What Is Diabulimia?

Diabulimia is a relatively new term that isn’t officially recognized as a medical condition, but is impacting the lives of thousands of people, particularly young women. People with diabulimia (a blend of the terms diabetes and bulimia) have Type 1 diabetes and try to lose weight by depriving themselves of the insulin their bodies need.

People with diabetes need regular doses of insulin to regulate their blood glucose levels, but when they begin taking insulin, they often gain weight because the body stores glucose as fat. For many teens, gaining weight is perceived as an unacceptable side effect, and they begin skipping insulin shots to counteract the extra pounds.

Symptoms of Diabulimia

As many as one-third of all females with Type 1 diabetes have engaged in the dangerous practice of insulin deprivation in order to lose weight. Some of the symptoms of diabulimia include:

  • Changes in eating habits and weight
  • Low self-esteem
  • Obsessively thinking about body image, weight or food intake
  • Frequent urination, excessive thirst or high blood sugar levels
  • Anxiety, fatigue, shakiness, irritability or fainting
  • Reluctance to eat or take insulin in front of others
  • Excessive exercise or laxative abuse
  • Chemical imbalance (also known as diabetic ketoacidosis, which can lead to rapid breathing, drowsiness, vomiting, dehydration and other complications)

Potential Causes of Diabulimia

Diabulimia can be confounding to parents and medical professionals. Why would people knowingly put their lives at risk or complicate one life-threatening illness with another?
While the exact causes are unknown, experts speculate that the following factors contribute to the onset of diabulimia:

  • Diabetes is an illness that requires close monitoring of food intake in order to maintain appropriate blood sugar levels. This increased attention to food and calories can trigger the development of an eating disorder.
  • Teens with diabetes may struggle to feel a sense of control and independence because so much time and attention goes toward managing their illness. For some, eating disorders are a way to feel in control.
  • When a child or teen is diagnosed with diabetes, their life changes dramatically. The stress can lead some to develop eating disorders to cope.

The Consequences of Diabulimia

When an individual with Type 1 diabetes skips their insulin shot, their blood sugar can rise to dangerous levels. Diabulimia can lead to:

  • Frequent emergency room visits and hospitalization
  • Diabetic ketoacidosis
  • Dehydration and fatigue
  • Increased risk of heart disease, nerve damage, kidney failure and blindness

These risks are in addition to the complications that can develop as a result of either Type 1 diabetes or an eating disorder alone. While most individuals with diabetes don’t have to worry about long-term health risks until mid-life, those with diabulimia may face serious consequences as early as their 20s. Yet once they have developed an eating disorder, threats like amputation and blindness aren’t enough to stop the insulin deprivation.

Treatment for Diabulimia

Like all eating disorders, diabulimia requires immediate and intensive treatment. Although specialized eating disorder treatment programs can be difficult to find, there are facilities that can help people suffering from diabulimia by addressing both the eating disorder and Type 1 diabetes simultaneously. The best eating disorders treatment programs employ a multidisciplinary treatment team made up of endocrinologists, registered dieticians and therapists.

Eating disorder specialists strive to help those with diabulimia to gradually gain weight by slowly introducing the appropriate amount of insulin into the body. As with other eating disorders, education about the disease, healthy nutrition and body image are essential for long-term recovery.