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Eating Disorder Pro Podcast: Diabulimia with Dr. Ann Goebel-Fabbri

Diabulimia - Dr. Goebel-Fabbri

Join us on WEDNESDAY, January 8 at 7:30 pm EST for a special encore presentation of our interview with Dr. Ann Goebel-Fabbri about Diabulimia!  For more information on Diabulimia be sure to read this article! You can tune in HERE.

Here’s some background information about Dr. Goebel-Fabbri from the Joslin Diabetes Center:

“Dr. Ann Goebel-Fabbri is a clinical psychologist at Joslin Diabetes Center and Assistant Professor in Psychiatry at Harvard Medical School. Her role at Joslin integrates teaching, research and treatment focused on disordered eating behaviors in patients with type 1 and type 2 diabetes. Her work covers the spectrum of eating problems from food and insulin restriction to binge eating and obesity.

Dr Goebel-Fabbri has lectured at local and national academic conferences and presented her work in peer-reviewed journals. She is involved in NIH-funded multi-center clinical research focused on non-surgical weight loss strategies for improved health outcomes in type 2 diabetes.

Women with type 1 diabetes are more than twice as likely to develop an eating disorder as the general public. The symptoms of eating disorders specific to this population include insulin omission and insulin underdosing (skipping or reducing necessary insulin injections to control weight).

Research indicates that insulin omission and reduction increase the risk of long-term microvascular and macrovascular medical complications of diabetes—such as nerve damage, kidney disease, cardiac disease and eye disease—and may also increase mortality rates.

Dr. Goebel-Fabbri is a clinical psychologist whose research focuses on the relationship between diabetes and eating disorders. In her own studies and in collaboration with others, Dr. Goebel-Fabbri seeks to better understand how eating disorders affect long-term medical complications in women with diabetes and what types of interventions might help improve health outcomes in these high-risk patients.

In collaboration with Katie Weinger, Ed.D., R.N., Dr. Goebel-Fabbri completed a 12-year follow-up of a cohort of 470 female Joslin patients with type 1 diabetes. This study investigates the natural course of insulin omission and underdosing as a means of weight loss over time.

The study also examines how these behaviors affect psychological and functional health, quality of life, diabetes-related distress, diagnoses of eating disorders and long-term complications of diabetes.

In the future, Dr. Goebel-Fabbri hopes to undertake a treatment outcome study to determine whether interventions specifically tailored to treat issues related to insulin omission and other eating disorders in women with type 1 diabetes can improve overall health outcomes in this population.

People with type 2 diabetes also appear to be at higher risk of developing eating disorders, particularly binge eating. It remains unclear whether the binge eating leads to weight gain and type 2 diabetes, or if events occur in another order. Dr. Goebel-Fabbri is the chief psychologist for WhyWAIT, a Joslin program created expressly to address the unique weight-management needs of people with type 2 diabetes. A multidisciplinary clinical research team is studying the effectiveness of this program for delivery in routine diabetes care.

Dr. Goebel-Fabbri serves as the Behavioral Consultant to the Joslin team of the Look AHEAD (Action for Health in Diabetes) Study, a multicenterclinical trial, funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), that examines the impact of weight loss and physical activity on cardiac outcomes in adults with type 2 diabetes.

She is also the supervising Behavioral Psychologist to the Joslin team of the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study, a multicenter research trial funded by NIDDK. This project aims to improve medical and behavioral treatments for children and adolescents with type 2 diabetes.”

Let’s Connect!

Like me on Facebook

Twitter @drrenae

Contact Dr Norton by phone 513-205-6543 or by form

Inquire about booking Dr Norton for a speaking engagement

Read About Dr Norton

View video about Dr Norton

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2014, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2014, Dr J Renae Norton. http://edpro.wpengine.com’.

Show Notes: Diabulimia – Dr. Ann Goebel-Fabbri

Eating Disorder Pro Radio Show

Photo Used Under a Creative Commons License

In this weeks episode we talked with we talked about Diabulimia with Dr. Ann Goebel-Fabbri, a clinical psychologist at the Joslin Diabetes Center and Assistant Professor in Psychiatry at Harvard Medical School.

