Normally, a person eats when they are hungry and stops eating when they are full. An eating disorder is when a person eats, or refuses to eat, in order to satisfy a psychological need rather than a physical need. They don’t listen to their body’s signals and perhaps aren’t even aware of them.
In an eating disorder, a person develops disturbed eating behaviours to influence their shape or weight. A person may have disordered eating but if it's not about controlling their weight or shape then it's not an eating disorder.
Eating disorders are more common in people with diabetes. The four most common eating disorders are listed on this page, but eating disorders are complex conditions, and not all can be easily classified.
Binge Eating Disorders
This is similar to bulimia in that sufferers eat large amounts of food, but (unlike bulimia) do not purge. This generally leads to significant weight gain. People who binge eat tend to feel out of control around food.
People with bulimia eat large amounts of food (much more than a person without the disorder would eat at a sitting) and then immediately get rid of it by vomiting or taking laxatives (or both), by starving or reducing food intake, or by working off the calories with exercise in an attempt not to gain weight. Consequently weight loss may not be excessive, or weight may fluctuate.
This is a variation on binge eating when people eat at times when they are not hungry. This may happen all the time, or it may come and go in cycles.
A compulsive eater usually feels out of control around food and may feel guilty after eating. Most people who are compulsive eaters are overweight.
This is when a person restricts the amount they eat and drink, sometimes to a dangerous level. They may exercise excessively to burn off calories.
People with anorexia also have an extreme fear of gaining weight and a distorted body image. People with anorexia tend to be extremely slim.
This is when people with diabetes - mostly teenage girls and young women with Type 1 diabetes – deliberately skip insulin injections in order to lose weight. Diabulimia isn’t a recognised medical term, it is a name coined by the media to describe this phenomenon.
How Does "Diabulimia" Cause Weight Loss?
If the body doesn’t have enough insulin, it can’t use glucose properly for energy. So it tries to get it elsewhere by breaking down stores of fat and protein instead – which causes weight loss.
How Common is "Diabulimia"?
It’s estimated that one in three women under the age of 30 – that’s 3000 in the UK – are abusing insulin at any one time because of a fear of weight gain.
How Does "Diabulimia" Affect Your health?
When you haven’t got enough insulin in your body your blood glucose will go too high. This can seriously affect your short and long term health:
Short term – it can cause ketoacidosis, an extremely dangerous condition which requires immediate medical attention.
Long term – continual high blood glucose can cause serious complications of diabetes e.g. strokes, blindness, heart attacks, kidney disease and amputation.
What are Typical Warning Signs of "Diabulimia"?
• Weight loss.
• Fear of gaining weight.
• Distorted perception of body shape or weight.
• Denial of the existence of a problem.
• Changes in personality and mood swings.
• Symptoms of high blood glucose levels – thirst, passing urine frequently (especially at night), extreme tiredness.
If you’re stuck in a cycle of skipping your insulin and can’t seem to break out of it, it’s really important you get some help. You’re risking your health and even your life. Being skinny just isn’t worth that. But it can be really difficult to do it alone, so try to open up to somebody. But who?
Your family and friends – they can be a great source of support in helping you to break the cycle.
Your healthcare team – they will have come across this before and can refer you on to a psychologist if you need/want.
Diabetes UK Scotland Careline – available 9am to 5pm Monday to Friday. Staff are trained counsellors and everything you discuss will be in total confidence. Call them on 0845 120 2690, or email: email@example.com
The Diabetes UK Scotland Careline can be contacted in confidence, the staff are trained councellors. You can find out more information on the Diabetes UK website.
The Beat website also has information on the advice and support they can offer to help people with eating disorders.
The National Centre for Eating Disorders website also provides advice and information on eating disorders.
There is also 'Diabetics with eating disorders' which has information about diabulemia for people with diabetes, carers, and professionals - www.dwed.org.uk