Diabulimia and Diabetes

But what is diabulimia? How does it develop? What symptoms do you need to watch for? How do you get help, or how do you help someone that may be battling diabulimia? So many questions! Keep on reading to find out more about diabulimia. 

What is Diabulimia?

Diabulimia is a type of eating disorder that occurs when a person with type 1 diabetes begins to restrict, or totally stop, taking insulin use to lose weight.¹ You need insulin to live if you have type 1 diabetes. Not taking your insulin can be super dangerous.

While you may start losing weight if you stop taking your insulin, to do so is actually classified as an eating disorder. Most people haven’t heard of diabulimia, but the condition is serious and actually pretty common.

How Does Diabulimia Develop?

Diabulimia can develop due to a lot of reasons. It’s usually not just a single thing, but can be a combination of social, mental health, and physical issues. Some aspects of your daily diabetes routine may even play a part, such as:²

• Focusing on your weight when you visit a doctor
• Constantly counting calories or carbohydrates in your meals
• Difficulty keeping your weight at a healthy level
• Having to read food labels carefully
• Poor relationships with a healthcare professional or team
• Feeling shame about how you’re managing diabetes

Sometimes diabulimia can be triggered by the constant focus on managing diabetes. Body image issues, a desire to lose weight, or diabetes burnout can also contribute.

If you’ve recently been diagnosed with type 1 diabetes, it’s likely that you lost weight before your diagnosis. When you go on insulin, you may gain that weight back. This can be difficult to deal with, and can lead to harmful behaviors like skipping insulin doses.

No matter how it begins, it’s often hard to recognize the symptoms of diabulimia and find successful treatment.

Common Warning Signs of Diabulimia

Physical Warning Signs³

• Regular attacks of nausea or vomiting
• Dry skin and hair
• Weight loss
• Low potassium or sodium levels
• Blurry vision
• A1C that’s 9.0 or higher
• Frequent urination
• Excessive thirst
• Irregular or lack of menstruation
• Fatigue
• Episodes of diabetic ketoacidosis
• Frequent yeast or bladder infections

Behavioral and Emotional Warning Signs

• Prescriptions that don’t get fulfilled
• Neglecting diabetes management
• Fearing low blood sugars
• Strict food rules
• Anxiety or depression
• Being secretive about diabetes management
• Avoiding eating in public or with others
• Worrying that insulin will “make me fat”
• Restricting foods to reduce insulin doses
• Withdrawing from loved ones
• Preoccupation with exercise, weight, food, or calories
• Excessive exercising
• Avoiding doctor’s appointments
• Anxiety about how their body looks

Potential Consequences of Diabulimia

Your blood sugar levels will remain too high if your body isn’t getting enough insulin. When blood sugar levels stay too high over a period of time, this can lead to serious consequences.³

Short term, diabulimia may cause:

• Bacterial infections
• Muscle wasting
• Disruption in your menstrual cycle
• Slow healing for wounds
• Dehydration
• Diabetic ketoacidosis

Long term, high levels of glucose in the blood can result in damage to your blood vessels, leading to eye problems. Nerve damage may occur and cause chronic constipation or diarrhea, slowed stomach emptying, or even burning, tingling, or weakness in your arms, legs, feet, or hands, known as peripheral neuropathy. Eventually, constant levels of high blood sugar can damage your kidneys, liver, or heart.

Treating Diabulimia

It can be tough to break the cycle of not taking insulin to try and lose weight. But recovery is possible with the right support and help.

Eating disorder specialists and diabetes teams have recently become much more aware of this eating disorder. Treatment requires a team of specialists to help you get on the road to recovery. This may include an endocrinologist, mental health professional specializing in eating disorders, and a dietician. Of course, the first step is asking for help.

Asking for Help if You Have Diabulimia

Dealing with diabulimia is tough. Unfortunately, it’s common to struggle with the way you view your body as a personal with diabetes, which may lead you to hide this eating disorder from those your love and your healthcare team.

When you’re battling a serious problem, remember that you’re not alone. Everyone experiences ups and downs throughout their diabetes journey, which is why a strong support network is so valuable. 

It might feel difficult to ask for help, but this is the first step to recovery. Once you share the problems you’re experiencing with someone, you’ll be ready to move forward and get help from healthcare and mental health professionals. Talk to someone you trust, bring it up to your physician, or reach out to the Diabulimia Helpline.

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Sources:

1. Kınık, M.F., Gönüllü, F.V., Vatansever, Z., Karakaya, I., 2017. Diabulimia, a Type I diabetes mellitus-specific eating disorder. Turkish Archives of Paediatrics, [online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396822/
2. Diabetes UK, 2020. Diabulimia and Diabetes. [webpage] Available at: https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/diabulimia [Accessed: 03/03/2021]
3. National Eating Disorders, 2018. Diabulimia. [webpage] Available at: https://www.nationaleatingdisorders.org/diabulimia-5  [Accessed: 03/03/2021]