Does Binge Eating Cause Type II Diabetes? Dietitian Explains Why Dieting Is Not The Cure For Diabetes
Around 20% of those with type II diabetes also have an underlying eating disorder, and in most cases, that eating disorder is binge eating disorder.
Many clinicians and healthcare practitioners believe that binge eating causes insulin resistance and type II diabetes, in addition to the size of someone’s body. They prescribe dieting and weight loss as the solution. The truth is: these are oversimplified solutions to complex physiological interactions.
What is binge eating disorder?
Binge eating disorder is characterized by frequent episodes of binge eating (“frequent” defined as one time per week for at least three months or more). Binge eating is when you eat past your hunger cues and eat a much larger amount of food than what most people would in a given time period. When it comes to the eating episode, binge eating is when you eat until uncomfortably full and it often involves feelings of guilt, embarrassment, or shame following the eating episode.
Signs and symptoms of binge eating disorder include:
Frequent dieting or experimentation with different kinds of diets
Feeling uncomfortable eating around others
Frequent body checking or checking one’s reflection in the mirror or reflective surfaces
Developing particular food rituals
Social isolation and withdrawal from friends and activities
Eating alone out of fear of eating with others
Feelings of shame, guilt, and depression around eating and following binge episodes
Fluctuations in weight (weight gain and weight loss)
Hoarding food and/or empty wrappers in secret hiding places
Eating much more food then wanted
Binge eating disorder is the most common, yet most misunderstood eating disorder.
While other well-known eating disorders like anorexia and bulimia have been recognized in the DSM for decades, binge eating disorder was only recently added to the DSM-V in 2013. Due to weight stigma in society and in healthcare, there is a lack of research on binge eating disorder.
Because of this, clinicians are often unable to recognize binge eating disorder symptoms. Studies show that many healthcare providers hold strong negative attitudes and stereotypes about people in larger bodies. Doctors misattribute the symptoms of binge eating disorder to lack of motivation, laziness, and apathy towards one’s health. Additionally, many clinicians don’t recognize that anyone of any weight can struggle with binge eating disorder. In other words, you don’t have to be in a larger body to experience binge eating disorder, and people in larger bodies also experience anorexia and have never experienced binge eating.
You can’t tell if someone has binge eating disorder simply by looking at one’s physical appearance, despite what many health practitioners and people think. No one chooses to have an eating disorder. Eating disorders are recognized as serious psychiatric conditions that are responsible for more deaths per year than any other psychiatric condition.
Binge eating disorder, like anorexia and bulimia, do not discriminate! Anyone of any weight, age, gender, race, ethnicity, and socioeconomic status can experience binge eating and struggle with binge eating disorder.
What is type II diabetes?
Type II diabetes is known as “non-insulin dependent” diabetes. Unlike type I diabetes, type II does not require insulin for treatment because the body is still capable of producing functional insulin.
Type II diabetes can develop in two different ways:
Insulin resistance - Insulin is made by beta-cells in the pancreas in order to help regulate blood sugar levels. In cases of insulin resistance, the tissues in your body no longer respond to insulin, and blood glucose levels remain elevated.
Beta-cell dysfunction - As insulin becomes less effective and tissues are less responsive, beta-cells try to compensate by producing more and more insulin. Although this works for a short period of time, it’s not sustainable for the body and eventually, beta-cells become dysfunctional and can no longer produce insulin.
Normal physiology of insulin works as follows:
You eat food.
As you begin to metabolize your food, your blood glucose levels rise.
To help regulate your blood glucose levels, the pancreas has beta-cells that secrete a hormone known as “insulin”.
Insulin allows other organs like the heart, liver, and muscles to uptake glucose and use it for energy.
Glucose levels in the blood decrease.
Physiology of insulin resistance:
You eat food.
As you begin to metabolize your food, your blood glucose levels rise.
Beta-cells in the pancreas secrete insulin, but tissues become insulin resistant, and require more and more insulin to decrease blood glucose levels.
As the beta-cells in the pancreas overcompensate by secreting higher amounts of insulin, they become dysfunctional and eventually stop producing insulin.
The body becomes insulin resistant, and the levels of blood glucose remain elevated.
Does binge eating cause diabetes (specifically type II)?
There are many misconceptions and flawed theories about diabetes and how it begins, and many people incorrectly assume that binge eating causes diabetes. Research studies examining the relationship between binge eating and diabetes show conflicting results. Some studies show a higher prevalence of binge eating disorder in patients with type II diabetes, while other studies show that the relationship between type II diabetes is insignificant. The truth is there’s no direct causation showing that binge eating or binge eating disorder directly causes type II diabetes.
