Diabetic Eating Disorders
When Diet Becomes Obsession

Diabetic eating disorders hurt type 1 and type 2 diabetics. Our obsession with food and diets can turn into an eating disorder. So you need to know how it happens and what to do for it.

The growth of these disorders in young type 1 diabetic girls worries parents and doctors. They know teens get hit hard with self image issues.

The emotional toll of living with diabetes compounded by body image problems has led to some new diabetic eating disorders.

Doctors call them diabulimia and orthorexia.

How a Diet Turns into an Eating Disorder

Eating disorders are hard to see in diabetics because some of the behaviors that mark food obsession are things we are supposed to do.

But the estimate is that 25% of diabetic women have at least one eating disorder.

As a diabetic you are taught to keep track of what and how much you are eating and told to lose weight.

Food diaries and scales are a part of a diabetic's life. But a fixation with food and measuring is a red flag for eating disorders.

You may have become type 2 diabetic after years with an eating disorder. If you have struggled with weight control and food issues all your life, it is likely that you have at least one.

Exercise helps you avoid diabetic complications.

Diabetes and Food Obsession

Diabetes can make diabetic eating disorders worse. How? The first thing you are told after the diagnosis of type 2 diabetes is that you need to lose weight.

This means a complete diet overhaul. Dietitians load you down with charts and booklets about weighing, measuring, portion size and food pyramids.

What they do not tell you is that diabetes medications often cause weight gain or that weight loss gets harder because of insulin imbalance.

So you wake up thinking about diabetes and go to bed stressed about the mistakes you made that day.

This focus on food and losing weight can worsen an eating disorder if you lose perspective.

Orthorexia Nervosa

Becoming obsessed with eating right leads to orthorexia. The word simply means "right eating," and it is the newest of the diabetic eating disorders.

It is considered an eating disorder because the obsession to eat only the right foods leads some of us to starvation. The best way to know you are obsessing about this is to ask yourself a question.

"Do I enjoy the virtue of eating the right things instead of enjoying what I am eating?" If the answer is yes, orthorexia is coming, and you are in danger of cutting some things out of your diet that you actually need.

Enjoying food is part of enjoying life, and we do not have to lose that simply because we have diabetes.


Move over anorexia and bulimia. Diabulimia has been added to the list of eating disorders. It refers to stopping insulin injections to cause weight loss.

An 11-year-old type 1 diabetic girl stops taking her insulin so she can lose weight. Another girl uses control solution instead of her own blood on her glucose monitor to hide the fact that her blood sugar is way too high.

These girls want to lose weight and know that high blood sugar leads to weight loss. But they are putting their lives in serious danger.

Insulin injections lower the after-meal (postprandial) spike in type 1 and some type 2 diabetics. It is something we have to do at every meal without fail.

Using insulin to control blood sugar helps us avoid kidney disease, blindness and amputations that used to plague long-term diabetics.

Skipping Insulin to Lose Weight

So why skip your insulin dose? The problem is that insulin is a storage hormone.

Along with getting sugar into your cells and keeping your body from using muscle to feed itself, insulin encourages fat cells to store glucose.

So weight gain can be a side effect of injecting insulin.

Diabulimia is the habit of lowering or skipping insulin doses to lose weight. Type 1 diabetic girls who do this are playing a dangerous game.

They allow their blood sugars to run high because long-term hyperglycemia makes them lose weight. The trouble is it works.

I know because right before I was diagnosed, my weight dropped dramatically. It was amazing to lose weight without dieting.

What was really happening to me? My body was dumping calories instead of using them, feeding on protein from my heart and other muscles. Then came the stroke.

When blood sugar stays too high, diabetics can die from stroke or heart attack. But that is not the only reason why skipping insulin to lose weight is a terrible idea.

High blood sugar blinds you with retinopathy, destroys your kidneys with nephropathy, and worsens neuropathy, the number one cause of below the knee amputations.

Recognize Diabulimia

 If you suspect someone you care for has diabulimia, watch for the signs.

She will have low energy and her blood sugars will be too high consistently. She will lose weight even if she is eating enough.

She will need to urinate frequently. Her hemoglobin A1C will be too high. Other symptoms are secretive eating, preferring to eat alone and eating from only certain food groups.

She may be obsessive with her body image and may wear baggy clothes to conceal weight loss.

It can happen to men too, but young teenage women seem to be more likely to have diabetic eating disorders.

When you suspect diabulimia, encourage the person to get help from someone who understands diabetic eating disorders.

You Can Fight Back

If you know you have one of the diabetic eating disorders, you have two choices. Continue your destructive course or call out for help.

An alert doctor or nurse might help you, but no one can make the decision for you.

Do not dwell on the mistakes you have made in the past. All you have to do is decide what to do now. Ask for help.

This is not something you can do by yourself so do not try.

Keep Your Perspective

If you are battling obsession because you are diabetic, try exercise to give yourself a different way of looking at diabetes.

Combining diet and exercise can help you avoid the tunnel vision of trying to lose weight by eating less and less.

A type 2 diabetic can lose weight. Simply eat a reasonable 1200 to 2000 calorie diet and be active for more than an hour a day.

You might mix heart pumping (aerobic) exercise, resistance training and active hobbies like gardening.

Being active has other benefits too. It stimulates the beta cells in a type 2 diabetic.

All of your hormones work better if you are not sedentary. You also sleep better. Build some muscle mass and keep off the weight you worked so hard to lose.

You might be able to take less type 2 diabetes medicine because of the changes.

A healthier pancreas is one result of exercise that can restore the balance of hormones - insulin, glucagon, amylin and leptin - that help your body regulate hunger.

So here is another reason why exercise is the best medicine for type 2 diabetes. Exercise can help you fight diabetic eating disorders.

But do not try to go on this journey alone. Hope and help are waiting for you if you ask.

  • "There are far, far better things ahead than any we leave behind." C. S. Lewis

Go to diabetes management from diabetic eating disorders.