Diabulimia is a disorder that's becoming more common among insulin-dependent diabetics who want to lose weight, explains Ann Goebel-Fabbri, a psychologist at the Joslin Diabetes Center. About one third of all American women with type 1 diabetes, have manipulated their insulin at some point to lose weight, according to the same body of research.

Those with diabulimia view insulin not as a life saving medicine but as an enemy that causes them to gain weight. When they don't inject themselves with insulin, they lose weight. Their focus is on getting skinny, not on getting healthy, and the consequences can be both short term and long term.

The typical person with diabulimia is a young woman with a poor body image who realizes that if she cuts back on insulin, she'll shed pounds.

"We are seeing more and more people with weight related problems like obesity who have to take insulin," says Roberta Pearle Lamb, RD, MPH, who has a specialty in eating disorders. "They see this as a quick fix for their weight problems."

The Consequences

If a person who needs insulin doesn't get it, he won't properly absorb nutrients, she explains. And they start to lose weight in much the same way that an as yet undiagnosed diabetic does. In the short term, they will have blood sugar abnormalities. Long term, the price people with diabulimia pay is with all the complications that can occur with out of control diabetes, such as kidney and vision problems and cardiovascular disease, according to Lamb.

When an insulin-dependent diabetic does not take insulin, she is prone to a host of maladies, explains Dr. Steven Joyal, internist and author of What Your Doctor May Not Tell You About Diabetes: An Innovative Program to Prevent, Treat, and Beat This Controllable Disease.

"If she doesn't take her insulin, she experiences not just weight loss but thirst, frequent urination, and being very hungry," he says. "Typically, these patients will overeat but what they have discovered is that they won't gain weight if they don't use insulin."

How to Help Someone Who May Be Suffering:

  • Know the signs of poor control in a diabetic: excessive thirst, frequent urination. If a person skips insulin, she also could be nauseated, have abdominal pain and vomit.
  • If the diabetic person shows signs of anxiety or depression, or has low self esteem, she may be more at risk for developing diabulimia.
  • If you suspect your child or teen is abusing insulin, seek help from a doctor right away.
  • Be understanding toward a diabetic teen who struggles with her weight, but also be vigilant about her diabetes management.