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American Diabetes Month: What You Should Know About Diabetes and Bulimia


November is American Diabetes month, and many people ignore the connection between diabetes and eating disorders.

Women with type 1 diabetes are twice as likely to develop an eating disorder than other women without diabetes. Women who struggle with both conditions typically experience the same symptoms as women who only suffer from an eating disorder.


The condition known as diabulimia, which is a mix of both diabetes and bulimia, is characterized by a purging of calories by restricting insulin. This occurs when a person stops taking insulin, or takes in less insulin than needed, in order to lose weight. When a person neglects to take insulin, he or she is able to purge calories through the loss of glucose in urine. This condition is also characterized by weight and body image issues that are seen in bulimics.

People suffering from diabulimia also put themselves at risk for developing other serious conditions that are related to diabetes. Many can suffer from eye problems, from blurred vision to blindness. Other major problems include kidney failure, foot ulcers and nerve damage caused by uncontrolled blood glucose. Diabulimia can be even more serious in teens, because they are often unwilling to accept the long-term consequences of their actions. Moreover, studies have shown that one in five teens with type 1 diabetes also suffers from depression, which increases the risk that he or she will experience diabulimia.

Recognize Diabulimia

  1. Unexplained elevations in A1C values. Glycosylated hemoglobin, or A1c, tests provide a count of the average blood glucose levels over a period of three months. One indicator of the presence of eating disordered behavior could be frequent emergency room visits due to diabetic ketoacidosis.
  2. Extreme concerns about weight and body shape. In many cases, these individuals strive for thinness and are plagued by body dissatisfaction. Like with other eating disorders, a person struggling with diabulimia may erroneously believe he or she is overweight, when really he or she is below a healthy weight.
  3. Irregular eating patterns. A person may restrict food or skip meals in order to lose weight. Furthermore, a person will also have periods of intense overeating coupled with a sense of guilt, which will be followed by limiting food intake and avoiding insulin treatment.
  4. Amenorrhea, or irregular menses. Studies have shown that high A1c levels can cause irregular menstruation or a complete cessation of periods. In young girls, it can cause delayed puberty due to an interference with the function of the brain.

Treatment Options

Diabulimia can be treated nearly the same way bulimia is treated. If diabulimia is caught before it reaches a serious point, it is possible to reach recovery with the help of a team that consists of a nutritionist, psychotherapist, endocrinologist, family and friends. Developing healthy eating habits, learning about portion size and practicing healthy weight loss are important to recovery as well. It is also important to shift a person's focus away from weight and to promote appropriate exercise. Some individuals may need to resort to an inpatient treatment facility if the combination of bulimia and diabetes has reached a critical condition.