Binge eating symptoms linked to earlier type 2 diabetes diagnosis

A Danish study has found probable binge eating disorder in 2.9% of adults with type 2 diabetes, with symptoms associated with younger diagnosis, obesity, female sex and lower well-being.

A new Danish study in Diabetic Medicine suggests binge eating symptoms are present in a small but clinically important share of adults with type 2 diabetes, and that the pattern is linked to younger age at diagnosis, obesity, female sex and lower reported well-being. The research, led by Pernille Fiil Nybo at the University of Southern Denmark, screened 2,459 adults from the Region of Southern Denmark and found that 2.9% met criteria for probable binge eating disorder, while a further 3.1% reported subclinical symptoms.

The findings add fresh data to an area that has drawn growing attention in Denmark in recent years. Earlier commentary in the Danish Medical Journal said binge eating disorder had only recently been recognised as a distinct diagnosis in the country and that the prevalence of the condition among people with type 2 diabetes remained uncertain. Another Danish review in Ugeskriftet argued that binge eating may be far more common in diabetes clinics than many clinicians recognise, though the new cohort study points to a lower rate when a large sample is screened with a structured questionnaire.

Participants with probable binge eating disorder were typically diagnosed with diabetes earlier in life than those without symptoms, with a median age at diagnosis of 51.8 years compared with 59.5 years. The study also found a strong association with body mass index: compared with people with a BMI below 25, the prevalence of binge eating symptoms was markedly higher in every heavier weight category and highest among those with a BMI of 35 or above. Women were more likely than men to screen positive, and people who reported poor well-being on the World Health Organisation’s five-item index were also at increased risk.

The researchers did not find a clear link with HbA1c, the measure of long-term blood glucose control often used to assess diabetes management, but they did see an association with higher diastolic blood pressure and greater use of GLP-1 medicines, a class of drugs increasingly prescribed for type 2 diabetes and obesity. That may reflect treatment patterns in people with more complex metabolic disease rather than any direct effect, and the cross-sectional design means the study cannot show whether binge eating led to diabetes or followed it.

Even so, the authors said the results support paying closer attention to eating behaviour in routine diabetes care, especially in women, people with obesity, those reporting low well-being and those diagnosed at a relatively young age. A systematic review published earlier this year in Diabetic Medicine found only limited evidence for treatments specifically targeting binge eating disorder in adults with type 2 diabetes, underlining how little guidance exists for clinicians despite the growing recognition of the problem.