Diabulimia: Emerging Eating Disorder in Diabetic Teens A Growing Cause for Concern

Eating disorders revolve around food: how much, when, where, and what exercise must be done to counter its effects. The criteria aren't that different from what a teenager trying to manage their diabetes goes through, except that teens with diabetes must also manage their insulin intake. Factor in the usual angst about fitting in and body image to the challenge of managing diabetes and in many teenage and young Type 1 diabetics and you come up with a potentially deadly eating disorder being labeled "diabulimia."

Diabulimia is usually practiced by teenage girls and young women, and it may be growing more common as the secret is exchanged on Internet bulletin boards for diabetics and those with eating disorders. According to a recent article, 450,000--one-third of the total--Type 1 diabetic women in the United States have skipped or limited their insulin to lose weight."People who do this behavior wind up with severe diabetic complications much earlier," said Ann Goebel-Fabbri, a clinical psychologist at the Joslin Diabetes Center in Boston.

One of the most dangerous aspects of this particular eating disorder is that the short-term health problems and dangers can be as equally debilitating as the long term consequences. With other types of eating disorders the health issues generally build over time; in someone with diabulimia the effects can take place in a much shorter time span. The following example is very telling in terms of what the mindset of someone who is willing to do anything to lose weight can be:

Jacq Allan, 26, is a diabulimic. She said she had not taken her insulin shots for two weeks and rarely takes them regularly. She weighs 42 pounds (19 kilograms) less than she did a year ago.

Allan is stuck between two fears: taking insulin, which may lead to weight gain, and the damage her destructive compulsion is doing to her body."I'm terrified of insulin," Allan said. "Every morning I wake up and think maybe I should go to the hospital." Diagnosed with Type 1 diabetes nearly three years ago, Allan said she can feel the constant, sky-high sugar in her blood. Her list of ailments--chest pain, heart palpitations, muscle cramps, bacterial infections and lower back pain--are not the usual health problems of a twenty-something. "I'm constantly worried that my eyes are going to go, but they seem relatively OK for the moment," she said. "I always wonder if this will be the day that some major organ fails. I kind of want something to happen because then maybe I'll stop."

Weight loss through diabulimia is frighteningly easy, as explained by Stuart Brink, M.D. in A Different Face of Eating Disorders: Diabulimia. "You don't have to vomit. You don't have to purge. You don't have to use laxatives. You just have to let your sugar stay high."

Without insulin, diabetics are unable to properly process food. As a result, many calories ingested may go unprocessed by the body. However, the consequence of withholding insulin are devastating, ranging from ketosis to joint, liver and kidney damage and even blindness, coma or death.

Like any other eating disorder, not only the physical symptoms need to be addressed, but most important, the underlying issues of self-esteem and body image need to be addressed as well.

If you have concerns about managing diabetes in a health way visit The American Diabetes Association.