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Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study

BMJ 2000; 320 doi: (Published 10 June 2000) Cite this as: BMJ 2000;320:1563
  1. Jennifer M Jones, research fellowa,
  2. Margaret L Lawson, headb,
  3. Denis Daneman, chiefc,
  4. Marion P Olmsted, directord,
  5. Gary Rodin, psychiatrist in chief (gary.rodin{at}
  1. a Department of Psychiatry, University Health Network, Toronto, Ontario, Canada M5G 2CA
  2. b Division of Endocrinology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada K1H 8LI
  3. c Division of Endocrinology, Hospital for Sick Children, Toronto, Ontario, Canada M5G 2CA
  4. d Ambulatory Care for Eating Disorders, University Health Network
  5. e Department of Psychiatry, University Health Network
  1. Correspondence to: G Rodin
  • Accepted 24 February 2000


Objective: determine the prevalence of eating disorders in adolescent females with type 1 diabetes mellitus compared with that in their non-diabetic peers.

Design: Cross sectional case-control led study.

Setting: Diabetes clinics and schools in three Canadian cities.

Subjects: 356 females aged 12-19 with type 1 diabetes and 1098 age matched non-diabetic controls.

Main outcome measure: Eating disorders meeting Diagnostic and Statistical Manual of Mental Disorders(DSM-IV) criteria.

Results: Eating disorders that met DSM-IV criteria were more prevalent in diabetic subjects (36, 10%) than in non-diabetic controls (49, 4%) (odds ratio 2.4, 95% confidence interval 1.5 to 3.7; P<0.001). Subthreshold eating disorders were also more common in those with diabetes (49, 14%) than in controls (84, 8%) (odds ratio 1.9, 95% confidence interval 1.3 to 2.8; P<0.001). Mean haemoglobin A1cconcentration was higher in diabetic subjects with an eating disorder (9.4% (1.8)) than in those without (8.6% (1.6)), P=0.04).

Conclusions: DSM-IV and subthreshold eating disorders are almost twice as common in adolescent females with type 1 diabetes as in their non-diabetic peers. In diabetic subjects, eating disorders are associated with insulin omission for weight loss and impaired metabolic control.


  • Funding Medical Research Council of Canada (MA-12855), Children's Hospital of Eastern Ontario Research Institute (96/15S(E)), Genesis Foundation, and Toronto Hospital Psychiatry Research Fund.

  • Competing interests None declared.

  • Embedded Image The diagnostic criteria used for eating disorders are given on the BMJ's website

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