man is measuring the level of glucose in the bloodDid you know there’s a strong correlation between binge eating disorder (BED) and type 2 diabetes (T2DM)? In fact, studies estimate that 12 percent of patients with T2DM also suffer from BED. Given binge eating disorder impacts 2-3.5% of US adults, and 9.3% of the American population has diabetes, it’s a dual diagnosis affecting millions of people in the United States.

Addressing both at the same time can certainly be a tricky, as treatment goals between the two often clash. Efforts to improve diabetes outcomes frequently point to a weight-focused treatment approach where weight loss and dietary change, with an emphasis on reducing carbohydrate and sugar intake, is a primary focus. Many treatment facilities encourage clients with Binge Eating Disorder to expose themselves to “trigger” foods, which often include carbohydrates and sugars in order to show that all foods can be appropriate when included in a balanced diet as directed by a professional, and that with practice and guidance, show that eating these “trigger” foods does not need to result in a binge.

So how can you strike the right balance? Here are five ideas to reduce binge-eating behaviors and improve your blood sugar control at the same time:

1). Eat an adequate amount throughout the day: It’s really hard to reduce binge behaviors or challenge urges when you’re also hungry at the same time. Eating meals and snacks throughout the day (including an adequate and appropriate amount of carbohydrates at each eating opportunity) can help improve blood glucose management and eliminate high blood sugar excursions following a binge. For example, one patient I worked with had the goal of eating “perfect” no- or low-carbohydrate breakfasts and lunches, skipped snacks, but would then binge on 400-500 grams of carbohydrate in the evening. Evening out intake throughout the day and increasing meal sizes to satisfy hunger helped her reduce binges later in the day.

2). Bring binges into the light: There is often a sense of embarrassment over binge episodes, which can make it difficult to talk about the experience or what it was like. Patients with diabetes have said it’s easier to ignore a binge if they don’t test blood sugar levels or otherwise avoid self-care afterwards. This can make managing diabetes more difficult. Finding a treatment team you trust and whom you feel safe sharing binge-eating behaviors with, can help reduce feelings of guilt or shame and improve diabetes self-care around behaviors that were previously kept secret.

3). Get curious: Your individual blood glucose response to specific foods or timing of meals and snacks is worth tracking and exploring. Instead of falling back on lists of “good” and “bad” foods (which can exacerbate the black-and-white thinking often seen in eating disorders), take note of what your blood sugar is doing after you eat. For example, one of my clients felt a lot of guilt around wanting cookies for dessert but didn’t feel strongly one way or the other about having Fig Newtons for a snack. When we specifically tracked her blood glucose patterns after meals and snacks, she found that her blood sugar was higher after a snack of Fig Newtons versus the cookies. Because the snack was just a “meh” choice for her, she switched to something that was more appetizing but had a smaller impact on her diabetes management. In the end, she approached her cookies with a bit more forgiveness.

4). Round out any gaps in nutrition education: Binge eating disorder intensive outpatient programs often include a component of nutrition education specific to BED recovery. Work with your dietitian to explore the nutrition advice you received in the past, and how you can integrate BED recovery into your diabetes care routine. Learning about carbohydrates, portion sizes, meal and menu planning, hunger and fullness and mindful and intuitive eating can all be helpful tools to learn and practice.

5). Seek ongoing support: Recovery from an eating disorder isn’t always a linear process, and diabetes is a condition that can change over time. Reaching out to your treatment team when you have a setback or need extra support, and working with diabetes care providers who understand both conditions, can help you achieve success with both binge eating recovery and diabetes management in the long run.

Are you impacted by diabetes and binge eating disorder (or another eating disorder like anorexia or bulimia)? We’re here to help.