Many people have never heard of Diabulimia.
In 2018, the American Diabetes Association estimated that nearly 1.6 million Americans had type 1 diabetes including 187,000 children and adolescents. Type 1 diabetes is a chronic condition in which the pancreas does not produce enough insulin. This requires constant treatment through monitoring blood sugar levels, restricting diet, exercise and insulin therapy.
Type 1 diabetes is often diagnosed in adolescence, which is traditionally a time of change and development. These changes in addition to the constant treatment of diabetes have the potential to make a young person feel out of control. Negative body image, pressure from society to be perfect and even peer pressure mixed with diabetes can sometimes lead to a dangerous disorder called Diabuliumia.
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 women 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 potential short-term and long-term consequences associated with trying to lose weight through manipulating insulin levels. Some of these include severe dehydration, muscle loss, diabetic ketoacidosis, skin infections, yeast infection and menstrual disruption as well as more severe consequences such as retinopathy, neuropathy, atherosclerosis, stroke, risk of needing dialysis, sterility and even death.
- The need to control something, such as weight loss, can be immensely powerful in someone suffering from an eating disorder. But the fact that this is happening may not be clear right away. According to diabulimiahelpline.org some of the signs to watch out for include:
- 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.
Manipulation of blood sugar testing, hiding the amount (or lack) of insulin being consumed and downplaying symptoms of failing health may also be attempts to conceal Diabulimia. An eye opening first person account of life with Diabulimia is available HERE.
Treatment for Diabulimia
The first step in Diabulimia treatment 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.
Relapse is always possible with eating disorders and with Diabulimia the rates are high. There is a 53% chance of relapse within six years of remission. Much like diabetes, the treatment of Diabulimia can mean a lifetime of monitoring. Seeking out a therapist with specific eating disorder experience can create an environment for ongoing recovery.
If you or someone you love is suffering from Diabulimia, or if you have questions about this eating disorder contact The Norton Wellness Institute at 513 205 6543. Dr. Norton offers individualized treatment plans for all types of disordered eating as well as family and couples therapy. Now accepting new patients. Tele-therapy options are available. Contact us today, we are here and we can help!
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Materials contained on this site are made available solely for educational purposes and as part of an effort to raise general awareness of the psychological treatments available to individuals with health issues. These materials are not intended to be, and are not a substitute for, direct professional medical or psychological care based on your individual condition and circumstances. Dr. J. Renae Norton does not diagnose or treat medical conditions. While this site may contain descriptions of pharmacological, psychiatric and psychological treatments, such descriptions and any related materials should not be used to diagnose or treat a mental health problem without consulting a qualified mental health care provider. You are advised to consult your medical health provider about your personal questions or concerns.