Listen to internet radio with Eating Disorder Pro on Blog Talk Radio

In this episode we covered:

5:18 – About Dr. Goebel-Fabbri
6:17 – What is Diabulimia?
8:36 – Are we seeing an increase in Diabulimia?
9:37 – Can you describe the diabetic in terms of weight and eating habits?
11:58 – Does the push to gain weight very quickly cause food addiction or unnecessary weight gain?
16:12 – Bulimics tend to be normal or slightly overweight, is that also true of the Diabulimic?
17:08 – Is there such thing as Diarexic?
17:25 – What are the complications of a disorder that involves restricting food and restricting insulin?
22:05 –  What are the long-term and short-term risks of Diabulimia?
28:03 – Type III Diabetes
29:20 – Caller Question: Is there such thing as a Type II Diabulimic? What would this complication be for older populations?
34:45 – What other things can people be on the lookout for, in terms of comorbidity?
36:27 – What treatment options are most successful in treating Diabulimia?
46:15 – What advice would you give to parents of children that are struggling with Diabulimia?

Links We Discussed

The Joslin Diabetes Center
ORDER A PERSONALIZED, SIGNED COPY of How Maji Gets Mongo Off the Couch! and/or Let’s Eat: Maji Teaches Mongo What it Means to Eat Clean for purchase from EatingDisorderPro.com

Let’s Connect!

Like me on Facebook

Twitter @drrenae

Contact Dr Norton by phone 513-205-6543 or by form

Inquire about booking Dr Norton for a speaking engagement

Read About Dr Norton

View video about Dr Norton

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2013, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2013, Dr J Renae Norton. http://edpro.wpengine.com’

The Eating Disorder Pro Podcast – Diabulimia – Dr. Ann Goebel-Fabbri


Diabulimia - Dr. Goebel-Fabbri

Join us tomorrow March 5 at 7 pm as we talk to Dr. Ann Goebel-Fabbri about Diabulimia! We’ll be taking your questions LIVE at 646-378-0494 or by email (drnorton@eatingdisorderpro.com). For more information on Diabulimia be sure to read this article we posted last week! Here’s some background information about Dr. Goebel-Fabbri from the Joslin Diabetes Center:

Dr. Ann Goebel-Fabbri is a clinical psychologist at Joslin Diabetes Center and Assistant Professor in Psychiatry at Harvard Medical School. Her role at Joslin integrates teaching, research and treatment focused on disordered eating behaviors in patients with type 1 and type 2 diabetes. Her work covers the spectrum of eating problems from food and insulin restriction to binge eating and obesity.

Dr Goebel-Fabbri has lectured at local and national academic conferences and presented her work in peer-reviewed journals. She is involved in NIH-funded multi-center clinical research focused on non-surgical weight loss strategies for improved health outcomes in type 2 diabetes.

Women with type 1 diabetes are more than twice as likely to develop an eating disorder as the general public. The symptoms of eating disorders specific to this population include insulin omission and insulin underdosing (skipping or reducing necessary insulin injections to control weight).

Research indicates that insulin omission and reduction increase the risk of long-term microvascular and macrovascular medical complications of diabetes—such as nerve damage, kidney disease, cardiac disease and eye disease—and may also increase mortality rates.

Dr. Goebel-Fabbri is a clinical psychologist whose research focuses on the relationship between diabetes and eating disorders. In her own studies and in collaboration with others, Dr. Goebel-Fabbri seeks to better understand how eating disorders affect long-term medical complications in women with diabetes and what types of interventions might help improve health outcomes in these high-risk patients.

In collaboration with Katie Weinger, Ed.D., R.N., Dr. Goebel-Fabbri completed a 12-year follow-up of a cohort of 470 female Joslin patients with type 1 diabetes. This study investigates the natural course of insulin omission and underdosing as a means of weight loss over time.

The study also examines how these behaviors affect psychological and functional health, quality of life, diabetes-related distress, diagnoses of eating disorders and long-term complications of diabetes.

