Dr Ann Goebel-Fabbri on the Challenges of Treating Concurrent T1D, Eating Disorders

Ann Goebel-Fabbri, PhD, a clinical psychologist in Boston, Massachusettes, discusses how limited research on patients with type 1 diabetes (T1D) and eating disorders hinders progress on developing effective interventions.

Research looking at specific treatments for eating disorders and type 1 diabetes is in very early stages, said Ann Goebel-Fabbri, PhD, a clinical psychologist practicing in Boston, Massachusettes.

Transcript

What challenges do patients with type 1 diabetes and eating disorders face?

What's been studied the most at this point, in terms of eating disorders and diabetes, is a very specific symptom that only people with type 1 diabetes can actually have. Namely, people who intentionally take less insulin than their body actually needs for the purposes of running their glucose levels high and intentionally purging calories in that way. You can imagine this is a very dangerous behavior that actually comes with a tremendous amount of medical complications happening at an earlier age and also at a shorter duration of diabetes than we would expect. In a sense, if you think about it, people who are experiencing this symptom are turning the clock back to before we had these high-tech, health and life-sparing technologies and treatments for type 1 diabetes.

What are some effective and practical approaches for treating these concurrent conditions, and what are some limitations to these approaches?

The limitations are that we really don't know. That's the problem. The research is just out of the very, very early stages in terms of looking at specific treatments for eating disorders and type 1 diabetes. There's some early pilot data that shows that women with type 1 diabetes seem to drop out of treatment more often than women without diabetes and that they have worse treatment outcomes as well. The question that that raises for me is, is that because these women are in some sort of standard eating disorder treatment that hasn't perhaps been tailored to the specific needs of patients with T1D? That level of intervention is what's just starting to be looked at in terms of how to best design such a thing and how to then go about evaluating it.