Prevalence of disordered eating behaviors in diabetics probed

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Public release date: 10-Dec-2008

http://www.eurekalert.org/pub_releases/2008-12/mcog-pod121008.php

Contact: Hilliard

jhilliard@...

Medical College of Georgia

Prevalence of disordered eating behaviors in diabetics probed

AUGUSTA, Ga. - Children with diabetes are at an increased risk for

developing eating disorders and researchers want to know if it's their

disease or treatment that's to blame.

" Diabetes treatment prescribes obsessive food behavior, such as

carbohydrate restriction, " said Dr. Deborah Young-Hyman, pediatric

psychologist in the Medical College of Georgia's Georgia Prevention

Institute. " We want to know if those prescribed behaviors contribute to

disordered eating and/or whether there are physiological mechanisms

which prevent children with diabetes from controlling their eating

behavior. For example, treatment with insulin makes you hungry and can

cause you to gain weight. "

There is some unfortunate synergy: diabetes makes it difficult to

control blood glucose and disordered eating behavior does as well, Dr.

Young-Hyman said.

Over the next three years, with funding from the American Diabetes

Association, she and researchers at Emory and Harvard universities will

study 90 children age 10-17 newly-diagnosed with diabetes or

transitioning to an insulin pump. They will monitor treatment patterns,

weight, psychological adjustment and attitudes about weight and eating.

They'll also look at changes in eating patterns and blood sugar levels

in response to insulin.

Children and their parents will answer computer-based questionnaires

about eating behaviors and psychological adjustment - in the context of

their disease and its treatment.

These include questions about parental attitudes, family factors,

personality of the child and parents and perceived societal attitudes.

" As they are diagnosed and are adjusting to diabetes treatment, children

are already dealing with all sorts of issues that put them at an

increased risk for eating disorders. The psychological issues that come

with the diagnosis can add to that risk, " she said. " There is also the

existing drive for thinness that exists in our society, dealing with the

diagnosis and management of a long-term illness and the psychological

adjustment that comes with that. "

Even the insulin the children must take may be a factor. " Large doses

can lead to uncontrolled hunger, which can be mislabeled as disordered

eating behavior. Patients with type 1 diabetes also lose amylin

production - a hormone responsible for gastric emptying and associated

with feelings of fullness - that can also lead to increased feelings of

hunger, " Dr. Young-Hyman said.

Study findings could support a different treatment approach.

" We might come to understand that putting a child or adolescent on an

insulin pump sooner rather than later and providing them with a more

flexible nutrition regimen could decrease their insulin needs and

prevent excess hunger, " she said. " If we don't approach weight control

as dieting, place less emphasis on food restriction and focus on healthy

nutrition and usual eating patterns, we can help patients gain more

control over their eating behaviors and their treatment without adoption

of maladaptive weight management strategies. Studies indicate that

feeling in control of your illness is one of the keys to successful

treatment and good psychological adjustment. "

--

ne Holden, MS, RD

" Ask the Parkinson Dietitian " http://www.parkinson.org/

" Eat well, stay well with Parkinson's disease "

" Parkinson's disease: Guidelines for Medical Nutrition Therapy "

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