Eating Disorders and Diabetes
By Amanda Comstock, PSY. D.
Diabulimia refers to an eating disorder in a person with diabetes and is most commonly found within type I diabetics. While found in both sexes, women with type I diabetes have close to two and a half times the chance of developing an eating disorder. With an intense focus on food, perfection, and numbers (A1C, Carb Counts, blood sugar readings) it is not surprising that a diagnosis of diabetes can be a risk factor for developing an eating disorder.
Diabulimia is when an individual purposefully restricts insulin in order to lose weight. It can be seen as a type of purging disorder if the person is eating normally and restricting insulin, or anorexia nervosa if the person is severely restricting both food and insulin. There are major physical health consequences associated with diabulimia and many of these complications can be severe and irreversible, so proper treatment and early detection are critical.
There are several warning signs of diabulimia including:
- Rapid weight loss with normal or heavy eating
- A high A1C
- Physical exhaustion
- Decreased concentration or motivation
- Increased appetite
- Mood changes
- Recurrent DKA
Diabulimia may first develop due to body image concerns or a desire to lose weight, and sometimes it may be a result of diabetes burn out. Regardless of how it begins, treatment can be challenging, as individuals with type I diabetes tend to drop out of treatment early. Effective treatment must address both the diabetes and eating disorder aspects of the disorder. A multidisciplinary team is vital to address the many issues present with diabulimia. The best approach includes an endocrinologist, a dietician, and a mental health professional that specializes in eating disorders.