Background Achieving early glycemic control in adolescents with diabetes is associated with improved short- and long-term health outcomes. The aim of this study was to examine the relationship between eating attitudes and glycemic control, as well as the factors associated with eating attitudes and glycemic control, in adolescents with diabetes. Methods This descriptive cross-sectional study included 143 adolescents with diabetes, aged 10–19 years, who attended a research hospital between February and April 2024. The data were collected using a Descriptive Information Form, Eating Attitudes Test (EAT) and an information form questioning the values of some metabolic variables. Results The mean age of the participants was 14 ± 2.3 years and 49.7% had diabetes between 1–5 years. The mean total score of the EAT scale was 16.62 ± 8.30. The mean score of the “Dieting” subscale of the EAT scale was 10.39 ± 5.58, the mean score of the “Bulimia food preoccupation” subscale was 2.33 ± 3.03 and the mean score of the “Oral Control” subscale was 3.79 ± 3.08. There was no significant difference between the mean EAT total score and glycemic control. Conclusions The mean EAT-26 total score was below the commonly used cutoff score, and no significant association was found between EAT-26 scores and HbA1c. Differences in EAT-26 total and subscale scores were observed according to selected demographic and clinical characteristics, including BMI, treatment modality, and treatment adherence. These findings describe self-reported eating attitudes in the study sample and support the inclusion of eating-related assessment within the holistic care of adolescents with Type 1 DM.
Orthorexia Nervosa (ON) is widely regarded as an emerging eating disorder although it is not currently recognised as a formal diagnosis. It is characterised by a strict adherence to “pure” eating which becomes excessive and can lead to nutritional deficiencies, psychological distress, and impaired daily functioning. Restrictive eating behaviour in ON shows overlap with Restricted Repetitive Behaviours (RRBs) observed in autism. However, the conceptual relationship between ON and autism remains underexplored. This perspective article synthesises existing literature to explore potential overlapping and diverging mechanisms of RRBs across ON and autism. Intolerance for Uncertainty is highlighted as a possible shared mechanism that may contribute to RRBs observed in both ON and autism, whereas Cognitive Inflexibility and Perfectionism may mechanistically differentiate the conditions. We consider that autistic RRBs reflect neurodevelopmental divergence, whereas orthorexic RRBs may be influenced by evaluative belief-centred cognitions. We propose a conceptual model outlining how cognitive, affective and functional factors may interact to produce and maintain RRBs. Clarifying these distinctions is important in supporting clinicians to appropriately consider the drivers and mechanisms underlying RRBs across ON and autism, therefore supporting accurate diagnosis, formulation and treatment.
