The Health Risks of Diabulimia Are FrighteningThe Health Risks of Diabulimia Are Frightening: Do You Know the Signs?

The side effects of Diabulimia almost sound like an ad for a crazy new fad diet: You can eat all you want, and still lose weight. The only problem, is the price you might pay for this miraculous method- blindness, hair loss, amputation, or death.

Unfortunately far too many diabetic teens and adult women are willing to take these risks. Diabulimia is the term used to describe the combination of mental health disorders that develop when a diabetic deliberately reduces their intake of insulin to reduce their body weight. It’s a very dangerous gamble. When diabetes collides with an eating disorder, the results can be fatal.

Diabetes and Eating Disorders

The intense focus on restricted diets that managing diabetes requires can easily contribute to disordered eating habits. The American Diabetes Association reports that women with type 1 diabetes are three times more likely to develop an eating disorder than their non-diabetic counterparts. For young women in the U.S., the risk of developing an eating disorder during college years can be as high as 40 percent. For young women with diabetes, however, this rate doubles. In a recent study of clients diagnosed with diabetes, 36 percent admitted to misusing insulin in order to control their weight.

The Numbers Tell the Story

According to a recent article in, the annual mortality rate from diabetes is around 2.5 percent of the general population. For anorexia nervosa, it’s 6.5 percent. For clients with diabulimia, a “dual diagnosis,” the mortality rate shoots up to 34.8 percent. Dr. Joel Jahraus, director of the Eating Disorders Institute, told Salon, “Both diabetes and eating disorders are high-risk conditions. But put them together and the risks are just wildly incremental.”

The Dangers of Mismanaging Diabetes

Along with the serious health risks that eating disorders pose, the added dangers of improperly managed diabetes can be horrific. Patients with diabulimia often suffer from retinopathy, neuropathy, metabolic imbalance, depression and other mood disorders, kidney disease and heart attacks. Diabetes demands proper treatment. “High blood glucose triggers a series of mechanisms that injures blood vessels and nerves throughout the body,” Dr. Richard Bergenstal, director of the International Diabetes Center told Salon. “It affects everything vascular, which means it’s the leading cause of blindness, kidney failure and amputations.”

How Diabulimia Begins

Type 1 diabetics need regular insulin injections to process glucose. Often diagnosed early in life, type 1 diabetics become used to their insulin regimen and adjust to monitoring their food intake. Without proper vigilance, a diabetic’s health can decline rapidly as their body struggles to regulate itself. One side effect of improper treatment is weight loss despite regular food intake. And this can be a great temptation for teens and adults that want to be thinner.

Because diabulimia results from the intentional restriction of insulin in order to lose weight, this reduction of insulin affects a diabetic’s inability to process glucose, and the body must burn through fat and muscle stores. The calories a person consumes are discharged through their urine, which contain high levels of glucose.

Diabulimia and Bulimia

The purging process that diabulimia permits often mirrors the cycles of bulimia. As Janice Dada explains in Today’s Dietician, “Diabulimia clients exhibit behaviors characteristic of the eating disorder bulimia nervosa by bingeing on large amounts of sugary or carbohydrate-rich foods and purging the excess sugar through urination. Individuals with bulimia nervosa who don’t have diabetes binge on large amounts of food but purge with the use of laxatives, self-induced vomiting, or excessive exercise to lose weight.”

Know the Red Flags

It’s important for concerned parents to know that diabulimia could be an issue for a diabetic teen with disordered eating habits. The following signs and symptoms of diabulimia provide significant clues:

  • hyperglycemia
  • a hemoglobin A1c value much higher than would be expected, given recorded blood glucose values
  • changes in eating habits (eating more but still losing weight)
  • dramatic changes in weight
  • low energy
  • unusual food patterns
  • bingeing on carbohydrates and sweets
  • obsession with food and body image
  • anxiety about weight or avoidance of being weighed
  • delay in puberty or sexual maturation
  • irregular or no menses
  • severe family stress
  • frequent hospitalizations for diabetic ketoacidosis
  • preoccupation with label reading beyond typical diabetes care
  • excessive exercise
  • hiding food
  • smell of ketones on the breath and in urine
  • frequent urination
  • physical signs of malnutrition such as hair loss and dry skin

Recovery is Possible

As a dual diagnosis, effective treatment for diabulimia requires a comprehensive approach by a team that includes experienced healthcare, mental health, therapy, nutrition experts, and more. If you suspect that someone you love may have this disorder, we urge you to call Center for Discovery immediately at 800.760.3934.

We’ve been guiding families to lifelong recovery for nearly 20 years. Our personalized behavior modification programs are tailored to fit the needs of each family. Center for Discovery provides integrated multi-faceted care options that range from residential treatment, intensive outpatient treatment, to partial hospitalization, for adults, adolescents, and teens that suffer from eating disorders, depression, anxiety disorders, bipolar disorder, self-harm behaviors, gender identity, oppositional defiant disorder, and most major mental health disorders.

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Today’s Dietician – Know the Signs and Symptoms to Better Counsel Female Patients, by Janice H. Dada, MPH, RD, CSSD, CDE, CHES. Retrieved November 11, 2016.

Salon: The diet that’s too good to be true, by Ann Bauer.  Retrieved November 11, 2016.

Eating Disorder Hope: Diabulimia: Dangers and Complications, by Crystal Karges, MS, RDN, IBCLC. Retrieved November 11, 2016.

Psychology Today: The Danger of Diabulimia, by Carlin Flora. Retrieved November 11, 2016.