The Association between Psychological Distress and Disordered Eating Behavior in Young People with Type 1 Diabetes: A Systematic Review

Abstract Context Young people with type 1 diabetes mellitus experience unique challenges, including physical and psychological changes, altered nutritional needs, and the risk of weight fluctuations. Psychological distress, a frequently overlooked factor in routine clinical practice, is a key variable, as it may be both a consequence of and a contributing factor to difficulties with dietary-insulin treatment in this population. It could contribute to the development of disturbed eating behaviors and more severe mental health conditions, such as eating disorders. Objective The aim of the present systematic review was to study the relationship between the presence of psychological distress and disturbed eating behaviors in young people with type 1 diabetes mellitus. Data Sources A systematic search was performed in the PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library databases for articles meeting the inclusion criteria as at October 2024. Data Extraction Ten observational studies analysing the relationship between psychological distress and disordered eating behavior were included. Risk of bias was assessed using the STROBE and the Newcastle–Ottawa checklists. Data Analysis Initially, 366 articles were identified. Of these, 10 articles were eligible for the review (2420 participants). Psychological distress was found to have a robust association with disturbed eating behaviors in all studies. Most of them found a strong association between these 2 variables and HbA1c and that women had higher levels of psychological distress and more disordered eating behaviors compared with men. Conclusion Psychological distress may contribute to the onset and persistence of disordered eating behaviors and eating disorders in this population. This finding underscores the importance of a comprehensive approach to type 1 diabetes mellitus clinical management, and the need for addressing both psychological and behavioral factors. Early identification and intervention for psychological distress and disordered eating behaviors can positively impact HbA1c and the overall well-being of these patients, particularly women.