About one-third of people with type 1 diabetes struggle with disordered eating behaviors, according to Gram Research analysis of a 2026 Spanish study of 451 adults. Women are more than twice as likely as men to experience these problems, and 37% of participants admitted to restricting insulin to control their weight—a dangerous practice. The research shows that poor blood sugar control, higher weight, low-quality diets, and poor sleep are all independently linked to eating problems, highlighting the need for doctors to screen for and treat these issues alongside diabetes care.
A new study from Spain looked at eating problems in people with type 1 diabetes and found that about one-third of them struggle with disordered eating behaviors. The research involved 451 adults and discovered that women are more likely to have these problems than men. The study also found that people with worse blood sugar control, higher weight, poor sleep, and low-quality diets are more likely to develop eating issues. These findings suggest that doctors should screen for eating problems in all diabetes patients and provide mental health support alongside diabetes care.
Key Statistics
A 2026 cross-sectional study of 451 Spanish adults with type 1 diabetes found that 31.7% screened positive for disordered eating behaviors, with women affected at more than twice the rate of men (35.4% versus 14.8%).
According to the D1ANAS project study published in 2026, 36.6% of people with type 1 diabetes reported restricting insulin doses to control their weight, a dangerous behavior that can lead to serious complications.
Research from a 2026 Spanish study of 451 type 1 diabetes patients showed that poor diet quality was the strongest independent predictor of eating problems, with a 13.42-point increase in eating disorder screening scores.
A 2026 study of 451 adults with type 1 diabetes found that higher body weight (BMI) was independently associated with eating problems, increasing eating disorder screening scores by 3.44 points even after accounting for blood sugar control.
The Quick Take
- What they studied: How common are eating problems in adults with type 1 diabetes, and what factors make them more likely to happen?
- Who participated: 451 Spanish adults aged 16 and older who have type 1 diabetes. The group included both men and women from across the country.
- Key finding: About 32% of people with type 1 diabetes screened positive for disordered eating behaviors, with women affected more than twice as often as men (35.4% vs 14.8%). Additionally, 37% of participants admitted to restricting insulin to control their weight.
- What it means for you: If you have type 1 diabetes, especially if you’re a woman, you should talk to your doctor about eating habits and mental health. Doctors should routinely ask about eating concerns because these behaviors can make blood sugar control harder and affect overall health.
The Research Details
Researchers conducted a cross-sectional study, which is like taking a snapshot of a group at one moment in time. They recruited 451 adults with type 1 diabetes across Spain and asked them to complete online questionnaires about their eating behaviors, health, lifestyle, and personal information. To measure eating problems, they used a validated tool called the Diabetes Eating Problems Survey-Revised (DEPS-R), which is specifically designed for people with diabetes. A score of 20 or higher on this tool indicates disordered eating behaviors.
The researchers collected information about many factors that might influence eating behaviors, including age, sex, how long someone has had diabetes, their current blood sugar control (measured by HbA1c), their weight status, diet quality, sleep patterns, and how they perceive their overall health. They then used statistical analysis to identify which factors were most strongly connected to eating problems, while accounting for the influence of other variables.
This approach is important because it helps identify patterns and risk factors in a real-world population rather than in a controlled laboratory setting. By studying people in their natural environment, the researchers could understand how diabetes management, lifestyle, and mental health factors interact to influence eating behaviors. This information helps doctors know who to screen for eating problems and what warning signs to watch for.
The study used a validated, diabetes-specific screening tool rather than a generic eating disorder assessment, which is more appropriate for this population. The researchers collected data from a nationwide sample across Spain, making the results more representative than a single-center study. However, because this is a cross-sectional study, it shows associations between factors and eating problems but cannot prove that one causes the other. The online questionnaire format may have introduced bias if certain people were more or less likely to participate. The study explains about 30% of the variation in eating problem scores, meaning other unmeasured factors also play a role.
What the Results Show
The study found that disordered eating behaviors are common in people with type 1 diabetes, affecting nearly one-third of the 451 participants. Women were significantly more affected than men, with 35.4% of women screening positive compared to only 14.8% of men. This two-fold difference suggests that sex-specific factors—possibly related to body image concerns, societal pressures, or how women experience diabetes management—play an important role.
One particularly striking finding was that 36.6% of all participants reported restricting their insulin doses to control their weight. This is a dangerous behavior because insulin is essential for managing blood sugar, and skipping doses can lead to serious complications like diabetic ketoacidosis, nerve damage, and kidney problems. The fact that more than one-third of the sample engaged in this risky behavior highlights how the demands of diabetes management can push people toward unhealthy eating and medication practices.
When researchers looked at what factors were most strongly connected to eating problems, several key patterns emerged. People with higher blood sugar levels (measured by HbA1c), higher body weight, poorer diet quality, worse sleep, and lower perceived health all showed stronger signs of disordered eating. Importantly, these associations remained significant even after accounting for other factors, suggesting they are independent risk factors.
