Eating attitudes in young females with diabetes: insulin omission identifies a vulnerable subgroup.

Eating attitudes were investigated in young females with diabetes (YFDs) and healthy age-matched female controls. Results from the Eating Disorder Inventory confirmed that YFDs had higher scores for drive for thinness, body dissatisfaction and bulimia. In addition, YFDs who omitted insulin injections had high scores for ineffectiveness and interoceptive awareness and had increased sensitivity to external eating cues (as measured by the Dutch Eating Behaviour Questionnaire). It is suggested that dieting and weight gain associated with diabetes treatment precipitate a deterioration in eating attitudes. Furthermore, omission of insulin and increased sensitivity to external eating cues serve as markers for a group of YFDs who are at increased risk of developing an eating disorder. The present results provide support for the spiral model of eating disorders (Heatherton & Polivy, 1992) and its emphasis on the importance of self-esteem and self-awareness.