Diabulimia among teen girls is not well known, but it will be. There’s a growing concern that a significant number of young people with type 1 diabetes, primarily teenage girls and young women, are experiencing a new type of eating disorder called "diabulimia." This term weds type 1 diabetes with bulimia and describes behavior in individuals who deliberately skip or reduce their insulin doses in order to lose weight.
A Dangerous Way to Lose Weight
When you have type 1 diabetes, you need insulin to process the glucose you get from food. If you don’t take enough insulin, the level of glucose in your blood rises. Your body tries to compensate by getting rid of some of the glucose or “purging” it through frequent urination — one of the classic symptoms of diabetes. In the absence of insulin, your body looks for the next available energy source: stored fat. As fat is burned for energy, you naturally lose weight. Deliberately withholding or restricting insulin, though, is a dangerous way to lose weight, because you flirt with a toxic and potentially fatal state called "ketoacidosis" that develops when the body is burning fat for energy instead of glucose.Type 1 and Eating Disorders
It’s been known for some time that type 1 diabetes increases the risk of eating disorders, such as anorexia (self-starvation) or bulimia (purging food after it is eaten). Young women who struggle with poor self-esteem or believe they must attain a specific weight in order to be acceptable, are at risk of developing an eating disorder. Combine body image issues with the measured food intake that is a constant part of diabetes management, and an eating disorder has fertile ground in which to grow.
Learn to Spot the Symptoms
Parents of teenage girls would do well to learn the symptoms of diabulimia. In one study, nearly one-third of the participants indicated that they had previously skipped or restricted their insulin in order to lose weight. The Juvenile Diabetes Research Foundation points to the following warning signs for diabulimia:
- Changes in eating habits, such as eating more while losing weight
- Unexplained weight loss
- Unexplained high blood glucose
- Low energy levels
- Frequent urination
Treatment
At a minimum, treatment should include your endocrinologist and a seasoned counselor knowledgeable about both eating disorders and diabetes management. Since endocrinologists see diabulimia on a regular basis, they are more likely to recognize the symptoms sooner than a primary care physician. A counselor can help your child develop a better body image and a healthier relationship with food. In addition, some families may benefit from the assistance of a dietitian to help plan meals and portion sizes.
Sources:
Diabulimia. Juvenile Diabetes Research Foundation. Accessed October 31, 2008. http://www.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=FDF69313-1279-CFD5-A79B429F10056B6F
Diabulimia: Eating Disorder. Medicinenet.com. Accessed October 31, 2008. http://www.medicinenet.com/script/main/art.asp?articlekey=81960
Joslin Study Finds Restricting Insulin Doses Increases Mortality Risk. Joslin Diabetes Center. Accessed October 31, 2008.http://www.joslin.org/1083_4281.asp
