Psychosocial Aspects


Sasja Huisman, Christel Hendrieckx, Mariska Bot, François Pouwer, Giesje Nefs

Prevalence, associations and health outcomes of binge eating in adults with type 1 or type 2 diabetes: Results from Diabetes MILES –The Netherlands. Diabet Med. 2023 Jan;40(1):e14953.

People with diabetes run a greater risk of experiencing eating problems. Exact prevalence rates are difficult to provide because of inconsistencies in definitions, methodologies and small study samples. Binge eating (regularly eating abnormally large quantities of food in an uncontrolled manner, feeling a lack of control) is one of the most common eating problems in people with diabetes. Both in the general population and among people with diabetes binge eating is related to psychological conditions. To date few studies have investigated eating styles (dietary restraint, emotional eating and external eating) in people with diabetes. This study, co-authored by Diabeter psychologist Giesje Nefs, aimed to assess 1) the prevalence of binge eating in a large sample of adults with diabetes (both T1D and T2D) and 2) differences between people with and without eating binges, and 3) differences between eating styles, diabetes treatment, weight, BMI and diabetes outcomes, and psychological comorbidity.


The current study sample comprises n=1,317 participants of the MILES (Management and Impact for Long-term Empowerment and Success) study, who completed questions on eating behaviours (Dutch Eating Behavior Questionnaire [DEBQ]).

Key findings (related to T1D):

  • Most participants did not report diabetes complications (72% of people with T1D)
  • Of participants with T1D, 25% reported eating binges (17% once a month, 7% once a week, 17% losing control during binges)
  • Compared with participants with T1D without eating binges, participants reporting eating binges:
    • Had higher DEBQ eating style subscale scores
    • Were younger
    • Were more likely to be female (small effect size)
    • Were more likely to use an insulin pump (small effect size)
    • Had shorter diabetes duration
    • Had higher weight and BMI
    • Had higher HbA1c
    • Reported more psychological disorders (depressive, anxiety and eating disorders)


Concluding, the authors state

"Despite the strong need for more research on interventions to treat eating disorders and disordered eating behaviours in people with diabetes, there is a consensus that a multidisciplinary approach, including licensed nutritional and mental health professionals is needed in supporting people with diabetes and comorbid eating disorders or disordered eating behaviours" -

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