Insulin becomes the enemy
This practice of withholding insulin to lose weight is often called “diabulimia” by the media and lay public. However, the syndrome — officially known as ED-DMT1 — is considered a serious dual diagnosis and is especially dangerous because the person has to deal with two potentially lethal illnesses.
Dr. Goebel-Fabbri says insulin restriction is a byproduct of the “fear of being fat.” Young women are especially vulnerable to messages from social media and friends about body size and self worth. At the same time, anxiety and depression, which are common in diabetes, often exacerbate the problem.
While withholding insulin can lead to rapid weight loss, it also increases the risk of serious complications such as ketoacidosis, long-term diabetes complications (eye, nerve and kidney disease), and even increases risk of dying, says Dr. Goebel-Fabbri.
Warning signs of “diabulimia” include:
- Rapid weight loss
- Elevated A1c
- A preoccupation with dieting
- Secrecy about blood sugars, eating and insulin shots
- Depression, mood swings or fatigue
- Unexplained episodes of ketoacidosis
Hitting rock bottom
As the eating disorder takes control over the person’s life, the need to drop a dress size or fit into skinny jeans outweighs how horrible the person may feel, or even the harm they’re doing to their body. Skipping insulin shots for periods of time can cause irreversible damage to the body.
“Women often describe losing “everything” — professional opportunities, their energy and health; romantic ties, friendships, and family relationships, essentially their overall quality of life,” says Dr. Goebel-Fabbri.