Psychological Factors Affecting Adherence to Diet in Male Diabetic Patients

10 patients with noninsulin-dependent diabetes mellitus were interviewed in depth to identify psychological factors which might influence their adherence to the diet. All patients were evaluated for adherence 6 mo. after an initial interview. Factors which appeared to influence adherence negatively were an established pattern of over-eating, life stress prior to diagnosis of diabetes, depression prior to diagnosis of diabetes, denial of anxiety or depression in reaction to the diagnosis, and denial of future difficulty in adhering to diet. The occurrence of starvation fantasies prior to diagnosis and following institution of the diabetic diet was noted as well as the known similarity of the metabolic state of diabetes to starvation. An intimate relationship between psychology of starvation, onset of diabetes, and adherence to diet is postulatd.