When most people think of eating disorders, there are two illnesses that usually come into people’s minds – anorexia nervosa and bulimia nervosa. Both of these brain disorders are extraordinarily serious and can cause a myriad of life-threatening complications such as severe kidney damage, esophageal tears, and even heart failure. Now what if I were to tell you that there is another type of eating disorder that most people, even those who are members of the eating disorder community, have never heard of despite the fact that this ED can become life-threatening much faster than anorexia or bulimia ever can.
The eating disorder I am talking about is diabulimia. Have you ever heard of it? No? Yep, that’s what I thought. In this post I hope to shed some light on what this ominous illness actually is and raise awareness for this very unrecognized ED.
What is Diabulimia?
Diabulimia is a portmanteau of the words diabetes of bulimia and is an unofficial medical term that describes an eating disorder that occurs strictly among those with type 1 diabetes mellitus. Those suffering from diabulimia intentionally omit taking their insulin injections in order to achieve rapid weight loss. How do they lose weight by not taking their insulin? Well, in order to understand that I am going to have to give you a quick crash course on what type 1 diabetes mellitus actually is.
Type 1 diabetes is an autoimmune condition of the endocrine system where an individual’s pancreas stops producing insulin. Insulin is an extraordinarily important hormone that allows the cells in one’s body to get the glucose they need to function. When the body is unable to produce insulin, the glucose is unable to enter the cells and glucose builds up in the bloodstream which causes high blood sugar or hyperglycemia. Hyperglycemia can cause a wide range of effects including fatigue, increased hunger and thirst, frequent urination, and let’s not forget weight loss. The reason why type 1 diabetics lose weight is because since there is such a high build up of glucose in the blood, the kidney filter it out and the excess sugar is excreted in the urine. When a person has diabulimia and refuses to take their insulin, they become hyperglycemic which causes them to urinate out the excess sugar. Because these sugars in the urine obviously contain calories, people with diabulimia are basically purging through urination.
The Scary Facts about Type 1 Diabetes and Eating Disorders
Compared to the general population, eating disorders are extremely prominent in type 1 diabetics. It is actually believed that 1/3 of those who have this chronic autoimmune condition have been trapped in Ed’s prison. Why do diabetics have such an increased risk for eating disorders? Just as it is with ED victims who do not live with diabetes, there is not just one answer. Some people hypothesize that because diabetics have to be hyper-vigilant about of what they eat and how much they eat, that this could possibly predispose them to developing ED behaviors. Another reason why diabetics are so prone to EDs may be due to the fact that many diabetics go through rapid weight gain after the initiation of insulin therapy. This weight gain may take a large psychological toll on the individual thus causing them to seek out unhealthy ways to get back their skinny physiques.
The Consequences of Diabulimia
As you know by now, when type 1 diabetics omit their insulin, they become hyperglycemic. Therefore, both the short-term and long-term consequences of diabulimia are usually the direct result of relentless high blood sugar.
The short-term consequences include . . .
- excessive appetite, thirst, and urine production
- diabetic ketoacidosis (DKA) – this condition occurs when there is a severe lack of insulin in the body which causes the cells to not get the nourishment they need. In order to get some form of energy, the body begins to break down triglycerides in adipose tissue (fat) and release a ton of fatty acids into the blood. This extremely excessive release of fatty acids causes the liver to produce something called ketone bodies. These ketone bodies are very toxic and if left untreated, it can lead to severe illness and even death.
- changes in sleep
- dizziness, headaches, and brain “fog”
The long-term consequences include . . .
- peripheral neuropathy
- autonomic neuropathy
- proximal neuropathy
- focal neuropathy
- severe kidney damage or even kidney failure
- heart attack or stroke
Treatment Centers for those with Type 1 Diabetes and Eating Disorders
- Center of Hope of the Sierras – this eating disorder treatment center is located in Reno, Nevada and offers a specialty track for those suffering from an ED and type 1 diabetes. http://www.centerforhopeofthesierras.com/
- The Melrose Institute – this ED center is located in St. Louis, MN and is actually in collaboration with the International Diabetes Center at Park Nicollet. This unique collaboration allows patients with a dual diagnosis of type 1 diabetes and an eating disorder to receive state-of-the-art, comprehensive care. http://www.parknicollet.com/eatingdisorders/
- Eating Recovery Center – Located in the picturesque city of Denver, Colorado, the Eating Recovery Center is a remarkable facility that has the capability to treat many of the health complications ED patients face. They are able to do this because of that fact that they offer around the clock nursing care and daily visits from medical doctors. ERC also is able to treat many co-occuring illness including diabetes, mood disorders, gastrointestinal disorders, and other organ issues. http://www.eatingrecoverycenter.com/patient-eating-disorder-treatment/why-eating-recovery-center-for-patients/
- Cumberland Hospital – This facility, located in between Williamsburg and Charleston, VA., provides children and adolescents who are dealing with brain injuries, chronic illness, and neurobehavioral issues with a safe, therapeutic environment. Cumberland Hospital offers a program specifically designed for adolescents who have a dual-diagnosis of diabetes and an ED. This program teaches these adolescents life-long skills such as healthy eating and exercise habits, cooking, and medication management. It also helps adolescents work through the many issues that come with an eating disorder like poor body image, self-esteem, and negative attitudes. http://cumberlandhospital.com/chronic-illness/diabetes-and-eating-disorders/