What causes diabulimia?

What causes diabulimia?

Diabulimia and all eating disorders are complex conditions. For this reason, there’s no one cause of diabulimia. There are lots of reasons diabulimia may develop, and it may be a combination of physical, social and mental health problems.

When you have Type 1 diabetes (T1D), the things you need to do to manage it can play a part in triggering diabulimia and other eating disorders, including:

• Constant and intense focus on food, especially counting carbohydrates.
• Having to carefully read nutrition labels.
• Needing to track several numbers, such as blood glucose levels, A1c results and weight.
• Needing to consume food in order to treat low blood sugar (hypoglycemia), which can lead to weight gain.
• Feeling shame about how you manage your diabetes and/or for having a chronic illness.
• Difficulty maintaining a healthy weight.

Several other factors could contribute to a person with Type 1 diabetes developing diabulimia, including:

• Diabetes burnout: Diabetes burnout involves feelings of frustration and mental exhaustion related to diabetes management. It can lead to certain behaviors such as not checking your blood sugar levels as often and more frequent guessing at carbohydrate counts and insulin doses rather than calculated measuring. These behaviors can lead to elevated blood sugar levels and not enough insulin, which can lead to weight loss. Because of this, diabetes burnout could lead to purposefully restricting insulin in order to lose weight.
• Wanting a sense of control: People with T1D may feel like they don’t have control of their body, and they may have anxiety about diabetes complications or even death. This could contribute to an increased need to control other aspects of their life, such as weight and eating.
• Body image issues: Having a distorted self-image of your body can contribute to developing an eating disorder, including diabulimia. People with diabetes may be extra concerned about their weight and shape due to certain stigmas against people with diabetes — mainly the stigma and myth that having excess body fat directly causes diabetes.
• A desire to lose weight: If a person with T1D wants to lose weight, they might try to restrict their insulin to lose weight (diabulimia) instead of using healthy ways to lose weight.
• Weight gain after initial diabetes diagnosis and treatment: Leading up to a T1D diagnosis, many people experience profound and rapid weight loss since their body is essentially starving due to a lack of insulin, and they’re very dehydrated. Once they receive insulin and become healthier, they usually gain back that weight — in large part due to rehydration. Someone with T1D may not see that treatment and process as becoming healthier but instead as “insulin made me gain weight.”
• Environment and culture: Cultures that idealize a particular body type — usually “thin” bodies — can place unnecessary pressure on people to achieve unrealistic body standards. Popular culture and images in media and advertising often link thinness to popularity, success, beauty and happiness. This may contribute to someone developing diabulimia.
• Peer pressure: Particularly for children and adolescents, peer pressure can be a very powerful force. Experiencing teasing, bullying or ridiculing because of appearance or weight or for having diabetes can contribute to the development of diabulimia.
• Emotional health: Perfectionism, impulsive behavior and difficult relationships can all play a role in lowering a person’s self-esteem and perceived self-worth. People with T1D often feel a lot of shame about their management. This can make them vulnerable to developing diabulimia.

It’s important to note that there’s no single path to an eating disorder or diabulimia. If you or a loved one are experiencing signs and symptoms of diabulimia and/or diabetes burnout, it’s important to seek help.