Potential Causes of ED-DMT1
Patients diagnosed with type 1 diabetes are two and a half times more likely to develop an eating disorder than other women. Steven Graybar, Ph.D., a licensed psychologist, speculates that a number of factors play into the occurrence of type 1 diabetes and eating disorders:
- The standard treatment for type 1 diabetes focuses on dietary restriction, counting carbohydrates, and paying close attention to weight, body, and food intake, all of which can trigger an eating disordered mindset.
- With diabetes, food is more than fuel for the body – it becomes a target of daily focus. Rather than a time of nurturing, mealtimes are rife with conflict and distress, as well as injections, finger pokes, and other less-than-pleasant activities. As a result, insulin becomes the enemy and young people will go to extremes to avoid taking it.
- A certain degree of rigidity is required to effectively manage diabetes, which can lead to a struggle for autonomy, personal independence, and a sense of control – all hallmarks of anorexia, bulimia, and other eating disorders. In this sense, diabulimia and other eating disorders become a way to regain control.
- Finding out that you have type 1 diabetes can be incredibly stressful, especially for an adolescent or young adult who is told she will have to take shots for the rest of her life. Without the appropriate coping strategies and life skills, the diagnosis can be so overwhelming that young people turn to eating disorders to cope.
"A diagnosis of type 1 diabetes is like dropping a bomb on a family," says Dr. Graybar. "One day the child has the flu, and the next she has a life-threatening illness that is never going away and that requires an incredible amount of complex treatment just to maintain a basic quality of life." Naturally, outside observers question how any amount of weight loss could be worth the risk of death and long-term health complications. For many, being thin seems more important than life itself. The threats of death, falling into a coma, blindness, and kidney failure seem like complications that could only arise 40-50 years from now – a time so far into the future that is almost impossible to imagine.
"Restricting insulin intake is an understandable but self-defeating strategy," explains Dr. Graybar. "Even though most teens and young adults understand the risks intellectually, they feel a sense of invulnerability. Others are fatalistic and feel like they’re going to die before they experience any complications, so they figure why not live fast and hard in the time that they have? Unfortunately, many individuals struggling with this condition live long enough to just begin to want families, careers, and long, fulfilling lives but a great deal of damage has already been done."