances are unhealthy eating attitudes and behaviors that are not severe enough to qualify as full-blown eating disorders.
Previous studies noted that eating disorders occur more frequently in women with diabetes, but this study, which focused on women with phenylketonuria (PKU) as well as on women with Type 1 diabetes, attempts to take a broader look at the association between eating-disordered behavior and chronic diseases.
Individuals with both Type 1 diabetes and PKU, a hereditary condition in which an amino acid found in protein-containing foods can't be properly metabolized, must adhere to strict diet regimens. Since diabetics don't produce enough insulin, a hormone that helps the body regulate carbohydrate metabolism, they must carefully monitor food intake. Individuals with PKU have to restrict severely their consumption of protein-rich foods like meat, eggs, and milk, and also certain fruits, vegetables, and grains.
Deviation from diet regimens carries serious health risks for both groups. Diabetics who deviate are at increased risk for vascular complications like heart disease, and individuals with PKU who don't adhere to their diets can develop brain damage.
A statistically comparable number of the 54 study participants with diabetes and the 30 study participants with PKU demonstrated symptoms of eating-disordered behavior, according to authors Joan C. Chrisler, PhD, and Jeanne E. Antisdel, MA, of Connecticut College, in New London, CT. Specifically, 33 percent of those with diabetes and 23 percent of those with PKU exhibited such symptoms.
Certain types of eating problems were more common within each group. Preoccupation with avoiding fattening foods and with weight loss was more common among study participants with diabetes, whereas PKU sufferers were more likely to be preoccupied with self-control around food. They were also more likely to perceive that others were pressuring them to gain weight.
Diabetics with eating problems had lower self-esteem and a more negative body image compared to those without such problems. They were also less vigilant about monitoring blood sugar levels, following a meal plan, and properly treating hypoglycemia. PKU study participants with eating problems demonstrated poorer psychological judgement as well as lower self-esteem, the researchers found. Their study findings appear in the April issue of the Journal of Developmental and Behavioral Pediatrics.
"Although the symptoms of disordered eating among our participants were not as severe as those of patients with eating disorders, they were more intense than those reported by nonclinical samples," said Chrisler.
"Clinicians who work with adolescents and young women with diabetes or PKU should be alert for signs of disordered eating that might interfere with their patients' health status," she added.
Eating disorders on their own are serious and potentially life threatening. Put together an eating disorder with a chronic condition such as diabetes and the results can be devastating and even fatal. On top of the risks of eating disorders, diabetic eating disorders are a deadly combination. It seems those who suffer from diabetes are more probable and at higher risk to develop an eating disorder.
In many ways, diabetes can be a starting point for the onset of an eating disorder as it can easily create a preoccupation with food, body image and weight issues. This preoccupation can lead someone into the powerful grips of an eating disorder. Part of diabetes control involves careful and healthy eating habits and patterns. Some with diabetes feel they have lost control over their life and an eating disorder can be an attempt to regain some of the control they feel they have lost in their lives. Some diabetics place a lot of food restrictions on themselves or by doctors therefore making them feel obsessed about food and often feel food deprived. Diabetics may also see food as "dangerous" or "unsafe" and can lead a person to develop an eating disorder. Some families, especially with teenagers involve themselves greatly in the life and care of their loved one and may lead the diabetic to feel the need to "rebel" and show their independence thus a person may use the eating disorder as a way of expressing their independence and control. Since weight loss can be seen as good and careful diabetes control, a diabetic may receive compliments and praise from others making the person feel good about themselves. This is also how an eating disorder in a diabetic can be hard to notice or detect. Many of the symptoms of diabetes and an eating disorder are similar and an eating disorder can go undetected for long periods of time, even years. Some diabetics when confronted often claim their eating habits are a part of their diabetes control and nothing to be worried about. Those who have an eating disorder and diabetes have unhealthy glucose levels over a long period of time and are at higher risk for diabetic complications and the result can be death. For any diabetic, lack of insulin and food can be fatal.
If you have diabetes and have suffered from an eating disorder, you need to seek medical and professional help. Gather all the information you can on eating disorders and reach out for the help you need and deserve. Eating disorders are fatal and with diabetes, you are putting your life at greater risk. Please seek professional help and support you require. You can recover from an eating disorder. There is help available to aid you in managing and treating your eating disorder as well as your diabetes.
The period of adolescence is a tremendously challenging time. For teens with diabetes, there is often a worsening in glycemic control. See Getting Control. The reasons for this deterioration are not fully understood, however, hormonal changes during puberty and the issue of decreased interest in self-care in adolescence, have an impact. The body demands more insulin during puberty and these needs are hard to control or predict. As well, judging food portions, balancing activity and insulin requirements, are generally seen as a "hassle" by most teens.
Self care neglect is a common feature of day to day diabetes management as the daily regimen of diabetes care usually fails to fit into an adolescent lifestyle. Most teens try to ignore their diabetes as their desire for independence and peer approval is their priority. In adolescence, conformity to peers social standards and acceptance by peers is central to positive self-concept. For teens with diabetes these issues may be of far more importance. The need for regular timing of meals/snacks and the limitations of food choices can make the teen stand out from their peers in an uncomfortable way. Also, they may develop a distorted perception of self related to having to give insulin shots and poke their fingers. These duties make teens feel "different" and disconnected from the routines of their peers.
Weight loss is often a symptom upon the diagnosis of Type 1 diabetes. Once diagnosed and insulin therapy is started, weight is quickly regained as the body can again store food calories for energy. Girls may not be considered overweight according to growth charts. However, they may find this rapid change in body image overwhelming. Research has demonstrated that adolescents with diabetes gain weight during puberty faster than their peers who do not have diabetes. If insulin doses are not carefully monitored, undesirable weight gain can occur as insulin is a growth hormone. The adolescent with diabetes does not have the freedom that their peers may have to achieve weight loss with fad or crash diets. Therefore, some choose to omit their insulin to achieve weight loss. This lack of insulin results in ketosis when body fat is broken down as an alternative energy source. Over extended periods, this can lead to problems such as growth failure, delay in puberty, prolonged loss of menstrual periods and repeated episodes of ketoacidosis. Having diabetes makes possible a further type of diabetes-specific "eating disorder" where secretive dosage reductions in insulin leads to weight loss. The evidence supports the view that abnormal attitudes to food are not uncommon in adolescent girls with diabetes, with the disturbing finding that reducing insulin to influence body weight is common practice. It has been found that insulin manipulation was a more common method of weight control than the common strategies of self-induced vomiting and laxative/diuretic abuse found in disordered eating.
|Eating Disorders and Diabetes|