Diabulimia is an eating disorder where people with type 1 diabetes limit their insulin to lose weight. People with type 1 diabetes take insulin to absorb glucose, which gets changed into energy or is saved as fat. When insulin is restricted, glucose leaves the body through the urine and energy is obtained by the body’s breakdown of fat, which results in weight loss.
Many diabulimia myths result from a lack of understanding of the disorder. Diabulimia misconceptions are common, as both the medical community and the general public have limited knowledge of the symptoms, facts and statistics and treatment of the disorder.
Awareness of diabulimia facts is important in debunking common myths that are associated with the condition.
1. Myth: Diabulimia is officially recognized as an eating disorder
Fact: Diabulimia is not formally recognized as an eating disorder.
Currently, the medical and mental health communities do not have a formal diagnosis for diabulimia in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Diabulimia is not an official term and, instead, is derived from a combination of the terms diabetes and bulimia. Diabulimia is not a medical term and is used by the general population to refer to the misuse of insulin for weight control.
When it is added to the DSM-5, diabulimia in the DSM-5 will likely be categorized as a purging behavior since insulin is omitted. If a person is binging and restricting insulin, it could be diagnosed as a type of bulimia. If a person is eating regularly and restricting insulin, diabulimia could be diagnosed as purging disorder. Or, if the person restricts both food and insulin, it could be classified as anorexia.
2. Myth: Diabulimia is well understood by health care providers
Fact: The medical community poorly understands diabulimia.
Due to the lack of research, the absence of formalized studies and non-existent diagnostic classification, diabulimia is not well understood by health care providers. Very few research studies have explored the efficacy of diabulimia treatment interventions.
Many medical providers do not assess for eating disorders in the diabetes population, which results in either a lack of diagnosis or misdiagnosis. Health care providers must be vigilant of symptoms associated with eating disorders in addition to those symptoms linked with diabetes. Educating health care providers about screening processes and treatment interventions can greatly assist them in identifying people who are at risk of developing diabulimia.
3. Myth: Diabulimia affects people with type 2 diabetes
Fact: Diabulimia only occurs in people with type 1 diabetes.
Diabulimia does not apply to people with type 2 diabetes, as many are treated with drugs that do not include insulin. Many non-insulin drugs can assist in weight loss, which offers an incentive to take them as prescribed. Diabulimia in type 2 diabetes also does not occur as these people’s bodies do not have a quick response to insulin restriction, like the bodies of people with type 1 diabetes.
Diabulimia is more common in teenagers and young adults, and those with type 2 diabetes are frequently diagnosed later in life. By the time a person with type 2 diabetes is prescribed insulin injections, they have often had diabetes for a long time, making them less likely to even try insulin restriction.
4. Myth: Diabulimia is a rare disorder
Fact: Diabulimia is a common disorder that is frequently underdiagnosed or misdiagnosed.
Research and diabulimia statistics have shown that a high rate of diabulimia prevalence exists in our society. A review of studies on diabulimia concludes that young adults with type 1 diabetes diagnoses have a higher prevalence of eating disorders and disordered eating patterns when compared to those without a diabetes diagnosis.
One study found that 37.9% of females and 15.9% of males with type 1 diabetes showed disordered eating patterns. Another study of individuals with type 1 diabetes, 61% of participants who had a history of disordered eating reported insulin misuse, compared to 26% who had no history of disordered eating.
5. Myth: Diabulimia can be safely treated at home
Fact: Diabulimia can be extremely dangerous and must be treated by medical professionals.
Diabulimia can be associated with significant and irreversible complications that are related to extended periods of elevated blood sugar. Diabulimia is a serious mental health condition that cannot be treated at home or through patient education.
Diabulimia is linked with poor glycemic control and poses an increased risk of mortality. A lack of insulin causes blood sugar to increase, which can cause diabetic ketoacidosis. Diabetic ketoacidosis occurs when the liver releases ketones in response to high blood sugar, putting a person at risk of death. Other complications can include damage to the eyes, nerves or kidneys.
Diabulimia treatment must address medical and mental health issues associated with diabetes and the eating disorder simultaneously. The first steps in treatment are typically designed to ensure that an individual with diabulimia is medically stable. In extreme cases, treatment may require hospitalization to stop the manipulation of insulin.
If hospitalization is not required, diabulimia treatment centers may house a multidisciplinary team of endocrinologists, medical personnel, nutritionists, counselors and psychologists who work collaboratively to address medical and mental health issues. Ultimately, diabulimia treatment works to change thought and behavior patterns and helps a person learn how to cope with triggers.
If you or someone you love struggles with a drug or alcohol abuse problem and an eating disorder, The Recovery Village can help. We offer comprehensive treatment for addiction and co-occurring conditions. Call today to speak with a caring representative who can help.
Tarkan, Lauren. “Diabulimia: The Diabetes Eating Disorder.” Endocrine Web, updated 2016. Accessed June 9, 2019.
National Eating Disorders Association. “Diabulimia.” (n.d.) Accessed June 9, 2019.
Hanlan, Margo; Griffith, Julie; Patel, Niral; Jasen, Sarah. “Eating Disorders and Disordered Eating in Type 1 Diabetes: Prevalence, Screening, and Treatment Options.” Current Diabetes Reports, September 12, 2013. Accessed June 9, 2019.
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