Disordered eating and insulin restriction in type 1 diabetes: A systematic review and testable model

Eat Disord. 2018 Jul-Aug;26(4):343-360. doi: 10.1080/10640266.2017.1405651. Epub 2017 Nov 28.


Aim: To provide an overview of the existing literature pertaining to insulin restriction as a disordered eating behaviour in individuals with type 1 diabetes and present a novel maintenance model: The Transdiagnostic Model of Disordered Eating in Type 1 Diabetes.

Method: A systematic review was conducted of the current literature relevant to insulin restriction and/or omission in the context of disordered eating in type 1 diabetes. A new maintenance model was then developed by incorporating diabetes-specific factors into existing eating disorder models.

Results: Type 1 diabetes may complicate the development and maintenance of disordered eating behaviour. Diabetes-specific circumstances, including disease diagnosis, insulin management, insulin restriction, and diabetes-related complications, contribute to the maintenance of disordered eating cognitions and behaviours.

Discussion: The proposed model offers a comprehensive representation of insulin restriction as a disordered eating behaviour in type 1 diabetes. Future research should test the model to further understand the mechanisms underlying disordered eating in type 1 diabetes and inform treatments for this at-risk population.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Diabetes Complications / prevention & control
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Feeding and Eating Disorders / complications*
  • Humans
  • Insulin / therapeutic use*


  • Insulin