Why Diabetes and Eating Disorders Are Linked

Living with type 1 diabetes means managing food, blood glucose, and technology, making you feel like you’re walking a tightrope. Add in a society obsessed with diets and body size, and it’s no wonder that eating disorders show up more often in people with diabetes than those without. This isn’t just some coincidence—there are real, heavy reasons behind it.

Diabetes Comes With Food Rules—and That Can Get Messy

Living with diabetes, especially type 1, food isn’t just food. It’s carbs to count, insulin to dose, lows to treat, highs to avoid, and guilt when it doesn’t go “perfectly.” That constant focus on food and numbers can mess with your relationship with eating.

It is easy to feel pressured to be “in control” all the time—like if your blood sugar isn’t in range, it means you’ve failed. This pressure can turn into disordered eating behaviors, like skipping meals, restricting carbs, binge eating, or even manipulating insulin to lose weight (a dangerous behavior known as diabulimia).

Stigma Adds Fuel to the Fire

Many young adults with diabetes experience stigma—not just from others, but inside their own heads. You might hear or think things like:

• “People are staring while I check my blood sugar.”
• “If I gain weight, they’ll think I caused my diabetes.”
• “It’s my fault I’m not doing better.”

That kind of shame wears on you. In one study, up to 98% of young people with type 1 diabetes reported feeling stigmatized. That stigma is linked to poorer self-care, less in range blood sugars, and—yep—higher rates of eating disorders.

Perfectionism and Control Can Go Too Far

Managing diabetes can make you feel like you have to do everything “right.” That pressure can push people into extreme eating patterns. You might start cutting out more and more foods, obsessing over healthy eating (which can lead to orthorexia), or feel like you have to “earn” your food with exercise.

If you’ve ever found yourself thinking, “I’ll skip lunch to make up for going high last night,” or “I have to run for an hour before I can eat,” that’s not healthy—it’s a red flag.

It Starts Young and Sticks Around

Eating disorders often begin in adolescence—the same time many people are diagnosed with diabetes. Combine that with hormonal changes, pressure to look a certain way, and social media filters, and it’s easy to see why teens and young adults are so vulnerable.

And it doesn’t just go away. People with diabetes and eating disorders are more likely to struggle long-term, with higher risks for complications like DKA, retinopathy, and even early death if the cycle isn’t interrupted.

It’s Not Just About the Body—It’s About Coping

Eating disorders aren’t just about wanting to be thin. For many people with diabetes, disordered eating is a way to cope with stress, burnout, trauma, or just feeling different. When food becomes the only thing you can “control,” it’s easy to see how that control can turn toxic.

So What Can You Do?

• Name it. If something feels off in your eating or insulin habits, discuss it with a friend, a diabetes educator, or a therapist. 
  • The act of saying, “Hey, something feels off, can I talk with you to explore why.” Is awesome place to start because everyone, at some point in their life, feels these hard to verbalize feelings. No one is born knowing, which means uncertainty and doubt are part of our human experience.
• Check your self-talk. Are you shaming yourself for blood sugar swings? That shame can sneak into how you treat your body.
  • Words like “should”, “must”, “have to”, “right”, “wrong”, “bad”, and “good” are often heard in diabetes care and you might be hearing them as judgment. Lean into choice and flip the script. “Could”, “options”, “choice”, “better”, “unhelpful”, and “helpful” can be powerful alternatives.
• Push back on the pressure. You don’t have to be perfect. Diabetes is tough. Your body is doing the best it can.
  • Acknowledge your effort. Focus on what is working. Imagine ways to do these more frequently or explore methods to make them easier.
• Seek out non-judgy support. Look for healthcare providers who understand the link between diabetes and mental health. You deserve care that supports your whole self—not just your A1C.
  • If you are looking for a therapist, Psychology Today Directory is a helpful resource [https://www.psychologytoday.com/us/therapists]