Diabulimia – New “Eating” Disorder Among Diabetics?
An AP story picked up on CNN reports that some type 1 diabetics are skipping their insulin in order to lose weight, and the behavior or condition is being referred to informally as “diabulimia.” Read on – it’s not truly an “eating” disorder, but a body image disorder (as are other “eating” disorders), and it’s apparently not so new after all.
Not yet a recognized medical/psychiatric disorder like its sibling conditions anorexia and bulimia, officials aren’t yet certain how many people skimp on their insulin to try to lose weight, but “one expert” estimates “that 450,000 Type 1 diabetic women in the United States — one-third of the total — have skipped or shortchanged their insulin to lose weight and are risking a coma and an early death” (the piece doesn’t address whether this behavior has been observed in men).
Skipping insulin puts these patients at a higher risk of coma, blindness, amputation, kidney failure, and death. [Read more about complications of Type 1 Diabetes] Simply put, the complications of poorly controlled diabetes are quite serious, something young people may not fully appreciate as they perform dangerous experiments with their insulin regimen. One woman interviewed for the story reportedly learned the “technique” when overhearing camp counselors chastise other girls for putting their health at risk in this way, and went on to suffer from “diabulimia” for the next 17 years. Another 26-year-old woman interviewed now lists her ailments as “chest pain, heart palpitations, muscle cramps, bacterial infections and lower back pain,” and says that every morning she wakes up wondering if she should go to the hospital.
In a discussion of this I found online, one “diabulimic” reported that her clinicians nag her about keeping her levels under control, but don’t get that what she has is an “eating” disorder, or body image disorder. I wonder to what extent this gets passed over because it’s not an official disorder, and the surface issue is the lack of insulin/glucose control, so the underlying cause is not discussed. I’m also curious as to whether the intense focus on controlling food and sugar in diabetes, in the absence of some preventative talk about eating disorders, contributes to developing the condition, and whether clinicians dealing with diabetes should be especially vigilant with patients known to have had more “traditional” disorders such as anorexia.
Don’t get me wrong – anorexia can have life-threatening effects as well. As someone who has seen a family member suffer from diabetes, it’s especially disturbing to know that these patients are continuing to induce very serious diabetes complications due to an under-recognized problem.