Virtual healthcare provider explaining to patient whether anorexia can cause diabetes

Can Anorexia Cause Diabetes?

Written on December 22, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Eating disorders are serious illnesses that can cause long-term complications with your health. The two most well-established eating disorders are anorexia nervosa and bulimia nervosa.[1] There are many ways that eating disorders can affect your health, but one of the things that you may be wondering is, “Can anorexia cause diabetes?” We’ll discuss some of the potential ramifications of anorexia including its link to diabetes.

What Is Anorexia?

Anorexia is a serious eating disorder that is associated with severe restriction of calories from food and drink. This leads to a very low body weight.[1] Anorexia comes in two primary forms: restricting type and binge-eating/purging type. In anorexia, the patient experiences severe anxiety associated with gaining weight or becoming fat even when the body weight is low. Anorexic people may hide their bodies under baggy clothes or extra layers to make weight loss more difficult to detect.

Restricting type anorexia means that the patient severely restricts their food intake. They may restrict their diet to low-calorie foods, skip meals, develop mealtime rituals, or take diet products. They also may exercise excessively or take laxatives regularly.

Binge-eating/purging type anorexia is what it sounds like. Patients may eat excessive amounts of food and then make themselves throw up. If this sounds like bulimia, that’s because the two conditions are similar. However, in bulimia, patients maintain a relatively normal weight, whereas in this form of anorexia, the weight is significantly abnormal. These patients may also participate in mealtime rituals or exercise excessively.

What Is Diabetes?

Diabetes is a condition where the body doesn’t make enough insulin and the blood sugar becomes high. This can cause several health concerns and have long-term effects on your body. Diabetes comes in two primary forms.

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease.[2] The body’s immune system malfunctions and starts attacking the pancreas, destroying the insulin-producing beta cells. There may be both a genetic and environmental cause for type 1 diabetes because having a family member with type 1 diabetes increases your risk about 15 times. Type 1 diabetes generally starts in childhood, but may also occur later in life.

Treatment for type 1 diabetes is insulin in either short or long-acting forms. Type 1 diabetes can cause long-term health risks including kidney damage, blood vessel disease, strokes, heart attacks, and eye disease. Tight control of diabetes is important for preventing these complications.

Type 2 Diabetes

Type 2 diabetes may also have genetic or environmental causes.[2] It is caused by acquired insulin resistance. The body becomes resistant to the insulin that is naturally produced in the pancreas. Insulin resistance is more common in people who are overweight or obese. Type 2 diabetics can be treated with oral medications or injectable medications. Type 2 diabetics are susceptible to many of the same complications as type 1 diabetics and also benefit from good control of their disease.

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Is There a Link Between Anorexia And Diabetes?

Eating disorders may be more common in people with diabetes. Specifically, there is a condition called diabulimia, which is a descriptive term to describe patients with type 1 diabetes and an eating disorder.[3] In this condition, patients with type 1 diabetes will restrict their insulin in an attempt to control their weight. They may also display other symptoms commonly associated with anorexia. In this case, anorexia doesn’t necessarily cause diabetes, but the two conditions coexist.

Eating disorders and diabetes are both conditions that impact food intake, so both conditions have a significant impact on metabolism. Evidence suggests that while binge eating disorder and bulimia nervosa can increase the risk of developing type 2 diabetes, anorexia nervosa does not.[4] During treatment for anorexia, healthcare providers have to be careful of refeeding syndrome, which can cause abnormalities in the electrolytes, swelling, vitamin deficiencies, and other abnormalities.[5] Refeeding can also increase abdominal fat, which can increase the risk of insulin resistance (and, therefore, the risk of type 2 diabetes) even in patients with normal weight.[6]

Take Control of Your Health With Everlywell

Controlling diabetes and monitoring your health are very important. At Everlywell, we provide an at-home HbA1c Test to monitor your blood sugar levels. You can also enroll in our telehealth program for one-on-one virtual visits with a licensed clinician, who can provide support while you adjust your lifestyle and manage your health.

Take the next step toward overall health with Everlywell.

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  1. Harrington BC, Jimerson M, Haxton C, and Jimerson DC. Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. American Family Physician. 2015;91 (1): 46-52. Accessed December 12, 2023.
  2. Symptoms & Causes of Diabetes. National Institutes of Health. Published December 2016. Accessed December 12, 2023.
  3. Winston AP. Eating disorders and diabetes. Curr Diab Rep. 2020 June 15;20(8): 32. Accessed December 12, 2023.
  4. Nieto-Martinez R, Gonzalex-Rivas JP, Medina-Inojosa JR, Florez H. Are eating disorders risk factors for type 2 diabetes? A systematic review and meta-analysis. Curr Diab Rep. 2017 Nov 22; 17(12):138 Accessed December 12, 2023.
  5. Skowronska A, Sojta Klaudia, Strezelecki D. Refeeding syndrome as treatment complication of anorexia nervosa. Psychiatr Pol. 2019 Oct 30; 53(5): 1113-1123. Accessed December 12, 2023.
  6. Prioletta A, Muscogiuri G, Sorice GP, et. al. In anorexia nervosa, even a small increase in abdominal fat is responsible for the appearance of insulin resistance. Clin Endocrinol (Oxf). 2011 Aug; 75(2): 202-6. Accessed December 12, 2023.
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