Objective
To examine gender differences in disordered eating behaviors (DEB) and body dissatisfaction in adolescents with type 1 diabetes. While evidence shows that female youth with type 1 diabetes are more prone to DEB compared to their peers without diabetes, little is known about male adolescents.

Method
In a national online survey, adolescents (13–19 years) with type 1 diabetes for ≥1 year completed the Diabetes Eating Problem Survey‐Revised (DEPS‐R), and the Body Mass Index Silhouette Matching Test (BMI‐SMT) and items on binge eating and insulin omission.

Results
About 477 adolescents (mean age 16 years; 62% females) completed the DEPS‐R and 431 the BMI‐SMT. The DEPS‐R total score was higher for females than males, with scores for females increasing with age. BMI, HbA1c, insulin omission, and binge‐eating frequency were associated moderately with DEPS‐R for both genders. On the BMI‐SMT, 88% of females wanted to be thinner. Of the males, 76% reported body dissatisfaction; however, only 43% expressed a desire for thinness with the remainder desiring a larger body size. DEPS‐R was positively associated with the discrepancy between perceived actual and ideal body size for both genders.

Discussion
A large proportion of adolescents with type 1 diabetes, particularly females reported engaging in DEB. Similarly, high rates of body dissatisfaction were reported, though ideal body shape preferences differed by gender. Given the high levels of self‐reported DEB and gender‐based patterns of body dissatisfaction, future research needs to examine the effectiveness of routine screening of DEB and consider implementation of stepped care approaches.