Diabulimia
Diabulimia is an eating disorder characterized by the intentional reduction of insulin intake by individuals with type 1 diabetes as a means of controlling their weight and body shape. This condition primarily affects young females, particularly during adolescence and early adulthood. Diabulimia is considered particularly dangerous due to its potential to cause severe health complications, including diabetic ketoacidosis (DKA), organ failure, and even death. The disorder arises from the intersection of diabetes management and eating behaviors, where individuals forgo necessary insulin to induce weight loss, leading to dangerously high blood sugar levels.
While diabulimia is not officially recognized as a distinct medical condition, it represents a significant mental health concern, with research indicating that a substantial percentage of young women with type 1 diabetes exhibit disordered eating behaviors. Estimates suggest that around 20% of children and 25% of females with type 1 diabetes demonstrate symptoms of abnormal eating behaviors. Advocacy groups continue to push for greater recognition of diabulimia within the medical community, emphasizing its serious implications for health and well-being. Understanding diabulimia is crucial for addressing the complexities of diabetes management and the mental health challenges faced by many individuals living with the condition.
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Diabulimia
Diabulimia is an eating disorder in which a diabetic individual intentionally reduces his or her intake of insulin as a means of controlling his or her weight and/or body shape. The term itself is a portmanteau of diabetes and bulimia. Although diabulimia is a lesser-known condition, many experts consider it one of the most dangerous eating disorders because it can lead to severe complications including coma and death. Controversially, diabulimia has not been recognized officially as a specific medical condition and is instead considered a form of mental illness.
Overview
Diabulimia primarily affects young females with type 1 diabetes. Type 1 diabetes is a medical condition in which an individual's pancreas does not produce enough insulin. The body uses insulin to enable digested sugars to enter cells, where they are converted into energy. Individuals with type 1 diabetes typically manage the condition with insulin therapy, which involves taking insulin to replace the body's natural deficiency of the hormone.
Bulimia, or bulimia nervosa, is a serious eating disorder in which a person consumes large amounts of food during binge-eating episodes. The person then resorts to extreme behaviors, such as inducing vomiting or relentlessly exercising, to prevent his or her body from absorbing the ingested calories.
According to JDRF, a leading Canadian diabetes research foundation, about 20 percent of children and 25 percent of females with type 1 diabetes display one or more symptoms of abnormal eating behavior. The organization notes that diabulimia is most common among females in adolescence or early adulthood.
A person with diabulimia deliberately avoids taking his or her prescribed insulin, which prevents cells from absorbing sugars. This causes rapid weight loss, but it also causes dangerous spikes in blood-sugar levels. As diabulimia progresses, it can become life-threatening. Diabulimia can result in young patients developing diabetes complications that are normally seen in much older people, including permanent loss of vision, organ failure, nerve damage, and limb amputations. The most dangerous aspect of diabulimia is that it can lead to a condition known as diabetic ketoacidosis (DKA), which causes the body to break down its own tissues in an effort to generate energy. DKA creates toxic by-products that carry a high risk of heart and organ failure, potentially leading to coma or death.
The prevalence of diabulimia is not known. Diabetes UK, a United Kingdom–based charitable research foundation, estimates that approximately 40 percent of female type 1 diabetes patients between the ages of fifteen and thirty deliberately give themselves less insulin than they need as a means of achieving weight control. Research also suggests that up to 60 percent of female type 1 diabetes patients under the age of twenty-five experience at least one clinically significant episode involving behaviors related to eating disorders.
Advocacy groups have yet to achieve their objective of having diabulimia officially recognized as a specific form of eating disorder. However, changes to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)added insulin omission to the list of clinical symptoms that indicate bulimia. DSM-5 is a widely used standard in the diagnosis and treatment of mental illnesses.
Bibliography
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"Diabulimia." National Eating Disorders Association,2016, www.nationaleatingdisorders.org/diabulimia-5. Accessed 18 Jan. 2018.
"Diabulimia: What It Is and Where to Get Help." Diabetes UK, 2017, www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/diabulimia. Accessed 18 Jan. 2018.
Hinde, Natasha. "Diabulimia: Symptoms of the World's 'Most Dangerous Eating Disorder.'" Huffington Post, 25 Sept. 2017, www.huffingtonpost.co.uk/entry/diabulimia-symptoms-and-treatment-explained‗uk‗59c8b92ae4b0cdc773323c62. Accessed 18 Jan. 2018.
Ollerenshaw, Tracy. "The Suicide Note That Told Megan's Diabulimia Story." BBC, 25 Sept. 2017, www.bbc.co.uk/newsbeat/article/40888659/the-suicide-note-that-told-megans-diabulimia-story. Accessed 18 Jan. 2018.
Sanghani, Radhika. "Diabulimia: The Little Known Eating Disorder That's Killing Diabetic Women." Telegraph, 18 Apr. 2016, www.telegraph.co.uk/health-fitness/body/diabulimia-the-little-known-eating-disorder-thats-killing-diabet/. Accessed 18 Jan. 2018.
"Type 1 Diabetes." Mayo Clinic, www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011. Accessed 18 Jan. 2018.