Type 1 Diabetes & Eating Disorders: Why We Need to Talk About the Overlap

In this blog, lived experience advocate Sarah discusses the complexities of managing Type 1 Diabetes when you have lived experience of an eating disorder.

My Type 1 Diabetes (T1D) Diagnosis

When I was diagnosed with T1D at 26 years old, my relationship with food was already complicated. Since 13 years old, I’ve struggled with disordered eating, and have lived experience of anorexia, bulimia and binge eating behaviours. Each experience has forever shaped the way I view myself, my body, and my worth.

My Type 1 Diabetes diagnosis arrived suddenly – after being sick for 6 months, I finally had answers, but it wasn’t what I was expecting.

Overnight, Type 1 Diabetes added numbers, alarms and life-threatening consequences to a part of my life that was already emotionally charged – my relationship with food, my body and exercise.

While T1D didn’t cause my eating disorders, it did make my existing struggles even more challenging. It brought pressures I didn’t yet have the tools to manage and it made recovery more complex, because managing diabetes involves constant decisions around food – decisions that often can’t wait. For someone with a history of eating disorders, it felt like I was walking through life with someone else in control, which took me back to the years I spent in and out of eating disorder recovery. 

In sharing my experience via this blog, my hope is that someone else navigating this intersection – a place where two invisible illnesses collide – feels less alone, and learns that you can live a strong, happy, life despite the struggle of eating disorders and Type 1 Diabetes.

Type 1 Diabetes and the Relationship with Food

Living with T1D means thinking about food constantly. It’s no longer just about hunger or preference – it’s about safety. Every meal involves counting carbohydrates, estimating insulin, predicting movement, and monitoring blood glucose – there are near to no moments of peace.

This level of monitoring and tracking further intensified the disordered eating patterns I had already struggled with – so while these restricting and tracking behaviours once gave me a sense of control, they now brought about a sense of fear.

Eating felt high stakes – the numbers on my blood glucose monitor felt like judgements, and the introduction of insulin injections made me anxious about changes in my body. 

The worry of experiencing a hypo created moments of overwhelming urgency, and the constant mental calculations made it difficult to listen to my own hunger cues – because diabetes often requires listening to the data instead.

Living with T1D means there are times where food isn’t food – it’s math, pressure, or fear. And that can be a very difficult place for someone to sit in every day. The enjoyment of food can be taken away, because it has become something you actively have to monitor as if your life depends on it… because it kind of does. 

The Challenges of Managing T1D and Eating Disorders

The hardest part isn’t always the practical management – it’s the internal conflict. I often felt pulled between what my eating disorder wanted, what my diabetes needed, and what my recovery asked of me.

Eating disorders can heighten disordered thoughts and behaviours, which is hard enough on its own, let alone living with a condition that requires constant focus on food – it feels contradictory and uncomfortable. 

Some of the challenges can include:

• Changes in weight or insulin needs.
• High blood glucose levels, which sometimes cause feelings of shame, even though you’re not at fault.
• Hypo-driven eating, which can feel chaotic and out of control.
• The necessity of regular meals and carbohydrates, which can clash with rigid rules from my eating disorders.
• Fluctuating body image, influenced by hormones, stress and normal diabetes-related changes.
  

Rebuilding trust in my body, while managing a condition that constantly requires monitoring was exhausting. Recovery wasn’t linear – I made mistakes, I had setbacks, and I had to learn to meet myself with patience rather than perfection.

Support from Healthcare Professionals

My experience with healthcare professionals has varied. Some understand the unique challenges of living with T1D and an eating disorder history, and their compassion makes all the difference. Others focus heavily on numbers – blood glucose, insulin units, weight – without recognising how intertwined those numbers are with my mental health.

Based on my own experience, if I could advise healthcare providers on the most helpful ways to support and treat someone with Type 1 Diabetes and an eating disorder, I would say:

• Ask about the person’s emotional relationship with diabetes, don’t just rely on the physical results to tell the whole story.
• Understand that eating disorders can present differently in people with Type 1 Diabetes.
• Avoid using shaming language around numbers or food.
• Encourage flexibility instead of rigidity.
• Empower the person to understand that insulin is a life-saving hormone, not something to fear.
• Supported the person to rebuild trust in their body.

A healthcare team that sees the whole person – not just the diagnosis – creates the safest space for healing.

What I Want Others to Know

If you live with T1D and an eating disorder, or love someone who does, here’s what I want to offer:

1. You’re not weak for finding this hard: Managing one condition is challenging enough – managing two that constantly interact requires enormous strength.
2. You deserve support from people who understand your experience: Eating disorders in T1D are real, serious and under-recognised – seeking help is an act of courage, not failure
3. Your numbers do not define you: Blood glucose fluctuates for many reasons outside of your control – it is data, not a measure of your worth
4. Insulin is your ally: It keeps you alive – developing a positive understanding and perception of your medication  takes time, but it is possible.
5. Eating disorder recovery and diabetes management can coexist: It won’t always feel smooth or simple, but both can be honoured – both matter, and both are possible.

Resilience, Healing and Self-Compassion

Resilience, for me, used to mean pushing through everything. Now, it means continuing gently on the days that feel overwhelming. Healing has never been linear for me, but it has always been worth it.

Self-compassion is what holds everything together – it’s the reminder that you’re doing your best, you’re allowed to rest, and there really is no ‘perfect’ in all of this.

Living with T1D and experiencing an eating disorder requires softness, patience, and a deep understanding that you are human – you deserve care, not criticism.

If you’re walking a similar path, please know that you are not alone. The intersection of Type 1 Diabetes and eating disorders is complex, exhausting and often invisible. But with patience, care and self-compassion, you can rebuild trust in your body, and live a fulfilling and peaceful life with Type 1 Diabetes.

 

About the Author

Sarah Loftus @smollsarahl is a writer, speaker and advocate living with Type 1 Diabetes. Using her lived experience of eating disorders and chronic illness – combined with a background in Public Health – Sarah aims to encourage real conversations about resilience, healing and self-compassion. Sarah is passionate about helping others feel less alone, more understood, and supported on their own journeys. She also runs a podcast called Sunday Sofa Series, where she talks further about her experiences of mental health, recovery, and Type 1 Diabetes.

Get Support

No matter how the eating disorder developed, recovery is possible, and Butterfly is here to help. For confidential and free counselling, call the Butterfly National Helpline on 1800 ED HOPE (1800 33 4673) or chat online or email, 7 days a week, 8am-midnight (AEDT).

Find an eating disorder professional – search Butterfly’s National Referral Database to find eating disorder practitioners closest to you.

For information and support around navigating diabetes, visit Diabetes Australia or talk to your local GP.

Resources

Read Butterfly’s Submission to the House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into Diabetes, where we provided an overview on eating disorders and body image concerns, research on the relationship between eating disorders and diabetes, and shared feedback from our lived experience network.

We also appreciate that going to a medical appointment can be stressful, especially when there’s certain topics you do and don’t want to discuss. We suggest using our Kindly Do, Kindly Don’t support script, to support you in advocating for yourself during the appointment.

Listen to this Let’s Talk podcast episode, about navigating eating disorders and co-occurring health conditions, such as diabetes, endometriosis, and coeliac disease.