In the future, Dr. Goebel-Fabbri hopes to undertake a treatment outcome study to determine whether interventions specifically tailored to treat issues related to insulin omission and other eating disorders in women with type 1 diabetes can improve overall health outcomes in this population.

People with type 2 diabetes also appear to be at higher risk of developing eating disorders, particularly binge eating. It remains unclear whether the binge eating leads to weight gain and type 2 diabetes, or if events occur in another order. Dr. Goebel-Fabbri is the chief psychologist for WhyWAIT, a Joslin program created expressly to address the unique weight-management needs of people with type 2 diabetes. A multidisciplinary clinical research team is studying the effectiveness of this program for delivery in routine diabetes care.

Dr. Goebel-Fabbri serves as the Behavioral Consultant to the Joslin team of the Look AHEAD (Action for Health in Diabetes) Study, a multicenterclinical trial, funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), that examines the impact of weight loss and physical activity on cardiac outcomes in adults with type 2 diabetes.

She is also the supervising Behavioral Psychologist to the Joslin team of the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study, a multicenter research trial funded by NIDDK. This project aims to improve medical and behavioral treatments for children and adolescents with type 2 diabetes.

Let’s Connect!

Like me on Facebook

Twitter @drrenae

Contact Dr Norton by phone 513-205-6543 or by form

Inquire about booking Dr Norton for a speaking engagement

Read About Dr Norton

View video about Dr Norton

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2013, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2013, Dr J Renae Norton. http://edpro.wpengine.com’.

Diabulimia

eating disorder treatment cincinnati

Diabulimia is an eating disorder in which individuals with Type 1 Diabetes purposefully give themselves less insulin than they require, with the intention of losing weight. The eating disorder is most common in woman between the ages of 15 and 30. According to Dr. Ann E. Goebel-Fabbri, about 30% of diabetic woman restrict their insulin to induce weight loss at some point in their lives.

There are many serious short-term and long-term consequences associated with diabulimia:

According to Diabulimia Helpline, there are several telltale signs that an individual is suffering from diabulimia:

  • A1c of 9.0 or higher on a continuous basis.
  • Unexplained weight loss.
  • Persistent thirst/frequent urination.
  • Preoccupation with body image.
  • Blood sugar records that do not match HbA1c results.
  • Depression, mood swings and/or fatigue.
  • Secrecy about blood sugars, shots and or eating.
  • Repeated bladder and yeast infections.
  • Low sodium/potassium.
  • Increased appetite especially in sugary foods.
  • Cancelled doctors’ appointments.

Treatment for Diabulimia

The first step in Diabulimia is to break through the denial the individual may have that s/he is abusing insulin to manage weight.  Unlike many eating disorders, this one may start as an attempt to control the diabetes but end up as a way of controlling weight.   Those with Type I diabetes are at risk for addiction to empty carbs early in their disease as the first symptom is significant weight loss. Efforts to help the child regain the weight usually do not include clean eating, such that s/he may develop bad habits or even an addiction to carbs, fat and/or salt.

Treatment for Diabulimia resembles treatment for Bulimarexia, the combination of Anorexia and Bulimia, in as much as it often contains elements of each disorder.  To the degree that the individual uses insulin to “binge” on empty carbs, the first step is to teach him or her to eat clean foods that have a healing impact on the endocrine system rather than a damaging effect.

The other essential ingredient in the treatment of the individual suffering from Diabulimia is to help the individual deal with the fear of gaining weight.  As with many individual’s suffering from Anorexia, an excessively low weight seems like an accomplishment. The Diabetic is particularly at risk for having control issues, as so many things seem beyond his or her control, especially when it comes to the body’s reaction to food.

Interested in learning more about Diabulimia? We’ll be talking with Dr. Ann Goebel-Fabbri on next week’s podcast! We’ll be taking your questions live at 646-378-0494 or you can submit your questions HERE.

Let’s Connect!

Like me on Facebook

Twitter @drrenae

Contact Dr Norton by phone 513-205-6543 or by form

Inquire about booking Dr Norton for a speaking engagement

Read About Dr Norton

View video about Dr Norton

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2013, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible. Please credit ‘© 2013, Dr J Renae Norton. http://edpro.wpengine.com’.