Diabulimia isn’t in medical books because it’s not a recognised condition, but it’s used as a term by the media to describe diabetics with bulimia. Bulimia occurs with eating and then purging calories, whereas diabulimia is a matter of purging calories by cutting back on insulin. Polonsky says ‘it can harm you terribly in the near-to-long term. It is so scary and hard to treat.’
If you have type 1 diabetes, your pancreas doesn’t produce insulin, the hormone the body needs to absorb glucose (sugar) and use it as energy or store it as fat. Therefore, you would lose weight without your insulin medication as the glucose would build up in your blood and be excreted in your urine. However, though it brings dramatic weight loss, reducing your insulin also brings dramatic consequences such as more frequent episodes of diabetic ketoacidosis, a condition in which acids build in the blood and can cause coma or death, more hospital visits, more infections and more early-onset diabetes complications like nerve damage, eye and kidney disease, and heart disease.
For parents who want to help their child’s wellbeing by detecting signs of diabulimia, Polonsky says the first clue to look out for is ‘Unexplained, chronically high blood sugar’. Watch out for your daughter’s A1C number, which means the average blood sugar level over a period of 3 months. If it rises inexplicably, that’s not a good sign. Also, watch out for a change in eating habits, such as eating more but still losing weight, low energy levels, frequent urination, extreme concerns about weight and body shape, repeated problems with diabetic ketoacidosis, missed menstrual periods and unusual patterns of intense exercise, which are sometimes associated with frequent hypoglycaemia. However, take care in approaching the situation, starting with an open discussion with your daughter and her diabetes team.