Dysfunctional eating in type 2 diabetes mellitus: A multicenter Italian study of socio-demographic and clinical associations

Abstract

Background and aims: Dysfunctional eating might impact on the management and metabolic control of type 2 diabetes (T2DM), modifying adherence to healthy diet and food choices. Methods and results: In a multicenter study, we assessed the prevalence of dysfunctional eating in 895 adult outpatients with T2DM (51% males, median age 67, median BMI 30.3 kg/m 2). Sociodemographic and clinical characteristics were recorded; dysfunctional eating was tested by validated questionnaires (Eating Attitude Test-EAT-26, Binge Eating Scale-BES; Night Eating Questionnaire-NEQ); food intake and adherence to Mediterranean diet were also measured (in-house developed questionnaire and Mediterranean Diet ScoreeMDS). Obesity was present in 52% of cases (10% obesity class III), with higher rates in women; 22% had HbA1c ! 8%. The EAT-26 was positive in 19.6% of women vs. 10.2% of men; BES scores outside the normal range were recorded in 9.4% of women and 4.4% of men, with 3.0% and 1.5% suggestive of binge eating disorder, respectively. Night eating (NEQ) was only present in 3.2% of women and 0.4% of men. Critical EAT and BES values were associated with higher BMI, and all NEQ þ ve cases, but one, were clustered among BES þ ve individuals. Calorie intake increased with BES, NEQ, and BMI, and decreased with age and with higher adherence to Mediterranean diet. In multivariable logistic regression analysis, female sex, and younger age were associated with increase risk of dysfunctional eating. Conclusion: Dysfunctional eating is present across the whole spectrum of T2DM and significantly impacts on adherence to dietary restriction and food choices.

<p>Binge Eating Disorder in Patients with Type 2 Diabetes: Diagnostic and Management Challenges</p>

“…Prevalence rates in patients with T2DM have ranged widely from a point prevalence of 1.4 to 25%. 7,8,19,23,24 Some studies however, like that by Kenardy et al, 22 noted an association between T2DM and some degree of binge eating, but not BED itself. These conflicting results may be due to differences in exclusionary criteria, sample characteristics, and the setting in which participants were recruited.…”

“…Many, 7,8,[18][19][20] but not all, 21,22 studies have reported a greater prevalence of BED in patients with T2DM than those without T2DM. Prevalence rates in patients with T2DM have ranged widely from a point prevalence of 1.4 to 25%.…”

“…[2][3][4][5] T2DM is also associated with increased risks of psychiatric conditions such as depression and binge eating disorder (BED). [6][7][8] BED was first added to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1994 as a feature of eating disorder not otherwise specified (EDNOS), and did not gain formal recognition as its own psychiatric condition until 2013 in the DSM-5. To meet criteria for BED, patients must display recurrent episodes of binge eating, defined as the consumption of an objectively large amount of food, with a sense of loss of control over eating.…”

Effect of Eating Attitudes of Individuals With Type 2 Diabetes Upon Quality of Life

“…42.7 % of the participant T2DM individuals demonstrated impaired eating behaviors. The rate of these eating behaviors was reported to be 40 % in the systematic review done by Garcia-Mayor et al [6], 20 % in the study of Papelbaum et al [7], 19.6 % in the study of Petroni et al [11], 12.2 % in the study of Nicolau et al [8] and 39.3 % in the study of Yılmaz and Çetinkalp [9]. Such factors as age, gender, metabolic status influence eating attitudes.…”

“…Data for the current study were collected by means of Eating Attitudes Test, Diabetes Quality of Life Measure, and a Patient Information Form developed by the researchers following a comprehensive review of the literature [7,[10][11][12][13]. After the questionnaire form was prepared, a preliminary interview was held with 5 patients and necessary corrections were made and the investigation started.…”