Why would insulin resistance have been a good thing to early humans and why does it get worse with dieting?
Insulin resistance is theorized to have been a great genetic adaptation to our ancestors and was crucial to their survival. Insulin resistance actually helped them live! Because food was less available than it is now, our ancestor’s bodies were often in periodic states of starvation (meaning they also had low blood sugar). Once they did eat, their bodies were able to slow down their metabolism and their cells became more and more insulin resistant. This allowed their bodies to hold onto glucose for longer and survive frequent periods of starvation and famine. Insulin resistance was a helpful genetic adaptation for many.
In today’s society, food is more readily available, and the majority of people have the privilege of obtaining food. The majority of people with that privilege don’t experience the same kinds of famine and periods of starvation that our ancestors did. That is, unless they are dieting.
When you diet or restrict certain foods or food groups, you are depriving your body of nutrition and sending it into “starvation mode”. Our bodies are incredibly smart, and they adapt accordingly by making insulin resistance worse not better. And how incredible that your body can sense you’re in a state of starvation and adapt your metabolism to keep you alive?!
Why is dieting not a good approach to prevent, treat, or manage type II diabetes?
One of the most common treatment options doctors give to their patients is “lifestyle management”, which tends to be code for dieting and weight loss. They tell their patients that in order to manage their diabetes, they need to “eat better” and we as dietitians at Bravespace Nutrition know that this advice can be really harmful.
This causes people to:
Dramatically change their eating and exercise behaviors
Reduce portion sizes
Eat less frequently
Strictly avoid certain vilified foods (like desserts, carbs, etc.)
Excessively exercise
Join expensive and highly restrictive diet programs (like Weight Watchers)
3 Reasons Why Dieting Isn’t The Cure To Diabetes:
Dieting is unsustainable.
Diets and food restriction aren't sustainable. Diabetes is a chronic condition, which requires lifelong changes. Diets also don’t work long term. The moment you stop dieting, you will gain weight back and thensome; develop disordered eating habits and feel out of control with food. When you’re unsuccessful in losing weight and treating your diabetes, you experience feelings of guilt, depression, shame, and embarrassment. A short-term solution like dieting cannot solve a long-term (but manageable!) condition like diabetes.
2. Dieting can cause low-blood sugar.
Culturally there is a overemphasis on high blood sugar levels and little focus on low blood sugar levels. Dieting and restriction can lead to low blood sugar levels, also known as hypoglycemia. Intense exercise, skipping meals, chaotic eating patterns, and gastroparesis, which are all behaviors associated with dieting and weight loss, are common culprits for hypoglycemia. This condition is dangerous for anyone, especially individuals with diabetes.
If the goal of diabetes management is to maintain consistent glucose levels, Doctors and other health professionals should not be prescribing dieting and weight loss (common culprits of low blood sugar) as the treatment.
3. Dieting leads to binge eating, which causes big changes in blood sugar.
Dieting causes you to enter the restrict-binge cycle, which repeats over and over again. The constant fluctuations of high and low food intake confuse the body. The continuous high and low levels of blood glucose caused by yo-yo dieting only exacerbate diabetic symptoms, are really hard on the body and tend to worsen diabetes, not make it better.
Dieting worsens insulin resistance, worsens binge eating, and worsens fluctuations in blood glucose levels. Taking all this into consideration, it doesn’t make sense to keep prescribing diets to people with diabetes, especially if they already binge eating disorder or are experiencing frequent binges. Society and healthcare needs to stop blaming every health issue on weight and body size. Having extra fat on your body doesn’t mean that you’re unhealthy, binge eating disorder doesn’t cause diabetes, and having diabetes doesn’t mean that you need to lose weight or go on a diet.
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Looking for treatment for binge eating or binge eating disorder while managing diabetes? Tired of being put on diets when you have diabetes only to find that you can’t follow them? Our dietitians can help you!
If you’ve been diagnosed with type II diabetes and have struggled with binge eating or binge eating disorder, we understand how difficult it can be to maintain a healthy relationship with food. You’re confused by doctor’s advice, wellness and diet culture, and your own thoughts about food. You want to manage your condition and live a healthy life, but you don’t know what that looks like without dieting. At Bravespace Nutrition in Seattle, WA, we understand your experience, and we want to help you regain control of your life. Our dietitians are trained eating disorder specialists, and are determined to help you live a life free from binge eating and dieting. To get started in your recovery journey, schedule a free 15-minute phone call today or contact us!