Negative Affect, Diabetes Distress Increase Risk for Binge Eating in Type 1 Diabetes

Individuals who tend to experience negative affect and diabetes distress before eating are at increased risk for objective binge eating at an upcoming meal.

Adults with type 1 diabetes (T1D) who experience negative affect and diabetes distress before eating are at increased risk for objective binge eating (OBE), which may lead to elevated postprandial blood glucose levels, according to research published in the Journal of Eating Disorders.

Investigators recruited 83 adults (aged 18-65 years) with T1D from 2 medical centers in the Southeast United States. Over the course of 3 days, participants received randomly generated telephone calls (1-2 times/h between the hours of 8 AM and 10 PM) asking them to use a scale from 1 to 6 (1 = not at all, 6 = very much) to rate their current emotions and how upset they felt about their diabetes or diabetes management. Participants also reported meals or snacks immediately after eating and answered questions about how much food they ate and whether they experienced a loss of control overeating. Participants wore continuous glucose monitors to assess ongoing glycemic control.

On average, participants responded to 96% of the random prompts and reported 4 eating episodes per day. Of the total eating episodes, 8% were characterized as OBE, and 43% of participants reported at least one OBE episode during the 3-day assessment.

Between-person analyses were significant for negative affect (odds ratio, 1.93; P =.02), indicating a 93% increased risk for OBE among individuals with higher negative affect than those with average negative affect. There were also significant between-person effects for guilt, frustration, and diabetes distress (odds ratio, 1.48-1.77; P <.05 for all).

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Additional analyses revealed that mean change in postmeal negative affect was significantly greater for OBE compared with non-OBE episodes (β, 0.44; P <.001). Blood glucose at 120 minutes postprandial was also higher for OBE than for non-OBE episodes (P =.03).

“These findings add to a growing literature suggesting diabetes distress is related to eating disordered behaviors among individuals with T1D,” investigators wrote.

“Overall, [the] results highlight the importance of helping individuals with [T1D] develop skills to cope with emotional distress in order to manage diabetes and achieve optimal glycemic control,” they concluded.

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Moskovich AA, Dmitrieva NO, Babyak MA, et al. Real-time predictors and consequences of binge eating among adults with type 1 diabetes. J Eat Disord. 2019;7:7.

This article originally appeared on Psychiatry Advisor