Meet the Eating Disorder Plaguing Diabetics

Last updated on November 4th, 2019

Asha Brown was diagnosed with Type 1 diabetes when she was five years old. She needs to take insulin every day to survive, but the medicine has a common side effect: weight gain.

As a teenager, Asha began taking extreme measures to control her weight, limiting herself to 1,600 calories a day. By college, she was skipping insulin doses, injecting only when she was on the verge of passing out from diabetic ketoacidosis, a potentially deadly complication of diabetes.

Depriving her body of insulin took a toll on Asha’s health; she was often sleeping through class, confused and dehydrated.

Introducing Diabulimia

Asha was suffering from diabulimia, a disorder in which diabetics “starve” themselves of insulin in an attempt to counteract the weight gain often associated with insulin therapy.

Though the prevalence of “diabulimia” is unknown, research suggests that eating disorders are probably more common among women with diabetes.“I was worried that diabetes would eventually make me fat, so I was trying to develop healthy habits to prevent that from happening,” she said. “But something in my brain just had this click, and it just loved the order and obsessive quality of these behaviors.”

As a result of diabulimia, Asha now suffers from a debilitating chronic muscle pain disorder called myofascial pain syndrome. However, she considers herself lucky to have avoided more serious consequences.

Though the prevalence of “diabulimia” is unknown, research suggests that eating disorders are probably more common among women with diabetes. Approximately 30 to 40 percent of young girls and women with Type 1 diabetes have also suffered from an eating disorder or will develop one. This could be in part because the condition fosters an intense focus on food, diet and control – all of which can quickly spiral into an eating disorder.

Is Being Skinny Worth Risking Your Life?

Depriving one’s body of necessary insulin can have severe health consequences. “When people are not taking their insulin purposefully, they feel absolutely rotten on a day-to-day basis,”” says Lorraine Platka-Bird, a registered dietitian and director of nutrition at the Center for Hope of the Sierras in Reno, Nevada. “In the long-term, the condition can cause damage to internal organs, including kidneys and heart, and can even be fatal.”

DiabulimiaAsha says, while in college, she would sometimes “flake out” on her school work or even pass out due to exhaustion. “I was doing more damage to my body than good,” she says. “When your blood sugar is over 250, the muscles aren’t getting the proper amount of oxygen.”

Diabetes alone puts patients at risk for a range of complications that include heart, nerve and kidney damage, amputation and blindness. Those who skimp on insulin are more likely to experience complications at a younger age and to experience more health problems, including the risk of long-term degenerative diseases.

“We’ve had patients at our center that were in their early 20s and already had severe neuropathy,’ says Platka-Bird. “One patient was already blind in one eye and severely visually impaired in the other.”

The Road to Recovery

People with both diabetes and an eating disorder require specialized care, as they need to “relearn” how to manage their diabetes without resorting to unhealthy behaviors and thought patterns.

Unfortunately, many eating disorder clinics and psychiatric inpatient facilities across the country lack the knowledge and resources to effectively treat the disorder.Unfortunately, many eating disorder clinics and psychiatric inpatient facilities across the country lack the knowledge and resources to effectively treat the disorder, says Marcia Meier, registered nurse and program manager of patient services at the International Diabetes Center at Park Nicollet in Minnesota. She has been working with a team of diabetes and eating disorder experts for more than a decade to develop a specific treatment framework for diabulimia that involves pairing up each patient with a team of specialists, including an endocrinologist, certified diabetes educator, registered dietitian and a psychiatrist.

“The whole message that we give is, ‘What do you need to do to maintain a healthy lifestyle?’” said Meier. “It’s helping someone discover what a healthy weight is for them. There’s a lot of work on meal plans and on diabetes care, because you can’t just assume someone knows what they’re doing just because they’ve had it for a long time.”
Additional Reading: 3 Common Myths About Eating Disorders

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