February 28, 2019
Anorexia, bulimia and even binge eating are perhaps the eating disorders that come to mind for most people. But there are other, lesser-known categories, including something called diabulimia.
Diabulimia is the popular (and unofficial) eating disorder term for when person with diabetes — typically Type 1 diabetes — deliberately restrict their insulin intake in order to lose weight. according to the National Eating Disorders Association.
Insulin is vital in getting glucose into your cells, which then burn it for fuel. Without insulin, as is the case with Type 1 diabetes, glucose can’t get to cells, and instead stays in the bloodstream unused. Too much glucose and you quickly have damaged blood vessels and organs.
Once diagnosed, people with Type 1 diabetes must take insulin medication to help regulate their blood sugar. Insulin not only protects the kidneys and the rest of the body from harm, it also prevents the rapid weight loss that is one symptom of the disease, per Everyday Health.
It's that rapid weight loss, however, that is so dangerously attractive to those with weight and body issues.
Some of the warning signs of diabulimia include rapid weight loss despite normal or heavy eating, physical exhaustion, mood changes, and recurrent diabetic ketoacidosis, or DKA, according to Beyond Type-1, a nonprofit educational resource.
Those with diabulimia may underdose their insulin or skip it altogether., forcing the body to use fat to support the brain’s functioning, Dr. Susan Herzlinger, a specialist in eating disorders in people with diabetes, told HEALTH:
Skipping insulin is now listed as a purging behavior in the current American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and more and more health professionals who treat people with diabetes are aware of the problem.
Marilyn Ritholz, Ph.D. told Beyond Type 1:
“If you have diabetes and are not taking insulin, your organs will become saturated in glucose. You can put your body into a state of DKA, and you can experience the long-term complications of diabetes such as retinopathy, nephropathy and neuropathy. If left untreated, it can lead to death.”
Treatment for diabulimia is similar to treating other eating disorder treatments: begin by ensuring the patient is medically stable.
In severe cases, treatment for diabulimia will require hospitalization to keep insulin dosage at the right level and prevent excessive exercise or purging. Once patients are medically and mentally stable, they would undergo individual and group therapy sessions, including sessions on how to manage stress and anxiety once they've been discharged, according to the Eating Recovery Center.