Has your daughter or son with Type 1 Diabetes suddenly lost weight? Does he or she think too much about food, body shape, and weight? Sometimes you may be surprised to find that he or she is not taking his or her insulin injections. This is not a joke, it is a very dangerous condition that can affect your life. In medical terms, we call this Diabulimia . Although the name may sound strange, we must understand the seriousness of this. So, let's talk about it in detail.
What is Diabulimia simply?
The word 'diabulimia' is formed by combining two words: diabetes , which means diabetes , and bulimia .
- As you know , diabetes is a disease that affects the way our body controls sugar. Especially in Type 1 Diabetes, the body is unable to produce the hormone insulin.
- Bulimia is an eating disorder in which a person eats a large amount of food at once and then purges the food by vomiting or other means, fearing weight gain.
Do you understand the connection now? Simply put, diabulimia is when a person with type 1 diabetes deliberately avoids taking their necessary insulin injections in order to lose weight.
Although this is not yet officially classified as a mental illness, the damage it can cause is extremely serious.
Who is most vulnerable to this dangerous situation?
This condition is most common in women and young girls. In fact, women with type 1 diabetes are twice as likely to develop an eating disorder. Studies show that about 30% of young people with diabetes reduce or stop taking insulin in an attempt to lose weight .
It is difficult to pinpoint a single cause for these types of mental conditions. It may be influenced by a family history of these conditions. Also, factors such as family stress and trauma can also contribute to this.
Especially at a young age, people become very sensitive about their body shape and what their friends think. Having to constantly think about food and weight due to diabetes can also contribute to this condition.
What happens to the body when insulin is stopped? How serious is this?
Imagine, a person with type 1 diabetes does not produce insulin in their body at all. So it is essential to take insulin from outside. Insulin is like a key that opens the door to the cells in our body. Only if this key is present can the sugar (glucose) in the blood enter the cells and be converted into energy.
If someone intentionally does not take insulin,
1. Blood sugar levels rise uncontrollably.
2. Since the cells cannot take up sugar, this excess sugar starts to be excreted in the urine. Since water is also excreted along with the sugar, body weight decreases rapidly.
3. This is what these people hope for, losing weight. But they don't see the devastation that comes with it. When sugar is no longer available for energy, the body starts to burn its own fat . In this process, toxic chemicals called ' ketones ' are produced in the body.
4. When these ketones build up, the blood becomes too acidic, leading to a potentially fatal condition called Diabetic Ketoacidosis (DKA) . This is a medical emergency. It can lead to a person falling into a coma or even death.
The short-term and long-term risks of this situation are very dangerous.
| Serious complications that can occur due to diabulimia | |
|---|---|
| High blood sugar | Sugar in urine |
| Diabetic Ketoacidosis (DKA) | Dehydration |
| Muscle loss | High cholesterol |
| Frequent bacterial and yeast infections | Irregular or stopped menstrual cycle |
| Damage to the blood vessels in the eyes (Retinopathy) - can lead to blindness. | Nerve damage - numbness in the limbs |
| Thickening of blood vessel walls (atherosclerosis) | Liver disease |
| Stroke | Coma and Death |
Remember, eating disorders have the highest mortality rate of all mental illnesses. Studies have found that women who don't take insulin to lose weight die about 10 years earlier than women with diabetes.
What are the symptoms that can identify this condition?
If you suspect that someone is engaging in this dangerous behavior, be on the lookout for these signs. The main sign is unexplained weight loss . In addition, you may see these things:
| Warning signs of Diabulimia | |
|---|---|
| Feeling tired all the time | Constantly feeling extremely thirsty |
| Talking or thinking too much about body weight or shape | Overeating (especially sweet things) |
| HbA1c test report, mismatch with home blood sugar levels | Skipping doctor appointments |
| Working secretly about sugar levels, insulin intake, and food | Restlessness, depression, or frequent anger |
| Excessive exercise | Fruity breath (a sign of increased ketones) |
| Hair loss and dry skin | Delayed puberty in young people |
What should I do if I or someone I know is suffering from this condition?
This is the most important thing. Diabulimia is a mental illness. Therefore, professional help is definitely needed to overcome it. If you notice these symptoms in yourself or someone you know, please do not ignore it. Seek medical advice immediately.
The first thing you should do is talk to your diabetes doctor (Endocrinologist). He or she is knowledgeable about this condition and can refer you to other specialists if needed. This is usually done by a team. This team may include:
- Endocrinologist
- Diabetes counselor
- Nutritionist
- Mental health counselor or psychologist
Treatments don't bring results overnight. They take time. But with the right support, recovery is definitely possible. Some of the main treatments are:
Cognitive Behavior Therapy (CBT)
Simply put, this involves identifying our incorrect and distorted thoughts (e.g., "I'm fat," "It's okay not to take insulin to lose weight"), changing them, and thereby changing our dangerous behavioral patterns.
Group Therapy
When you talk to other people who are going through similar problems, you feel like you're not alone. This helps a lot to learn from others' experiences and support each other.
Family Based Therapy (FBT)
This is a very effective method, especially if a young child is suffering from this condition. Here, the entire family is involved in the treatment process. This helps the parents understand the child and provide the child with the right support.
Take-Home Message
- Diabulimia is a very dangerous condition in which a person with type 1 diabetes intentionally does not take insulin to lose weight.
- Skipping insulin can lead to fatal complications such as diabetic ketoacidosis (DKA), blindness, nerve damage, stroke, and death.
- If you notice signs like unexplained weight loss, obsessive thoughts about food and weight, or secretive behavior, don't ignore them. It could be a cry for help.
- This is not something that can be controlled with mental strength, but a mental illness that requires professional medical help.
- If you or someone you know is suffering from this condition, talk to your doctor immediately and seek necessary treatment. You don't have to fight this battle alone.
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