Diabulimia can be dangerous when left untreated. Fortunately, medications and therapy options that can improve symptoms are available.
Diabulimia is a health condition that can affect people with diabetes. While it is not officially recognized as an eating disorder, diabulimia shares many traits with bulimia nervosa. People with diabulimia restrict insulin use and have unstable eating patterns to lose weight. Because of these behaviors, diabulimia is a severe condition that requires careful medical attention.
Diabulimia can have dramatic adverse effects on physical health and well-being. This disorder also has a distinct psychological element. Because of these factors, complete diabulimia treatment must cover mental and physical health needs, including medical stabilization, psychological treatment and support groups.
The primary goal of medical stabilization is to bring insulin levels back to normal. According to a report from Advances in Psychiatry and Neurology, a person with diabulimia intentionally reduces insulin doses to avoid gaining weight. A person with diabulimia may also develop bulimic behavior patterns, including binging, purging and ritualistic eating. Dangerous eating behaviors like these can put a person’s body at risk for medical complications, including nerve damage and eye damage.
Medical stabilization is needed to improve health and prevent additional physical harm for people with diabulimia. An endocrinologist and registered dietician take part in the process. Because introducing insulin back into the body can be a challenge, this process requires close observation and monitoring. Inpatient hospitalization is usually necessary for the safest results.
Cognitive Behavioral Therapy
Diabulimia is a condition with clear medical risks because of its ties to diabetes. However, the psychological component of this disorder requires just as much professional care. Psychological treatment is needed to help them stay on track and address the underlying causes of diabulimia. Cognitive behavioral therapy (CBT) is a form of therapy examines the connections between a person’s emotions, thoughts and behaviors.
CBT can be helpful for diabulimia because self-defeating thoughts are at the root of the disorder. In many cases, the thoughts a person with diabulimia has are extreme or framed in absolute terms, often containing words like “always” or “never.” With CBT, the individual can better understand how their feelings and behavior choices are connected.
Dialectical Behavioral Therapy
Dialectical behavioral therapy (DBT) is another method of therapy that can also be used to help reframe black-and-white thinking patterns. DBT teaches an individual how to hold two different and opposing viewpoints at the same time. For example, a person may feel uncomfortable with a recent change in their life. At the same time, they can become accepting of that discomfort.
DBT also teaches people how to tolerate distress and regulate their emotions. Distorted thoughts and disruptive feelings often drive diabulimia. DBT addresses these patterns and prepares individuals for ongoing recovery.
Intuitive eating is a healthy eating philosophy that explores mental health, food and the body’s needs. Intuitive eating encourages a person to listen to their body’s signals. Individuals learn to recognize hunger, fullness and satisfaction, and are encouraged to move away from disordered eating patterns.
Diabetes management requires detailed attention to food intake and nutrition. Nutrition counseling is a key part of any eating disorder treatment process. This therapy is a priority for people with diabulimia because of their unique dietary needs.
Nutrition counseling has several components, including:
- Nutrition education
- Focus on health instead of weight
- Healthy exercise habits
- Focus on personal goals
- Meal planning
A person with diabulimia has learned to manage their emotions in unhealthy ways. Food and insulin are misused to feel better temporarily. An educational approach can help a person see diabetes and their personal life from a healthier perspective, and promote a safer, more satisfying relationship with food.
Diabulimia Support & Resources
Support groups are available in several formats. Some groups near larger population areas meet regularly in person, while others take place exclusively online. Groups are open to anyone with internet access.
Some of the most popular organizations that host diabulimia support groups and resources include:
- NEDA Support Groups: This page has a support group finder that can help locate in-person groups by geographic location, as well as online support groups
- Diabulimia Helpline: This page provides several ways to connect with others online
- Diabulimia Awareness: This Facebook page has many active members with new posts and daily conversations
- Diabulimia Friends and Family Support Group: This Facebook page is for anyone helping a loved one through diabulimia
- National Eating Disorder Association (NEDA): This website has several forums for people who in recovery, as well as friends and family members
Treating Diabulimia and Co-Occurring Disorders
Eating disorders like diabulimia are complex and can be a challenge to live with. Co-occurring disorders like depression, anxiety disorders and addiction are also common for people with diabulimia. These disorders may develop before, during or after diabulimia symptoms emerge.
Regardless of the timing of their development, disorders that occur together need to be treated simultaneously. If only one disorder gets attention, progress may be slow or short-lived. Because co-occurring disorders are interrelated, they each need equal attention in treatment.
If you or a loved one are living with co-occurring diabulimia and addiction, reach out for assistance. Professionals are available around the clock to help you explore your treatment options. Call our staff at The Recovery Village today for more information.
Mafi, R., Naqvi, A., Jeschke, J., Kucharska, K. “Therapeutic traps in management of diabulimia in acute setting: A case report.” ScienceDirect, 2016. Accessed March 27, 2019.
NEDA. “Forums.” Accessed March 27, 2019.
NEDA. “NEDA Feeding Hope.” Accessed March 27, 2019.
NEDA. “Support groups and research studies.” Accessed March 27, 2019.
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