Bidirectional Relationships between Eating Disorders and Type 1 and 2 Diabetes: A Scoping Review

Abstract

Eating disorders (ED) represent complex conditions with multifactorial etiopathogenesis. Recent scientific findings suggest that diabetes, a chronic disease profoundly influencing eating habits, could significantly contribute to the risk of developing ED. Both type 1 diabetes (T1DM) and type 2 diabetes (T2DM) patients are identified as susceptible to developing binge eating disorder (BED) and other dysfunctional eating behaviors, such as diabulimia, a condition not yet officially recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Diabulimia is characterized by a deliberate choice to omit or limit necessary insulin doses, with the aim of losing weight or limiting weight gain. This scoping review aims to consolidate the latest evidence on the bidirectional relationship between ED and diabetes, as well as their impact on patients’ quality of life. The findings from various studies reveal varied prevalence estimates, as diabetic patients often do not meet the formal diagnostic criteria for ED. Nonetheless, having diabetes appears to increase the risk of developing dysfunctional eating patterns. Simultaneously, the presence of an ED may heighten the risk of developing T2DM. Given this bidirectional relationship between ED and diabetes, this evidence underscores the importance for healthcare professionals, particularly those in diabetes care, to implement screening programs aimed at preventing and/or treating ED. Such initiatives could significantly improve patient outcome and quality of life.