Diabulimia : Causes, Signs, Symptoms, Treatment

Diabulimia is a serious eating disorder that affects people with type 1 diabetes.⁽¹⁾ People with type1 diabetes are given insulin to survive but it has its own risk and diabulimia is one of the risks. People with diabulimia limit or avoid taking insulin deliberately to avoid weight gain.

People with diabulimia are concerned about gaining weight and also have certain factors that can drive this behavior, including:

• Difficult behavior
• Difficulty in coping with diabetes and its demands in life
• Need to be in control

Females are known to be affected more by this disorder. A review of research from 1990 found that 30-35% of females with diabetes restricted insulin to lose weight, 1 in every 6 men experienced diabulimia, and adolescent females with type 1 diabetes were 2.4 times more likely to have an eating disorder.^{(2, 3)}

Another study was done in 2016 that suggested the presence of the same risk in those with insulin dependence including those with type 1 diabetes and latent autoimmune disease.⁽⁴⁾

Insulin is important for a person with diabetes and it has a common side effect that is it makes a person gain weight. People with diabulimia avoid taking insulin so that they do not get fat. This tendency can make a person drastically stop insulin or avoid taking it. They may try lowering glucose levels by exercising or purging.

Just like any other eating disorder, a person with diabulimia may suffer from a range of behavioral, physical, and emotional symptoms. A few of its symptoms are common in people with eating disorders:

• Being over concerned about calories, carbohydrates, fat, and dieting
• Purging post meals with laxatives or forced vomiting
• Exercising compulsively to burn the eaten calories
• Focus on one’s appearance, weight, and food
• Imposing diet restrictions on oneself
• Being isolated physically and socially
• Feeling tired most of the times
• Delayed puberty
• Feeling depressed or having mood swings
• Canceling doctor’s appointments
• Having hair loss, dry skin, and sweet-smelling breath
• Exercising a lot

The specific symptoms of diabulimia include:

• Being secretive about the diabetes care routine
• Believing that insulin will lead to weight gain
• Neglecting diabetes management routine
• Restricting eating to reduce the insulin intake
• Having the level of HbA1C high regularly

Diabulimia can be dangerous and lead to:

• Muscle loss
• Dehydration
• Sugar in urine
• High blood sugar levels
• Confusion
• Diabetic ketoacidosis
• Yeast infection
• Bacterial skin infection
• High cholesterol
• Staphylococcus infection
• Liver disease
• Thicker arterial walls
• Low sodium and potassium
• Stroke
• Coma
• Death

Treatment of diabulimia is not a quick fix. A person needs to go through different approaches to change the behavior pattern. Counseling a person can prove to be really helpful. A few of the therapies include:

• Cognitive Behavior Therapy: It can be helpful in changing the way a person thinks to change their actions.
• Group Therapy: In this, support is provided by other people suffering from diabulimia.
• Family Based Therapy: This therapy involves the whole family. This can really be helpful for parents with a teen dealing with this problem.

Diabulimia is an eating disorder that affects people with diabetes, in which a person restricts diet and insulin intake to lose weight. It can be a life-threatening condition. Therefore seeking early help can make recovery possible.