According to the American Diabetes Association, “Diabulimia” is an eating disorder characterized by intentionally withholding insulin to result in weight loss. This rarely discussed disorder is shocking common with over 30% of females with type 1 diabetes (ages 15-30) report skipping insulin or reducing insulin to lose weight.
If you or a loved one is struggling with Diabulimia, you came to the right place.
This blog will inform you on the things that you should know and also where to get support for recovery.
Thinking about the day in the life of a Type 1 Diabetic may not cross your mind too frequently, unless you have diabetes or a close friend or family member of yours has it.
What you might not know, is that a Type 1 Diabetic has to think about food pretty regularly throughout the day. Since a Type 1 diabetic is completely dependent on the hormone insulin (which regulates blood sugars), every time he or she eats, they have to think about the amount of carbohydrates that were in the meal and then decide how much insulin is appropriate. If they give too little insulin, they run the risk of their blood sugars getting to high. If they give too much insulin, they run the risk of their blood sugars going too low. Both of these have serious consequences.
Individuals with Type 1 Diabetes have to decide how much insulin they need for the amount of carbs they will be eating. Combine type 1 diabetes, thoughts about food and insulin, pressure to look a certain way, pressure to eat a certain way, fear of gaining weight from insulin, and genetics. You have a set-up for development of a potential eating disorder. These individuals will give themselves far less insulin than what is recommended when consuming carbs, causing sugars to sky rocket. This causes consequences like diabetic ketoacidosis, which means there are unsafe levels of ketones in the blood and requires hospitalization to manage.
Who is at risk?
- Individuals with Type 1 Diabetes
- Women around the age of 20. While most eating disorders generally develop in adolescent years, Diabulimia may actually develop later in life. Diabulimia is more common in women.
- 16% of men with Type 1 Diabetes have disordered eating behaviors, while 35% of women do.
Signs and Symptoms of Diabulimia
There are several signs and symptoms of diabulimia:
- Skipping and canceling doctors appointments
- Drastic weight loss
- A1C more than 9 on a regular basis
- Increased appetite
It is important to be self-aware of these signs and symptoms for your own safety and healing.
Double Trouble: Diabetes and Eating Disorders
Diabulimia is definitely an emerging sub-type of eating disorders and new research and information is coming out more frequently.
How to Manage Diabulimia
If you or a loved one is struggling with Diabulimia, you do not have to go through the recovery journey alone. A team approach is important for when you are managing diabetes and an eating disorder. There are a few members of your team that you will want to contact.
A doctor with some eating disorder knowledge is necessary. He or she will be able to support your loved one in proper insulin doses and to manage any symptoms, side effects or complications. Additionally, you will want to find a therapist who is a good fit. This therapist should have knowledge in treating eating disorders. He or she will be able to support you or a loved one in learning more about some of the emotional aspects of the eating disorder.
Last but not least, a Registered Dietitian (RD) is a crucial member of the team. You will want to find a dietitian who specializes in eating disorders, but who also has substantial knowledge of how to manage diabetes. In this situation, an RD will not only help you or a loved one develop a healthy relationship with food and assure you are getting proper nutrition without eating disorder thoughts, but she will also support you in achieving healthy blood glucose levels.
Diabulimia Resources to Use
Also read this excellent article by the Renfrew Center on Managing an Eating Disorder and Diabetes
Stay tuned for updates about Diabulimia on our eating disorders website page.
If you are concerned a loved one is struggling with food, whether or not they also have Type 1 Diabetes, click here to set up an initial screening appointment. A dietitian specializing in eating disorders can properly assess where your loved one is and what are the next best steps.
A team approach is key to recovery from all types of eating disorders. We are here to help you set up your healthcare team with a Registered Dietitian, Therapist, Endocrinologist and whoever else you may need to help you recover.
Blog reviewed and updated June 2020.
Rebecca Bitzer loves to empower Registered Dietitian Nutritionists (RDNs) and their clients. Co-author of Welcome to the Rebelution: Seven steps to the nutrition counseling practice of your dreams and Taste the Sweet Rebellion: Rebel against dieting.