The study found that perceived health status was one of the strongest predictors of eating problems. People who felt their health was poor had significantly higher eating problem scores. Sleep quality also mattered—those with poor sleep perception showed higher rates of disordered eating. Diet quality was another strong factor; people eating lower-quality diets had much higher eating problem scores. These findings suggest that eating problems don’t exist in isolation but are connected to overall lifestyle and well-being. The research also showed that body weight (measured as BMI) was independently associated with eating problems, even after accounting for blood sugar control, suggesting that weight concerns may drive some of the disordered eating behaviors.
This research aligns with existing studies showing that people with type 1 diabetes have higher rates of eating disorders than the general population. Previous research has identified insulin restriction as a unique concern in type 1 diabetes, and this study confirms that finding. The higher prevalence in women is consistent with both general eating disorder research and previous diabetes-specific studies. However, this is one of the first studies to comprehensively examine multiple lifestyle and psychosocial factors together in a large Spanish population, providing new insights into how these factors interact.
Because this study took a snapshot at one point in time, it cannot determine whether eating problems cause poor blood sugar control or whether poor blood sugar control leads to eating problems—likely both happen. The study relied on self-reported information, which means people might not have answered completely honestly about sensitive topics like eating behaviors or insulin restriction. The online questionnaire format may have excluded people without internet access or those less comfortable with technology. The study was conducted in Spain, so results may not apply equally to other countries with different healthcare systems or cultural attitudes toward food and body image. Finally, the study explains only about 30% of the variation in eating problem scores, meaning many other factors not measured here also play a role.
The Bottom Line
Healthcare providers should routinely screen all people with type 1 diabetes for eating problems and disordered eating behaviors, with special attention to women and those with poor blood sugar control. When eating problems are identified, patients should receive support from a multidisciplinary team including diabetes educators, mental health professionals, and registered dietitians who understand diabetes-specific eating concerns. Patients should never restrict insulin to control weight, as this is dangerous and can cause serious complications. Instead, they should work with their healthcare team on safe approaches to weight management that don’t compromise diabetes control. (Confidence level: High—based on strong associations found in this study)
This research is most relevant to people with type 1 diabetes, their families, and healthcare providers who care for them. Women with type 1 diabetes should be especially aware of these findings. Healthcare systems should use these findings to develop better screening and support programs. People with type 1 diabetes who struggle with eating, body image, or are considering insulin restriction should definitely discuss these concerns with their doctor.
Changes in eating behaviors and mental health support typically show benefits over weeks to months. Improvements in blood sugar control may take 2-3 months to become apparent. Long-term benefits of addressing eating problems include better diabetes management, fewer complications, and improved quality of life, but these develop over years of consistent healthy behaviors.
Frequently Asked Questions
Why do people with type 1 diabetes have more eating problems than other people?
Type 1 diabetes management requires constant attention to food, carbohydrates, and insulin timing, which can create an unhealthy relationship with eating. Additionally, some people restrict insulin to control weight, and poor blood sugar control itself is linked to eating problems. The daily burden of diabetes management increases vulnerability to disordered eating.
Is insulin restriction common in type 1 diabetes?
Yes, according to a 2026 study of 451 Spanish adults, 36.6% reported restricting insulin to control their weight. This is a diabetes-specific eating disorder behavior that’s dangerous because it prevents proper blood sugar management and can cause serious complications like diabetic ketoacidosis and organ damage.
What should I do if I’m restricting insulin or struggling with eating and diabetes?
Talk to your doctor immediately. Never stop or reduce insulin without medical supervision, as this is dangerous. Ask for a referral to a mental health professional and registered dietitian who specialize in diabetes. Your healthcare team can help you manage both your diabetes and eating concerns safely.
Are women more likely to have eating problems with type 1 diabetes?
Yes, a 2026 study found that 35.4% of women with type 1 diabetes screened positive for eating problems compared to 14.8% of men. Women should be especially aware of these risks and discuss eating and body image concerns with their healthcare provider.
Can improving sleep and diet quality help with eating problems in diabetes?
Research suggests both poor sleep and low-quality diets are independently linked to eating problems in type 1 diabetes. Improving these factors, along with mental health support and diabetes education, may help reduce disordered eating behaviors and improve overall diabetes management.
Want to Apply This Research?
- Track daily insulin doses taken as prescribed, meals eaten, and a simple mood/stress rating (1-10 scale). This helps identify patterns between emotional stress, eating behaviors, and insulin management.
- Set a daily reminder to eat a balanced meal with protein, vegetables, and whole grains. Use the app to log meals without judgment and share weekly summaries with your healthcare team to identify patterns and get support.
- Weekly check-ins on eating satisfaction (not restriction), insulin adherence, and overall well-being. Monthly reviews with your healthcare provider using app data to adjust diabetes management and mental health support as needed.
This research describes associations between eating problems and various factors in people with type 1 diabetes but does not establish cause-and-effect relationships. If you have type 1 diabetes and are struggling with eating behaviors, insulin restriction, or body image concerns, please consult with your healthcare provider, endocrinologist, or a mental health professional who specializes in diabetes. Never change your insulin regimen without medical supervision. This article is for educational purposes and should not replace professional medical advice. If you are experiencing an eating disorder, contact the National Eating Disorders Association (NEDA) helpline at 1-800-931-2237 or visit their website for support.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.