When diabetes is not managed correctly (i.e if insulin is not taken regularly) the body goes into a state called diabetic ketoacidosis. This is when the body builds up poisonous toxins called ketones. If insulin is not taken, the cells in the body cannot be ‘unlocked’ therefore ketones/sugar build up in the blood and calories/energy cannot be stored properly in the body. As a result, the body begins to break down fat to be used for energy and thus the diabetic begins to rapidly lose weight.
There are many obvious and dangerous ‘give away’ symptoms, of which include constant thirst, a constant need to urinate, a sweet ‘pear drop’ smell on the breath which can also be likened to the smell of nail polish remover (this is due to a build up of acid/ketones on the lungs), shortness of breath, weakness/fatigue/constant sleeping, constant appetite/loss of appetite, higher than average HBA1C levels, nausea, aggressiveness, mood-swings, inability to concentrate and of course, rapid weight loss.
Long term symptoms (when the diabetic has been practicing diabulimia for a fairly long time) include severe dehydration, muscle loss, hair loss, loss of periods/irregular cycle, acid reflux, edema (mostly in the ankles, legs and stomach), extremely above average HBA1C levels, severe weight loss, low potassium levels, and in the worst cases, he or she may fall into a diabetic coma.
Symptoms that may occur later on in life, due to diabulimia include kidney failure/disease, blindness, neuropathy (nerve damage), heart problems, amputation, and a lower life expectancy.
For many diabetics (particularly girls) the initial weight-loss can be very rewarding, just as anorexia or bulimia can be, and therefore can often become addictive. Although life-threatening and extremely dangerous, this can result in a serious eating disorder where the diabetic begins to put the eating disorder before diabetes control. The reason why this ‘new found’ eating disorder has been named ‘diabulimia’ is because, essentially, it is the same as typical bulimia, except there is no need to purposely vomit; the restriction of insulin is extremely similar to the results of vomiting after food, thus why it is sometimes called ‘purging’ the body of insulin – in both cases, the body is not given the chance to absorb enough calories/fat etc from the food.
Unlike with anorexia, a diabulimic can eat as much as they want and still lose weight rapidly; so long as they carry on restricting their insulin. As a result, a food addiction may present itself, thus making recovery a harder job. On the other hand, if the diabulimic is forced to take insulin, they may panic and resort to anorexic behaviours, as when insulin is regularly taken after insulin-withdrawal, it is very common to weight gain to occur very rapidly and can be extremely difficult to deal with, especially if the diabetic was used to being slim/skinny or even underweight before.
As a result of this, diabulimics can often become caught in a catch-22 situation. If they neglect to take their insulin, they can lose masses of weight but become sick and rapidly detoriorate, often leading to hospitalisation if things become out of hand. However, if they attempt to get their diabetic control back on track and return to regular insulin shots, they may gain weight and often will fall trap to the temptation to skip insulin to lose weight as before to deal with this.
Unfortunately, around 30% of women with type 1 diabetetes admit to ‘omitting’ insulin at one point or another and it seems that many are ashamed to admit this and struggle in silence. Although, of course, other eating disorders such as anorexia nervosa and bulimia nervosa are potentially deadly, the mortality rate for diabulimics is 34.8% per year. The mortaility rate for anorexia is 6.5% per year.
Diabulimia kills. If you think you or a loved one may be suffering with it, please refer to my ‘Need help?’ page. You do not need to suffer in silence.