All About Diabulimia
Diabulimia is a serious medical and mental health condition that affects a large population of individuals with diabetes. We’ve answered a few of the most commonly asked questions to help you understand what diabulimia is and how you can help yourself or someone you know who might be struggling with this disorder.
How can someone tell if they're suffering from diabulimia?
Diabulimia is a term used for clients who have an eating disorder in addition to diabetes, and are deliberately misusing their insulin shots (not administering, or administering lower levels) to cause weight loss. There is no visible way to tell if someone has diabulimia. Potentially a family member or close friend may notice that the client is not giving themselves their insulin shot around mealtimes.
How common is it and does it usually go undiagnosed?
It is not uncommon for women with Type 1 diabetes to deliberately restrict insulin in order to lose weight. Statistics suggest up to as many as 30% of women do this on occasion - that, however, doesn't mean they have a full-blown eating disorder. It appears that women who have Type 1 diabetes are also at 2.5 times more at risk to develop an eating disorder. So the risks go hand in hand, and, therefore, definitely needs more attention.
However, unfortunately, diabulimia usually goes undiagnosed, as few doctors are trained in detecting eating disorders, and fewer still would know that this is a behavior that can occur with their clients who are insulin-dependent (Type 1 diabetics).
Diabulimia has been documented in research literature since the 1980s but is only starting to get press coverage whereby the general population might hear of the term. That suggests some hopefulness that as more people learn of it, it will be screened for more regularly by our medical specialists and treated appropriately.
What should you do if you might have it?
See an eating disorder specialist as soon as possible! An eating disorder is a mental health issue and requires psychological treatment as well as medical treatment - usually, a team with a therapist, Registered Dietitian, MD and if necessary, a psychiatrist.
How is it treated?
Diabulimia is treated by treating the eating disorder. The anxiety about weight is what is driving the behavior with the insulin manipulation, so anxiety needs to be addressed. Alternate skills need to be learned to deal with anxiety and the underlying trauma that is often present so that the client can deal with it in functional ways that are not harmful, as opposed to the preoccupation with weight which is leading to dysfunctional and harmful behaviors.
What are the risks?
Diabulimia is very harmful. It is the equivalent of untreated diabetes and all that that encompasses - damage to small capillaries, blindness, amputations, kidney failure, heart disease, and death.
What are the biggest misconceptions about it?
The biggest misconceptions are that it is just about vanity and the client needs to grow out of it. Eating disorders may manifest as an irrational fear around body weight and size, but they are not really about those things. That is simply how the anxiety manifests. Eating disorders have the highest mortality of any mental illness and therefore need to be taken seriously.