Other eating problems
Diabulimia
Sometimes, but not always, classified under OSFED, diabulimia affects those with type 1 diabetes who intentionally reduce or stop insulin intake to lose weight. Someone with diabulimia will generally not have any other eating disorder behaviours, but since the consequences of reducing or stopping insulin can be very serious and even life threatening, it is essential professional help is sought.
Although not as widely known as an eating disorder, those with diabetes are considered at higher risk of developing an eating disorder due to several factors including the need to carefully consider nutritional food labels, being very aware of carbohydrate and calorific content in foods eaten and a clinical focus on weight for management of diabetes. One study in 1991 for example revealed that around 37% of women had reduced or omitted insulin to influence their weight.
More specialised information on diabulimia is available via Diabetes UK’s website.
For those with type 1 diabetes who do engage in other eating disorder behaviours, such as food restriction, purging or bingeing alongside insulin omission/restriction, they may receive a different diagnosis of eating disorder-diabetes mellitus type 1, often abbreviated to ED-DMT1, or perhaps more memorably T1ED (type 1 eating disorder).
Specifics of this diagnosis from an eating disorder perspective will be in line with the symptoms and behaviours of the range of eating disorders. For example, those with anorexia alongside type 1 diabetes will be restricting both insulin and food/calorie intake. Those with binge eating disorder and type 1 diabetes may engage in bingeing episodes and then restrict insulin to control/reduce weight.
Treatment for Diabulima
Due to the complexities of health problems diabulimia can cause, it is important to seek help as soon as possible. A multidisciplinary approach to recovery will be needed and is likely to include diabetes specialists, GP, psychological and eating disorder dietetic support.
Orthorexia
Although more research is needed, there are some studies that point to a relationship with obsessive compulsive disorder (OCD).
Signs of orthorexia:
- The creation of rules around eating and which foods are ‘pure’ or ‘healthy’
- Compulsive checking of ingredients and nutrient information on food packaging
- Eliminating a wide range of foods or food groups, such as all carbs, sugar or dairy without medical reason or guidance
- Being uneasy about eating food prepared by others, or avoiding social situations where food has been provided by others
- Experiencing severe distress if self-prescribed ‘healthy’ foods are unavailable
- Anxiety and shame resulting from breaking self-imposed food rules which may also impact body image perception
Symptoms of orthorexia:
- Intended or unintended weight loss
- Nutritional deficiencies or possible malnutrition
- Gastrointestinal issues
- Problems with concentration and focus
- Low self-esteem and anxiety
Treatment for Orthorexia
Psychological support and therapy are generally very effective for the treatment of orthorexia and typically will involve a similar approach to the treatment offered for anorexia or obsessive compulsive disorder. This may include guided exposure to foods that cause anxiety and, where necessary, help to ensure weight restoration.
If you are concerned that you, or someone you care for, may have an eating disorder or eating distress, we are here to help. Please book a 1:1 support call or take a look at our peer support groups . Our team of staff and volunteers have lived experience of eating disorders. They can listen to your worries and provide practical guidance to help you take positive steps towards getting help and recovery.
