Diabulimia
Have you heard of diabulimia? Today, Allison Tucker, RD is diving into all things diabulimia and why it can be so dangerous. Take it away, Allison!
What’s diabulimia? This is a term you may not be familiar with, but it’s a dangerous issue that affects individuals with diabetes. People with diabetes are already at higher risk for developing eating disorders (up to 20% of type 1 diabetics will develop an eating disorder in their lifetime). So, what is diabulimia and why is it a problem?
What is Diabulimia?
While diabulimia isn’t an official diagnosis, it’s a term used to describe someone with Type 1 Diabetes, or T1D, restricting insulin, in order to lose weight. This may involve a person skipping an insulin dose or taking less insulin than they need. For people with T1D, insulin is essential for managing blood sugar. When there isn’t enough, the body can’t absorb glucose, leading to rapid weight loss. This weight loss can be appealing to someone struggling with body image issues, especially in a society that ties thinness to health and worth (aka, diet culture).
But this weight loss is anything but healthy.
When people are first diagnosed, unintentional weight loss is often one of the first signs of T1D. Once insulin therapy begins, weight is naturally restored, but the societal obsession with thinness leads many to link insulin with weight gain, assuming this is "bad." Medical professionals can sometimes reinforce this idea, overlooking the fact that weight loss in this context is actually a serious complication of diabetic ketoacidosis, which occurs when blood sugar levels are dangerously high.
Diet culture’s fear of weight gain causes people to view life-saving insulin as harmful, perpetuating dangerous behavior. Deliberate insulin restriction is one of the most common weight practices among Type 1 Diabetics. What’s scarier? 30% of adolescents living with T1D will skip or reduce insulin to lose weight.
Why Restricting Insulin is Dangerous
Type 1 diabetics who restrict insulin are three times more likely to die prematurely. In the short-term, uncontrolled blood sugar levels can lead to higher infection risk, slower wound healing, loss of muscle tissue, electrolyte imbalances, loss of menstrual function, and diabetic ketoacidosis, or DKA. DKA can cause nausea, vomiting, dehydration, and confusion and even death. In the long term, consistently high blood sugar leads to nerve damage to feet, eyes, and organs including the kidneys, liver, and heart.
What About Type 2 Diabetes?
While diabulimia is most commonly associated with type 1 diabetes, people with type 2 diabetes (T2D) can also develop disordered eating behaviors around insulin and other medications used to manage blood sugar. Since people with T2D are also often pressured to lose weight, some may avoid taking medications or restrict food intake to achieve weight loss, putting their health at serious risk.
How We Can Help
People with diabetes are already working around the clock to manage food, blood sugar, and medications. The pressure to lose weight or eat “perfectly” can create an unhealthy focus on food and body size. Insulin is a life-saving medication and the obsession with thinness should never come at the cost of someone’s health.
At Collaborative Counseling & Nutrition, we understand that dealing with both diabetes and disordered eating can feel overwhelming. Our team of dietitians, therapists, and eating disorder recovery coaches work together to provide support that is tailored to your individual needs. If you or someone you know is struggling with managing diabetes and disordered eating, reach out. We are here for you!
Learn more:
Resources Used:
Coleman, Sophie Elizabeth, and Noreen Caswell. “Diabetes and eating disorders: an exploration of 'Diabulimia'.” BMC psychology vol. 8,1 101. 23 Sep. 2020. Retrieved on September 5, 2024 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7513317/
Ip, Eric J et al. “Diabulimia: A Risky Trend Among Adults with Type 1 Diabetes Mellitus.” Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists vol. 29,11. 2023. Retrieved on September 5, 2024 from: https://pubmed.ncbi.nlm.nih.gov/37567472/
Rittenhouse, Margot. “What is Diabulimia: Symptoms, Risk Factors, and Causes”. Eating Disorder Hope. July 11, 2021. Retrieved on September 5, 2024 from: https://www.eatingdisorderhope.com/information/diabulimia
“What is Diabulimia?” Eating Recovery Center. Retrieved on September 5, 2024 from: https://www.eatingrecoverycenter.com/conditions/diabulimia
Collaborative Counseling & Nutrition is an outpatient nutrition and body image counseling center, with locations in Indianapolis and Carmel, that provides compassionate, holistic eating disorder treatment. Through practicing mindfulness, intuition, and Health At Every Size, we are on a mission to help you find a true state of well-being! We take an anti-diet, weight-inclusive approach with all our clients and work to help guide you towards a way of healthy living designed by you, just for you! This post is for education purposes only and should not be used as a substitute for treatment for an eating disorder. If you are looking for a registered dietitian or therapist to assist you on your recovery journey, please reach out today!
