Diabulimia Is the Serious Eating Disorder You Probably Haven't Heard Of - Article Health

While it’s not a formal diagnosis, the term refers to the “unique eating disorder symptom of insulin restriction for the purposes of calorie purging,” says Ann Goebel-Fabbri, PhD, a former assistant professor of psychiatry at Harvard Medical School and author of Prevention and Recovery From Eating Disorders in Type 1 Diabetes: Injecting Hope. While you may have heard of people purging through self-induced vomiting or diuretic or laxative use, it can be done by misusing necessary medications like insulin as well. “This is a very dangerous behavior that can lead to diabetes complications and increase the likelihood of early death,” Goebel-Fabbri says.

People with type 1 diabetes don’t produce insulin. “Insulin acts like a key to allow g

lucose to enter into cells,” explains Susan Herzlinger, MD, a specialist in eating disorders in people with diabetes at the Joslin Diabetes Center in Boston. Glucose is the fuel your body runs on, but without insulin, your body can’t utilize the glucose in your blood. Normally, your pancreas does this automatically. With type 1 diabetes, you need to give yourself insulin either through injections or an insulin pump.

Those with diabulimia may underdose their insulin or skip it altogether. Then, blood sugar rises and the kidneys dispose of the excess glucose in urine. “This is a way to purge what’s been eaten because the sugar you ingested isn’t absorbed and instead is eliminated,” says Dr. Herzlinger. What’s more, limiting insulin forces your body to digest fat (and some muscle) to support the brain’s functioning, she says.

Doing this can leave people feeling irritable and fatigued at best. Worst, it can be deadly. “The most severe consequences when blood sugar is allowed to become so high and insulin so low is a risk of developing diabetic ketoacidosis,” says Dr. Herzlinger. This is an emergency medical condition where fat is broken down too quickly into ketones, making the blood acidic (which is different from what happens in the popular ketogenic diet). Diabetic ketoacidosis usually requires an ER visit “at minimum” and often admission to intensive care, she says.   

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