Prevalence and associated factors of eating disorders in adults with type 2 diabetes: a systematic review

People with type 2 diabetes (T2DM) have a higher risk of eating disorders, specifically binge eating disorders (BED) and night eating syndrome (NES) which may affect the diabetes management and long-term outcomes of T2DM. There is limited evidence to determine the prevalence and associated factors of this condition for targeted interventions. Our study aimed to systematically synthesise existing evidence exploring the prevalence of eating disorders and associated factors among adults with T2DM.

This review was pre-registered with PROSPERO (CRD42024587276). A systematic review was undertaken searching Embase, Medline, PsycINFO, Cochrane Central database. The National Institutes of Health Quality Assessment tool for Observational Cohort and Cross-Sectional Studies was used to evaluate the quality of eligible studies. Given the insufficient number of studies assessing the targeted outcomes, a meta-analysis was not attempted. A narrative synthesis was conducted.

Twelve studies were included with cross-sectional studies. BED and NES were the two most common eating disorders in people with T2DM. Point prevalence was 2.5-29.6% for BED and 1.6-8.4% for NES. No data were available on the prevalence of bulimia and anorexia nervosa. Having eating disorders in T2DM was associated with a low level of psychological well-being, greater depression, anxiety symptoms, and high levels of BMI and HbA1c.

There are psychological, physical and social factors associated with to high prevalence of eating disorders in T2DM. The current literature on eating disorders in T2DM is relatively limited, with few studies applying rigorous methods. Further studies are needed for large, high-quality studies that focus on the management, diagnosis, physical and psychosocial effects, and long-term outcomes of eating disorders in adults with T2DM.