Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study
Open accessAbstract
OBJECTIVE: To determine the prevalence of eating disorders in adolescent females with type 1 diabetes mellitus compared with that in their non-diabetic peers. DESIGN: Cross sectional case-control led study. SETTING: Diabetes clinics and schools in three Canadian cities. SUBJECTS: 356 females aged 12-19 with type 1 diabetes and 1098 age matched non-diabetic controls. MAIN OUTCOME MEASURE: Eating disorders meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. RESULTS: Eating disorders that met DSM-IV criteria were more prevalent in diabetic subjects (36, 10%) than in non-diabetic controls (49, 4%) (odds ratio 2.4, 95% confidence interval 1.5 to 3.7; P<0.001). Subthreshold eating disorders were also more common in those with diabetes (49, 14%) than in controls (84, 8%) (odds ratio 1.9, 95% confidence interval 1.3 to 2.8; P<0.001). Mean haemoglobin A(1c) concentration was higher in diabetic subjects with an eating disorder (9.4% (1.8)) than in those without (8.6% (1.6)), P=0.04). CONCLUSIONS: DSM-IV and subthreshold eating disorders are almost twice as common in adolescent females with type 1 diabetes as in their non-diabetic peers. In diabetic subjects, eating disorders are associated with insulin omission for weight loss and impaired metabolic control.
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Eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating, are overrepresented in type 1 diabetes populations, particularly in young women but may also occur in men.
“Eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating, are overrepresented in type 1 diabetes populations, particularly in young women (193,194) but may also occur in men.”
From The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2021) · cites this paper as [193]
The Frequency of DSM-IV and subthreshold eating disorders section reports that eating disorders were more common in adolescent females with type 1 diabetes than in controls, and the Self reported data section reports more binge eating. But there were no cases of anorexia nervosa in either group, so this study does not establish that anorexia nervosa was overrepresented. The statement about men follows the citations and is not attributed to this source. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn people with type 1 diabetes, the pooled prevalence of feeding and eating disorders based on registers was 0.60% (95% CI 0.50-0.73) across 2 studies with a total sample size of 18,424.
“| Type 1 diabetes [20-26,31,33,34,43,45,50-52,54] | 2 | Registers | 18,424 | 0.60 | 0.50-0.73 | N/A |”
From Prevalence of mental disorders in people living with type 1 diabetes: A systematic literature review and meta-analysis (2023) · cites this paper as [25]
In people with type 1 diabetes, the pooled prevalence of feeding and eating disorders based on interviews was 6.60% (95% CI 4.11-9.09) across 14 studies with a total sample size of 2004.
“| | 14 | Interviews | 2004 | 6.60 | 4.11-9.09 | 86.75% |”
From Prevalence of mental disorders in people living with type 1 diabetes: A systematic literature review and meta-analysis (2023) · cites this paper as [25]
In healthy controls, the pooled prevalence of feeding and eating disorders based on interviews was 1.25% (95% CI 0.00-2.84) across 5 studies with a total sample size of 3581.
“| | 5 | Interviews | 3581 | 1.25 | 0.00-2.84 | 90.73% |”
From Prevalence of mental disorders in people living with type 1 diabetes: A systematic literature review and meta-analysis (2023) · cites this paper as [25]
In healthy controls, the pooled prevalence of feeding and eating disorders based on registers was 0.27% (95% CI 0.27-0.28) across 2 studies with a total sample size of 1,703,033.
“| Healthy controls [20-26] | 2 | Registers | 1,703,033 | 0.27 | 0.27-0.28 | N/A |”
From Prevalence of mental disorders in people living with type 1 diabetes: A systematic literature review and meta-analysis (2023) · cites this paper as [25]
The heterogeneity (I2) for the pooled prevalence of feeding and eating disorders in healthy controls based on interviews was 90.73%.
“| | 5 | Interviews | 3581 | 1.25 | 0.00-2.84 | 90.73% |”
From Prevalence of mental disorders in people living with type 1 diabetes: A systematic literature review and meta-analysis (2023) · cites this paper as [25]
The heterogeneity (I2) for the pooled prevalence of feeding and eating disorders in people with type 1 diabetes based on interviews was 86.75%.
“| | 14 | Interviews | 2004 | 6.60 | 4.11-9.09 | 86.75% |”
From Prevalence of mental disorders in people living with type 1 diabetes: A systematic literature review and meta-analysis (2023) · cites this paper as [25]
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- Authors
- Jones, J. M.
- Affiliations
- University Health Network (CA)
- Corresponding author
- Jones, J. M
- ORCID
- Jones, J. M
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2000-06-10
- Volume
- 320
- Issue
- 7249
- Pages
- 1563-1566
- ISSN
- 0959-8138 (ISSN-L)
- PMC
- PMC27398
- OpenAlex
- W2131008571
- Cited by
- 568
- References
- 29
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 15 · 2023: 29 · 2022: 16 · 2021: 22 · 2020: 29 · 2019: 16 · 2018: 23 · 2017: 34 · 2016: 26 · 2015: 32 · 2014: 27 · 2013: 33 · 2012: 24
- FWCI
- 21.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- eating disorders, type 1 diabetes, adolescent girls, subthreshold eating disorders, prevalence, glycemic control, HbA1c, metabolic control
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Child, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Humans, Insulin, Weight Loss, Prevalence, Confidence Intervals, Chi-Square Distribution, Odds Ratio, Case-Control Studies, Treatment Refusal
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