Recently, Dr. Merwin proposed an investigation into the disturbances in appetite regulation among type 1 diabetes (T1D) patients with eating disorders (EDs). The following synopsis explains some of her most recent work in the field.

I have been PI or Co-Investigator on several grants on the mechanisms and treatment of EDs, many from NIH. My more basic research has focused on deficits in interoceptive awareness (or the ability to sense, label and respond to internal cues, including hunger, satiety and the somatic correlates of affect) as a risk and maintenance factor for EDs. I have studied these processes among individuals with anorexia nervosa, and among individuals with T1D who evidence eating disorder symptomatology. My work in T1D has focused on how patients’ unique
experience of the body and its signals contributes to the development of uncontrolled eating and subsequently,
intentional insulin restriction to compensate for calories consumed. I was the lead investigator on a study
funded by NIDDK to identify mechanisms of comorbidity EDs in T1D (R01 DK0893293, PI: Merwin). This study
used continuous glucose monitoring paired with ecological momentary assessment to identify real-time
precursors to ED behavior in T1D patients’ natural environment and test diabetes-specific contributory factors
(e.g., emotional-behavioral reactivity to blood glucose change).

Most recently, I received an award from NIDDK
to translate some of our novel findings from this study into an intervention that uses mobile technology to help
individuals with T1D recognize triggers for ED symptoms in the moment (Merwin et al., 2015) and cope more
effectively (R21 DK106603, PI: Merwin). My past research provides evidence of the ability to recruit this patient
population and employ advanced, multi-level assessment to answer novel questions of ED maintenance in
T1D. I have a network of scientific collaborators with complementary expertise (Nancy Zucker, PhD, Director of
the Center for Eating Disorders, Jenny Tong, MD – endocrinologist with expertise in appetite regulation,
Richard Surwit, PhD and Dr. Mark Feinglos, MD – Experts in glucose kinetics and behavioral endocrinology)
and a T1D patient registry for research recruitment. Given my previous experience conducting grant-funded
research in EDs and EDs in T1D with expert collaborators, I am well-positioned to execute this project and
develop a successful application for additional NIH funding.