What is Diabulimia? (March 2013)

Have you heard this term before Diabulimia? It is an eating disorder merging individual with Type 1 diabetes (those on insulin) with bulimia. These patients must take insulin in order to metabolize glucose (sugar) and these patients will intentionally skip their doses of insulin or take less the amount of the prescribed dose of insulin in order to lose weight.

There isn’t much literature published about this eating disorder but it is suspected that this eating disorder occurs primarily in young women and adolescent girls. This doesn’t mean than men and other individuals who are on insulin can’t develop this type of eating disorder. People who have Type 1 diabetes are at risk for body image issues since weight gain often times occurs when they are taking insulin.

Diabulimia is considered very dangerous because it merges the complications from both diabetes and eating disorders. Also one study indicated that people who skip insulin doses are three times more likely to die as a result of diabetes than those who did not skip doses. Lastly, these clients are at risk from the long term complications from hyperglycemia (high blood sugar) such as neuropathy, cardiac disease, CVA’s (strokes) and blindness.

It is also important to mention that Diabulmia falls under the category “EDNOS” (eating disorder not otherwise specified) by the current diagnostic criteria, although many eating disorder professionals and medical professionals consider it to be a type of bulimia nervosa. Currently there is not a diagnostic criteria for diabulimia.

There are not many symptoms for diabulimia. The main symptom is hyperglycemia and of course the patient telling the practitioner that she/he is not taking their doses of insulin regularly due to the fears of weight gain. The skipped insulin dose could lead to diabetic ketoacidosis, which is a potentially life threatening medical condition. It can also be accompanied by other more common eating disorder symptoms such as the obsession with weight and body image. Patients can also experience binging too.

It is important that this patient seek treatment with an eating disorder treatment team in addition to their endocrinologist.