by Diabulimia, when the patient stops taking insulin to lose weight, is more common in young diabetic girls
People with diabetes are 2.5 to 3 times more likely to develop eating disorders than those without the disease in the same age group. And the problem can easily go unnoticed by doctors and family members. The scenario is more worrying in young people with type 1 diabetes, who may have a condition called diabulimia – when they stop taking insulin in order to lose weight.
On this June 2nd, the World Day of Alert for Eating Disorders, the Brazilian Society of Diabetes reinforces a campaign launched especially to draw attention to these cases, called #DiabulimiaNao.
Although still largely unknown, diabulimia usually appears in pre-adolescence and adolescence and can affect up to a third of diabetic girls between 16 and 22 years old. In addition to failing to take or skipping insulin doses, these patients may also exhibit so-called compensatory behaviors, such as vomiting, use of laxatives and diuretics, or excessive physical activity.
“At this age, there is usually dissatisfaction with the body and the very nature of diabetes, with more attention to food, carbohydrate counting, diet planning, it ends up leaving aside more those who are predisposed”, explains endocrinologist Claudia Pieper, coordinator of the Department of Psychiatry, Psychology and Eating Disorders of the Brazilian Society of Diabetes and Member of the Academy for Eating Disorders. It is even more serious in cases where there are other mental health disorders involved, such as anxiety or depression.
decompensated diabetes
The lack of insulin leads to excess blood sugar that causes metabolic changes and makes the body use fat reserves, promoting weight loss. The person ends up eliminating glucose and excess calories through the urine as well. But uncompensated diabetes brings serious, potentially fatal, risks, such as malnutrition, impaired growth, a greater chance of early chronic complications (with only 4 or 5 years of disease) such as retinopathy (a complication that occurs when excess glucose in the blood damages blood vessels within the retina), damage to the kidneys, diabetic neuropathy, among others.
The diagnosis of diabulimia is not always easy. Attention should be paid to the patient’s warning signs, such as frequently forgetting the glucometer (device that measures blood glucose), not correctly recording dosage results, not wanting to weigh themselves, asking for more restricted diets, having high blood glucose levels in exams that show the average of the last months, doing excessive physical activity, having hospitalizations for diabetic ketoacidosis (high blood glucose), pens or bottles of insulin that take time to finish.
The treatment must be taken care of by a multidisciplinary team, including physicians, psychologists and psychiatrists. “These are two very stigmatized diseases, but they can be treated and it is possible to recover from an eating disorder”, says an expert.
Although the best-known eating disorder is anorexia – when a person is terrified of getting fat and starts restricting more and more food – the most prevalent in the world is binge eating, in which the individual comes uncontrollably, but does not exhibit compensatory behaviors. This favors weight gain and obesity, with a higher risk of developing type 2 diabetes. Anorexia is rare in diabetics. (Source: Einstein Agency)
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