Diabulimia

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Treatment of type 1 diabetes is difficult enough on its own, but the added problem of an eating disorder can make treatment very complicated. There are 3 things that affect blood sugar; food, medication, and exercise. Treating diabetes effectively means having to balance these 3 factors every day. The constant focus on food, nutrients, calories and carbohydrates increases the risk of developing an eating disorder.

Among female patients with type 1 diabetes, 30-40% have, or will develop an eating disorder. They are less common in male patients with diabetes, as in the general population.

Weight gain is seen as a common side effect of insulin use. Insulin works by allowing sugar to enter the cells to be used as energy and if too many calories are consumed, the insulin causes the body to start to store fat, and weight gain occurs.

“Diabulimia” is a name given to an eating disorder among diabetes patients where the patient withholds insulin with the goal of losing weight. This can cause the blood sugar to get dangerously high and cause damage to kidneys, eyes, nerves, and the cardiovascular system. Ketoacidosis can develop quickly, leading to severe dehydration, hospitalization, and diabetic coma.

Some signs of diabulimia include: poorly managed diabetes, secrecy, avoiding appointments or testing, eating alone, excessive exercise, extreme diet changes, and obsession with weight. Patients may also have weight loss despite eating more food, express fear of low blood sugars, and have classic symptoms of diabetes (excessive thirst, frequent urination, and constant hunger).

For help with diabulimia, visit http://www.diabulimiahelpline.org/

Sources:

https://www.medscape.com/viewarticle/857221#vp_1

https://www.joslin.org/info/why_did_i_gain_weight_when_i_started_taking_insulin.html

https://www.nationaleatingdisorders.org/diabulimia-5

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