How Diabulimia Develops
There are lots of reasons diabulimia may develop. It’s often not just down to one thing – it might be a combination of physical, social and mental health problems. When you have type 1, the things you need to do to manage it can play a part in setting off diabulimia, like:
- having to carefully read food labels
- being constantly aware of calories or carbohydrates in your food
- the focus on your weight when you go to the clinic
- losing a lot of weight before a type 1 diagnosis and regaining the weight when starting medications
- having to eat to treat hypos, which can cause weight gain and guilt
- feeling shame over how you manage your diabetes
- a bad relationship with your healthcare team
- difficulty keeping to a healthy weight.
How common is diabulimia?
We don’t know exactly how many people are living with it. It is estimated that up to 30% of people with type 1 diabetes have an eating disorder. Eating disorders are twice as common in people with type 1 diabetes than people without the condition.
Insulin and weight loss
When you’re diagnosed with type 1 diabetes, you’ve generally lost weight. Starting insulin can mean you put that weight back on. Some people can find this hard to deal with and this can be one of the reasons they start to skip doses.
Without insulin, your blood sugar levels build up really quickly. This is known as hyperglycaemia (or hyper) and you start going to the toilet a lot. Any calories you’re taking in pass straight through and out of the body in your urine.
This means you can’t get the energy you need from food and you start to break down body fat instead. This leads to dramatic weight loss.
Consequences of diabulimia
If you don’t get any or enough insulin, your blood sugar levels won’t come down. This is very dangerous and it can send you into diabetic ketoacidosis (DKA) – which can be fatal.
And if you regularly stop taking insulin for a long time, you will harm your body. You could lose your sight, damage your kidneys and damage the nerves in your feet. These are called diabetes complications. They can happen because high blood sugar levels are damaging your blood vessels.
It’s not always easy to manage diabetes. And coping with an eating disorder like diabulimia can make it even harder. You may also feel bad about hiding it from the people you care about.
But you’re battling a serious condition and no one can do that alone. It doesn’t mean you’re a weak person. Everybody with diabetes has their ups and downs. You’ve managed your diabetes well in the past, but now you’re not able to. So you need help.
“It’s easy to say, but speak to someone. If you don’t speak to someone it just gets worse. You’ll feel better when you acknowledge it’s a problem. I felt I’d got into such a deep hole with not managing things that it would be impossible to change that around, but the right people can help you get there.” Lynsey
Asking for help can feel difficult because you know this is the start to facing up to and dealing with the problem. But you won’t be doing it alone.
Once you’ve shared the difficulties you’re having, you can take the next step when you’re ready – and that’s getting advice and treatment from a healthcare professional.
Talk to someone
Talk to someone you trust. This could be a friend, a parent or sibling, a flat mate, a colleague, or a member of your healthcare team. Their response may surprise you. People who care about you will want to help even if they don’t understand what you’re going through. They will worry less if they know you’re being honest with them.
Type 2 diabetes and diabulimia
If you have type 2 diabetes and you take insulin to treat it, the consequences of not taking insulin are often not the same. So that’s why we talk about diabulimia only affecting people with type 1. But we know people with type 2 and other types of diabetes can struggle with other eating disorders. If that’s you, we know asking for help can be difficult. But opening up to someone you trust will mean you’re not alone with it. And it can be the first step in getting the help you need.
Source: Diabetes UK