Eating Disorder That Can Worsen Your Diabetes: Diabulimia

Diabulimia is a disorder when someone reduces or stops using insulin from the body to burn fat. It is often characterized as an emotional disorder that is often characterized by bouts of overeating. So, know in detail about this life-threatening disease.

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