Understanding disordered eating in individuals with type 2 diabetes: A theoretical model evaluation

Disordered eating is associated with negative physical and psychological outcomes for those with type 2 diabetes (T2DM), making it an important target for intervention. Theoretical modelling is recommended to inform interventions; however, it is unclear whether established disordered eating models are applicable to those with T2DM. We aimed to evaluate Stice's dual pathway model of disordered eating within a T2DM population. Participants included 192 adults living with T2DM, who completed a cross-sectional survey incorporating measures of body weight shame, dietary restraint, negative affect, binge eating and other disordered eating behaviours. Structural equation modelling was used to test the model. Results indicated that a dual pathway model demonstrated poor fit, with the restraint pathway not supported. Following removal of the restraint pathway, a revised model produced superior fit, with negative affect mediating the relationship between body weight shame and binge eating. Clinical implications for interventions and future research directions are discussed.