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J Eat Disord. 2019 Nov 1;7:35. doi: 10.1186/s40337-019-0266-y. eCollection 2019.

Associations between self-reported diabetes mellitus, disordered eating behaviours, weight/shape overvaluation, and health-related quality of life.

Author information

1
1Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
2
2Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia.
3
3Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW Australia.
4
4Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia.
5
5Adelaide Rural Clinical School, University of Adelaide, Adelaide, South Australia Australia.
6
6School of Psychology, University of Sydney, Camperdown, NSW Australia.
7
7Group of Obesity and Eating Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
8
8Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW Australia.

Abstract

Background:

Eating disorders (ED) and disordered eating behaviours (DEB) have been found to be common in people with diabetes mellitus (DM). However, findings have been inconsistent.

Objective:

This study investigated the association between self-reported diabetes (Type 1 or 2) with ED/DEB (binge eating, subjective binge eating or loss of control overeating, severe dieting and purging) weight/shape overvaluation, and health-related quality of life (HRQoL) in a household survey in South Australia.

Method:

In 2017 2977 people aged ≥15 years, who were representative of the general population, were interviewed. Participants reported their gender, age, household income, highest educational attainment, area of residence, presence of DM, ED/DEB, level of overvaluation, current HRQoL and height and weight. For the analyses between ED/DEB, self-reported DM and HRQoL, a grouping variable was created: 1) people without ED/DEB or self-reported DM; 2) people without ED/DEB and with self-reported DM; 3) people with ED/DEB and without self-reported DM; and 4) people with ED/DEB and self-reported DM. Analyses were stratified by sex and age group.

Results:

Subjective binge eating prevalence was higher in people with self-reported DM (6.6% vs 2.8%, p = 0.016), and overvaluation was lower in those with DM (36% vs 43.8%, p = 0.007). In analyses stratified by sex and age group, subjective binge eating was higher in women and in people over 45 years with self-reported DM and overvaluation was lower in men and in people over 45 years with self-reported DM. However, these differences were not significant on tests of gender and age interaction. People in both DM groups scored significantly lower than people without DM groups on physical HRQoL. In contrast, people in both ED/DEB groups scored lower than people without ED/BEB on mental HRQoL.

Conclusion:

People with self-reported DM had a higher prevalence of subjective binge eating, a lower prevalence of overvaluation and there were no significant effects of age or gender. Furthermore, participants with self-reported DM and comorbid ED or DEB had impairments of both mental and physical HRQoL. Assessing an individual's sense of control over eating along with other DEB is likely important for identification of these mental health problems.

KEYWORDS:

Diabetes mellitus; Disordered eating behaviors; Epidemiology; Health-related quality of life; Weight/shape overvaluation

Conflict of interest statement

Competing interestsDr. Deborah Mitchison is member of the executive board of the Australian and New Zealand Academy for Eating Disorders (2017-) and has received research grants from the NHMRC. Professor Jose Carlos Appolinario receives/has received research grants, consultancy fees, and advisory board fees from Shire Pharmaceuticals. He has prepared also an Educational Material about Binge Eating Disorder for Shire Pharmaceuticals. He receives/has received royalties/honoraria from Artmed Panamericana Editora. He also received a research grant from the Brazilian National Research Council (CNPq). Professor Gloria Valeria da Veiga received a research grant from the Brazilian National Research Council (CNPq) and Foundation Carlos Chagas Filho for Research Support of the State of Rio de Janeiro (FAPERJ). Professor Stephen Touyz receives royalties/honoraria from Hogrefe and Huber, McGraw Hill Educational and Biomed Central and has received research grant funding from the NHMRC, ARC and Shire Pharmaceuticals. He has also received an honorarium from Sheppard Pratt. He is the Chair of the Shire BED Australian Advisory Committee on Binge Eating Disorder and has received honoraria/ consulting fees and travel grant funding as well. He is a mental health adviser to the Commonwealth Department of Veteran Affairs. Professor Phillipa Hay receives/has received sessional fees and lecture fees from the Australian Medical Council, Therapeutic Guidelines publication, and New South Wales Institute of Psychiatry and royalties/honoraria from Hogrefe and Huber, McGraw Hill Education, and Blackwell Scientific Publications, Biomed Central and Plos Medicine and she has received research grants from the NHMRC and ARC. She is Chair of the National Eating Disorders Collaboration Steering Committee in Australia (2019-) and was Member of the ICD-11 Working Group for Eating Disorders (2012–2018) and was Chair Clinical Practice Guidelines Project Working Group (Eating Disorders) of RANZCP (2012–2015). She has prepared a report under contract for Shire Pharmaceuticals in regards to Binge Eating Disorder (BED; July 2017) and Honoria for training Psychiatrist in BED assessment. The other authors declare that they have no competing interest.

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