Diabulimia comes from 2 words, diabetes and bulimia. Diabetes is a disease that affects the way your body uses sugar. Bulimia nervosa means "gorge and purge". It is an emotional disorder characterized by bouts of overeating; typically alternating with fasting or self-induced vomiting.
Diabulimia mostly affects women, but that does not mean that it doesn't affect men. It affects people with type 1 diabetes who skip their insulin dosages deliberately, especially during adolescence in order to lose weight or preventing weight gain.
Warning Signs-
- Unexplained weight loss
- Weight fluctuations
- Fatigue/weakness
- Excessive thirst
- Frequent urination
- Excessive hunger
- Amenorrhea (abnormal absence of menstruation)
- Hyperglycemia or Elevated Hba1c levels
- Excessive exercise
- Severe self-criticism
- Socially withdrawal symptoms
- Body image issues
- Depression
- Stress
- Restricting or eliminating certain foods or food groups
- Inappropriate use of diet pills, laxatives, etc
Why is there an increased risk for diabetics to develop an eating disorder-
- Insulin treatment often leads to increased hunger and weight gain, increasing the likelihood of poor body image
- Shame about food choices
- Contraindication of high-carbohydrate foods when blood glucose levels are elevated
- Fear of bad experiences like eating will lead to weight gain
- Role of parents or others in managing diabetes
- Misconceptions or judgments of others- "you can't eat that, you're diabetic"
- A diabetes diagnosis can contribute to developing diabulimia.
Diabulimia complications-
- Hyperglycemia
- Glycosuria (sugar in urine)
- Elevated hba1c levels
- Confusion
- Dehydration
- Diabetic ketoacidosis
- High cholesterol
- Skipped or abnormal periods
- Retinopathy
- Neuropathy
- Heart disease
- Low sodium and potassium levels
- Liver disease
- Kidney failure
- Death
In order to treat diabulimia, a team-based approach would work including a mental health professional, endocrinologist, nutritionist, and others. Counseling is the best method.
Treatment methods-
- Behaviour management- Individual, family, and group therapy sessions which include body appreciation, cognitive behavioural therapy (CBT), anxiety management, yoga, meditation, self-empowerment, etc.
- Daily monitoring of blood glucose levels
- Eat when hungry and stop when full.
- There are no good or bad foods.
- Educating patients about carbohydrate counting from the first day of treatment.
- Educate patients to read labels for carb counting when appropriate.
- Less emphasis on the restrictive diabetic diet. Educate about mindful eating.
- Don't deprive yourself of certain food groups like carbohydrates and fats. Include complex carbohydrates like whole grains which is rich in fiber.
- Include atleast 5 servings of fruits and vegetables every day.
- Include protein like milk, fish, eggs, cheese, etc
- Avoid processed foods and sugary drinks.
- A nutritionist will teach the patient about the nutritional benefits of foods and help them develop a positive relationship with food.
Inputs:
Divya Gupta
Consultant Nutritionist
Diabetes Educator
You can reach out to Divya Gupta with your queries at nutritionistdivyagupta@gmail.com
