Secrets of ‘diabulima’ emergeThe practice of skipping insulin shots to create weight loss hasn’t been medically recognized.
By JIM ELLIS
The Associated Press
At her home in Magnolia, N.J., type 1 diabetes sufferer Lee Ann Thill, 34, holds her glucose meter as she gets ready to check her blood sugar, a daily occurrence.
“I took just enough insulin to function.”
Lee Ann Thill, who has diabulimia
Like many teenage girls, Lee Ann Thill was obsessed with her appearance. A diabetic, she was already suffering from bulimia — forcing herself to throw up to lose weight. But it wasn’t enough, and she’d recently put on 20 pounds.
Then one day at a camp for diabetic teens, she heard counselors chew out two girls for practicing “diabulimia” — not taking their insulin so they could lose weight, one of the consequences of uncontrolled diabetes.
Don’t you realize you could die if you skip your insulin? the counselor scolded. Don’t you know you could fall into a coma or damage your kidneys or your eyes?
But that’s not what registered with Thill, who has type 1, or juvenile, diabetes. Instead, she focused on this: Skipping insulin equals weight loss. For the next 17 years, diabulimia was her compulsion.
“I took just enough insulin to function,” said Thill, now 34, of Magnolia, N.J.
Today she worries about the long-term damage that may have come from her weight obsession. At 25, a blood vessel hemorrhage in her eye required surgery. At 28, doctors told her she had damaged kidneys.
“I’m fearful for the future,” Thill said. “I feel very strongly that had I taken care of myself, I could have lived as long as anyone without diabetes. I don’t think that’s going to happen now.”
Diabulimia is usually practiced by teenage girls and young women, and it may be growing more common as the secret is exchanged on Internet bulletin boards for diabetics and those with eating disorders. One expert who has studied the phenomenon estimates that 450,000 type 1 diabetic women in the United States — one-third of the total — have skipped or shortchanged their insulin to lose weight and are risking a coma and an early death.
“People who do this behavior wind up with severe diabetic complications much earlier,” said Ann Goebel-Fabbri, a clinical psychologist at the Joslin Diabetes Center in Boston.
The American Diabetes Association has long known about insulin omission as a tactic to lose weight. But “diabulimia” is a term that has only cropped up in recent years and is not a recognized medical condition, said Barbara Anderson, a pediatrics professor at Baylor College of Medicine in Houston.
When type 1 diabetics skip or reduce their insulin, they risk falling into a coma or even dying. Blindness, amputations and kidney failure are some of the long-term complications that can develop.
Warning signs for diabulimia include a change in eating habits — typically someone who eats more but still loses weight — low energy and high blood-sugar levels, Goebel-Fabbri said. Frequent urination is another signal. When sugars are high, the kidneys work overtime to filter the excess glucose from the blood.
This purging of sugar from the body through the kidneys is similar to someone with bulimia, who binges and then purges, or vomits, Anderson said.
Studies show that women with type 1 diabetes are twice as likely to develop an eating disorder. Ironically, good diabetes management, which requires a preoccupation with food, counting carbohydrates and following a diet, may lead some to form an unhealthy association with food, Goebel-Fabbri said.
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Understanding diabetes
Type 1 diabetes is a disorder in which the body’s own immune system attacks insulin-producing cells in the pancreas. People with this disease produce little or no insulin, so they take shots of the hormone daily.
It differs from type 2, the form associated with obesity and which accounts for about 90 to 95 percent of all diabetes.
Insulin is vital for delivering glucose from the bloodstream to the body’s cells. Without insulin, cells starve even while the bloodstream becomes burdened with too much glucose.
A few pounds gained gets me upset but when I gained nearly 30 lbs when I went on insulin I went nuts. I would never do such a thing these days.
What is is called when you abuse your insulin so you can eat things you shouldn't??? is it normal??? If not, can it harm you...I need to know b/c my husband does it all of the time!!!
, Feb 2007 A1C 7.9 
, Jun 2007 A1C 8.0 
, Aug 2007 A1C 7.7 
, Nov 2007 A1C 7.7 
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