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Diabu-what? Diabulimia explained…

By BodyMatters therapist Sarah McMahon

Diabulimia is a life threatening eating disorder that is poorly known about & still not even acknowledged as a formal eating disorder. However that is not a reflection of the seriousness or prevalence of the problem- after all, it was only a few months ago that Binge Eating has formally been acknowledged as an eating disorder in the DSM V. Here we explain a bit about Diabulimia & what can be done about it.

What is Diabulimia?

Diabulimia is a condition whereby individuals with type 1 diabetes intentionally take less insulin than actually required in a conscious attempt to lose weight. You can read a personal anecdote about Diabulimia here. One of the most concerning things about Diabulimia is that research suggests up to one third of females with diabetes misuse insulin injections in an attempt to lose weight. Further, that people with type 1 diabetes are more than twice as likely to have an eating disorder than those without diabetes.

Essentially Diabulimia produces a particular sequence of events: Improper amounts of insulin sends the body into state of starvation mode. The muscles and fat breakdown into ketoacids and the body of the patient is not able to process sugar that has been consumed. As a result, the sugar from the body goes out through urine and the body loses energy as no fats are stored. The body loses weight, and at a serious price: the high risk of diabetic ketoacidosis, which can be a life threatening condition. 

Signs and Consequences of Diabulimia:

Possible indicators of Diabulimia are as follows:

  •  Hemoglobin level 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 Hemoglobin A1c 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

Now take a look at the short term and long term consequences of Diabulimia:

Short term consequences:

  •  Excessive appetite
  •  Frequent urination
  •  Lower sodium level
  •  Fatigue and weakness
  •  Constant thirst
  •  Dehydration
  •  Ketonemia
  •  High cholesterol level
  •  Inability to concentrate
  •  Indigestion
  •  Yeast infection
  •  Skin infections
  •  Electrolyte imbalance

Long term consequences:

  •  Extreme fatigue
  •  Heart disease
  •  Coma
  •  Osteoporosis
  •  Neurotherapy
  •  Blindness
  •  Edema
  •  High cholesterol level
  •  A kidney problem
  •  Stroke
  •  Death

Treatment for Diabulimia

Sufferers with Diabulimia often do not realize how serious this condition actually is. To stress the point, it is life-threatening. Even when they do realise this, sufferers often struggle with ambivalence towards recovery, much like any other eating disorder, simply because thinness is so rewarded in our culture. Therefore, a therapist with eating disorder expertise should be engaged as part of a treatment team to assist someone with Diabulimia. However because of the medical risk associated with Diabulimia, a doctor who specializes in treating diabetes must also be engaged.

Usually the condition, in its early stages, can be managed in an outpatient setting. However it is very common that an inpatient admission is required for medical management & stabilise the condition.

There are also services with specialized assistance on this issue, including the Diabulimia Helpline & facebook group Diabetics with Eating Disorders.

Please feel welcome to be in touch with us if this is a problem you or someone you love is suffering from.

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