"Diabulimia" — risky weight management for people with type 1 diabetes?

Originally Published: December 12, 2008 - Last Updated / Reviewed On: August 9, 2011
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Hey Alice!

I recently read an article in a magazine regarding a new disorder termed "Diabulimia." Supposedly, this is a disorder displayed by women with type 1 diabetes in order to lose weight. The women with type 1 diabetes, who take insulin shots, compared these shots to "injectable fat" and therefore they skip their shots all together.

The reason why this topic is so surprising to me is because I am a type 1 diabetic and have been for almost 17 years and I have gained weight since beginning treatment. What happens to the body when this occurs? Also, if a person tries to treat the "diabulimia," will all the weight that was lost be gained right back when she begins to inject the shots again? What other method of losing weight would you suggest for someone like this? I would never risk my life in order to lose weight, but I would still like to learn about it because it is something I have never heard of. Thank you so much!

Sincerely,
The Wondering Diabetic

Dear The Wondering Diabetic,

As you've experienced, weight gain can be a common side effect of insulin therapy. Some diabetics do resort to skipping their insulin shots in order to lose weight, a disorder known as "diabulimia." Although diabulimia is not recognized as a medical condition, recent research indicates that this risky weight loss strategy can cause serious health problems and even death. Diabetics and non-diabetics alike can safely control their weight through regular exercise and a healthy diet.

Normally, insulin allows body cells to absorb sugar from the food we eat. Cells burn the sugar as energy and any leftovers are stored as fat. Before being diagnosed, type 1 diabetics are often under-weight since their bodies are unable to use sugar properly. Insulin therapy enables type 1 diabetics to process sugar, and to convert excess sugar into fat, which then causes weight gain. Skipping insulin shots may seem like an easy way to lose weight, but denying the body insulin has harmful effects.

Without insulin to metabolize sugar, body cells are deprived of necessary fuel. To survive, the body breaks down fat and protein (instead of sugar) for energy, which releases toxic acids called ketones. This leads to a potentially deadly condition called ketoacidosis. According to the Mayo Clinic, signs of diabulimia and/or ketoacidosis include weight loss, excessive thirst, frequent urination, low energy, nausea, fruity-scented breath, neglecting blood sugar monitoring or insulin dosage, and uncontrolled blood sugar. Diabulimia and lack of insulin also cause sugar to build up in the bloodstream. Over time, high blood sugar can cause heart and blood vessel disease, nerve damage, and kidney damage.

Safe weight management strategies for diabetics (and people recovering from diabulimia) include a healthy diet, frequent exercise, and proper insulin therapy. Nutrition recommendations are similar for diabetics and folks without insulin disorders, and include eating mainly fresh fruits and veggies, whole grains, and a daily breakfast to keep your metabolism steady. The American Diabetes Association has several good resources for diabetics who are looking for healthy ways to keep off excess pounds and stay in shape. Take a look at their exercise plan and meal plan for diabetics. You might also want to check out Meal planning for people with diabetes on Go Ask Alice! 

Before making diet or exercise changes, diabetics should talk with a health care provider. Columbia students can make an appointment with a clinician and/or a registered dietician at Primary Care Medical Services through Open Communicator or by calling x4-2284. CU Move, Columbia's physical activity motivation program, is another good resource for students beginning a new exercise plan.

Although it may be tempting to skimp on your insulin shots to lose a few pounds, diabulimia has serious health consequences so you're right to be wary of this weight loss strategy. Healthy diet and exercise are safe ways to manage your weight that will keep you healthy in the long run.

Alice