It doesn’t yet have its own entry in the DSM, but a deadly disorder commonly referred to as “diabulimia” is threatening the lives of people who are struggling with both diabetes and an eating disorder.
People who have Type I diabetes must take regular doses of insulin to regulate their blood glucose levels. Unfortunately, many people have discovered that skipping doses of insulin can help them “manage” their weight.
This risky practice can have catastrophic health consequences. Often these individuals take just enough insulin to function and consistently feel dehydrated, fatigued and irritable and face long-term health complications, including the following:
- Nerve disorders
- Kidney failure
- Diabetic ketoacidosis (an acidic buildup in the blood resulting from inadequate insulin levels).
Diabulimia most commonly affects adolescent and young adult women. As many as one-third of all women with Type 1 diabetes (about 450,000 women in the U.S.) have engaged in insulin deprivation for the purposes of weight control.
Research by Denis Daneman, published in Diabetes Spectrum in 2002, indicates the following:
- One percent of 12-year-old diabetic girls are manipulating their insulin.
- By age 15, that number increases to 14 percent.
- By age 19, 34 percent admit to manipulating their insulin intake.
Though the appeal of easy weight loss may be the initial draw, once individuals are in the grip of an eating disorder, the threat of amputation, blindness or even death is not strong enough to overcome the disordered thoughts and behavior patterns.
Treatment of diabulimia entails significant medical monitoring, gradual weight gain, and education about nutrition and appropriate self-care. Because individuals with diabulimia struggle with weight gain and body image issues, intensive therapy and eating disorder treatment are also essential to help patients learn healthy ways to cope and develop a support network.