Remuda Ranch

Diabetes and Eating Disorders

Today, millions of women and girls throughout the United States are starving themselves, exercising to an excessive degree, or spending huge amounts of money to take part in the latest diet craze. All this with one goal in mind: to be thin. However, another group of people, equally driven by the desire to shed pounds, have discovered a different way. Some individuals with Type I diabetes have found they can have a skinny body without cutting back on calories, running a single mile, or spending a dime. By reducing their insulin intake, this goal can be achieved without the efforts of dieting and exercise. This practice is commonly referred to as diabulimia.

But though a waif-like body may result, the price is huge and the price is often permanent, frequently paid in the form of disability or death.

By definition, diabetes is very taxing on a person’s body, especially the eyes, nerves, and kidneys. In fact, the leading cause of blindness in the US is diabetes. Yet, with good medical care, healthy diet and reasonable exercise, Type I diabetics can live long and healthy lives… unless an eating disorder is added to the equation. Unfortunately, far too many adolescents in particular use insulin manipulation as a form of weight control. Whereas a young woman with bulimia might purge through vomiting or excessive exercise, a diabetic purges by under dosing insulin, which causes sugar to be eliminated from her body via urine.

The combination of the two isn’t just unhealthy, it is often lethal. When anorexia is present, the mortality rate for these young women escalates to 35%. Perhaps even worse than the heightened death rate is the escalation of medical complications such as vision loss and kidney failure. What a diabetic woman might expect to experience in 15 to 20, even 30, years, she is accelerating to five to seven years. This means if a Type I diabetic begins insulin manipulation at the age of 17, she could be totally blind, suffering from extreme nerve pain, or on a kidney-transplant list by her mid 20s. To say nothing of the fact that her ability to have children may be permanently compromised. No wonder this is considered by the health profession to be the worst possible combination, Type I diabetes plus an eating disorder.

What can be done? A lot. If you or someone you know is manipulating insulin as a method of weight control, professional help must be sought immediately. Damage does not have to be permanent, but rarely can a good outcome be accomplished without medical intervention. If you are a parent of a diabetic child and you think this behavior may be occurring, you must take action. Do not expect your daughter to be honest when questioned. Deception is part of eating disorders. Rather, take note of such things as her insulin. Does she seem to be using less, or have you seemingly had to purchase fewer bottles lately? Check her blood sugar yourself, and if possible, examine the sugar log on her glucometer. Get to her physician for a Hemoglobin A1C --- often this number will be very revealing in terms of possible long-term under dosing. Remember, the earlier you get help, the greater the possibility for a positive outcome.

For more information, contact Remuda Programs for Eating Disorders at 1-800-445-1900.