Diabetes and Eating Disorders

Rates of eating disorders are higher in patients with type 1 and type 2 diabetes than in the general population. Types of eating disorders include anorexia; bulimia; binge-eating disorder; subclinical eating disorders; and an eating disorder unique to type 1 diabetes, intentionally restricting insulin doses as a calorie purge—often referred to by laypeople as “diabulimia.” Women with diabetes and eating disorders (including disordered eating behaviors) have significantly elevated blood glucose ranges, higher rates of hospitalization, higher rates of diabetes complications, and, in some cases, higher mortality rates. This chapter discusses risk factors, presentation, and identification of eating disorders within the diabetes population. Specific recommendations are given for this difficult-to-treat population, including the need for an expanded treatment team as well as the need to establish mutually agreed upon and incremental diabetes management goals.

Health state, eating and body image disorders among beauticians

Introduction: Beauticians are considered as risk populations for eating disorders and body image disorders, as their work is closely related to beauty and fashion. Aim: The aim of the authors was to examine whether eating and body image disorders occur more frequently among beauticians than in control subjects. Methods: Eating disorders were assessed using the Eating Attitudes Test, Eating Behaviour Severity Scale, and body image measures included the Human Figure Drawings Test, the Body Dissatisfaction Subscale of the Eating Disorders Inventory, the Body Attitudes Test, and the Body Investment Scale. The study sample included 56 beauticians from Transylvania and 59 from Hungary. These groups were compared with control groups including 57 subjects from Transylvania and 54 subjects from Hungary. Questionnaire data were analysed. Results: The occurrence of weight reducing methods such as binge eating was significantly more prevalent in the beautician groups than in controls. Subclinical eating disorders were more frequent in the Transylvanian beautician group. Conclusions: Clinical and subclinical eating disorders occur more frequently in beauticians than in control subjects. Orv. Hetil., 2013, 154, 665–670.

Eighty-five per cent of what? Discrepancies in the weight cut-off for anorexia nervosa substantially affect the prevalence of underweight

BackgroundDSM-IV cites <85% of expected body weight (EBW) as a guideline for the diagnosis of anorexia nervosa (AN) but does not require a specific method for calculating EBW. The purpose of the present study was to determine the degree to which weight cut-off calculations vary across studies, and to evaluate whether differential cut-offs lead to discrepancies in the prevalence of individuals who are eligible for the AN diagnosis.MethodTwo coders independently recorded the EBW calculation methods from 99 studies that either (a) compared individuals with AN to those with subclinical eating disorders or (b) conducted AN treatment trials. Each weight cut-off was applied to a nationally representative (n=12001) and treatment-seeking (n=189) sample to determine the impact of EBW calculation on the proportion who met the AN weight criterion.ResultsCoders identified 10 different EBW methods, each of which produced different weight cut-offs for the diagnosis of AN. Although only 0.23% of the national sample met the lowest cut-off, this number increased 43-fold to 10.10% under the highest cut-off. Similarly, only 48.1% of treatment seekers met the lowest cut-off, whereas 89.4% met the highest.ConclusionsThere is considerable variance across studies in the determination of the AN weight cut-off. Discrepancies substantially affect the proportion of individuals who are eligible for diagnosis, treatment and insurance reimbursement. However, differences may not be fully appreciated because the ubiquitous citation of the 85% criterion creates a sense of false consensus.