The dangers of diabulimia

Posted on 03/09/21 12:48:pm

 

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An estimated 10% of patients with type 1 diabetes meet the criteria for an eating disorder.

Though many are familiar with the dangers of anorexia and bulimia, only recently has the term diabulimia entered mainstream conversations about eating disorders. While there is debate about the appropriateness of the term, it is important to understand the seriousness of co-occurring type 1 diabetes and an eating disorder.

What is diabulimia?

"Diabulimia is not a formal DSM-V diagnosis," explains Jody Langford, MD, medical director of child and adolescent inpatient Eating Disorder Recovery. "However, the term is often used to describe someone with type 1 diabetes and a co-occurring eating disorder. Most often it refers to an individual who deliberately takes less insulin than their body needs with the intent of weight loss, as this impacts the body's ability to absorb nutrition."

While diabulimia typically describes withholding insulin to lose weight, Dr. Langford says it can also refer to patients who overdose insulin when they have a low blood sugar reading to allow them to consume more carbohydrates. Additionally, it's important to recognize that eating disorders can exist in patients with type 1 diabetes who are compliant with their insulin regime.

Key symptoms

Diabulimia has many symptoms, but Dr. Langford points to the following as being especially common:

  • Rapid changes in weight
  • Increased hunger and thirst
  • Excessive urination
  • Electrolyte disturbances
  • Poorly controlled diabetes (elevated hemoglobin A1C)
  • Elevated blood sugars

Additionally, in some cases, patients may develop ketoacidosis, a potentially life-threatening condition that occurs when acids build up in the blood and the body is unable to produce enough insulin.

Treatment

Individuals with diabulimia require prompt care with close medical monitoring to ensure that both the eating disorder and diabetes are appropriately addressed.

"Treatment must involve close consultation with the patient's endocrinologist, as insulin regimens often need frequent adjustments," explains Dr. Langford.

Dr. Langford says individuals with diabulimia should not only talk with their endocrinologist or diabetes educator, but also seek specialized treatment for the eating disorder. She says it is especially important that patients find an eating disorder program or provider with proven experience working with patients with type 1 diabetes and eating disorders to ensure optimal care and understanding.

Help is available at Rogers

If you or someone you love is suffering from diabulimia or another eating disorder, Rogers is here to help. To request a free, confidential screening, contact us at:

  • 800-767-4411 for inpatient, residential, or outpatient care in Brown Deer, Oconomowoc, or West Allis.
  • 888-927-2203 for all other outpatient locations.
  • The screening request online form

Call 800-767-4411 or go to rogersbh.org to request a free screening.