Diabetes, eating disorders and body image in young adults: an exploratory study about “diabulimia”
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The purpose of this study was to compare disordered eating (DE) and body image dissatisfaction (BID) among young adults with type 1 diabetes and their peers without diabetes, to investigate the consequences of diabetes for food, body image and weight in individuals with diabetes and to identify the behavior of insulin omission as a weight loss strategy.
Fifty-five young adults with diabetes and 73 without diabetes (ages 18–30) completed self-report questionnaires to evaluate their behaviors, attitudes and feelings related to eating disorders and their perceptions about body image. The participants with diabetes were asked to answer a questionnaire with open and closed questions developed specifically for this study.
No significant differences between participants with and without diabetes in relation to BID and DE were found. The results demonstrated several changes resulting from diabetes in terms of food, body image and weight that interfere with the day-to-day life of individuals with diabetes; 7.3% of these participants reported insulin omission as a weight loss strategy.
This study emphasizes the importance of research on DE in the population with diabetes and their prevention, screening and treatment. In particular, it is essential to give more attention to insulin omission as a compensatory behavior that is inappropriate and harmful to health.
Level of evidence
Level III, case-control analytic study.
KeywordsDiabetes Disordered eating Body image dissatisfaction Omission of insulin Diabulimia Young adults
This study was partially supported by the Research Center for Psychological Science (UID/PSI/04527/2013) of the Ministry of Science and Technology (FCT, Portugal). The authors would like to express appreciation to all the participants.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.International Diabetes Federation (2013) IDF diabetes atlas, 6th edn. International Diabetes Federation, BrusselsGoogle Scholar
- 2.Observatório Nacional da Diabetes (2014) Relatório anual do observatório nacional da diabetes [Annual report of the national diabetes observatory]. Sociedade Portuguesa de Diabetologia, LisboaGoogle Scholar
- 3.World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus. World Health Organization, GenevaGoogle Scholar
- 5.Menina A, Akers EM (2014) Diabulimia: not so secret-or shameful-anymore. Diabetes Health 23(1):14–19Google Scholar
- 6.Powers MA, Richter S, Ackard D, Gerken S, Meier M, Criego A (2012) Characteristics of persons with an eating disorder and type 1 diabetes and psychological comparisons with persons with an eating disorder and no diabetes. Int J Eat Disord 45(2):252–256. doi: 10.1002/eat.20928 CrossRefPubMedGoogle Scholar
- 10.Shih GH (2009) Diabulimia. Diabetes Health 18(2):14–21Google Scholar
- 11.Shih GH (2011) Once a spokesperson for juvenile diabetes, Erin now suffers from diabulimia. Diabetes Health 20(4):10Google Scholar
- 12.Direção Geral de Saúde (2011) Diagnóstico e classificação da diabetes mellitus [Diagnosis and classification of diabetes mellitus]. Direção Geral de Saúde, LisboaGoogle Scholar
- 13.Ackard DM, Vik N, Neumark-Sztainer D, Schmitz KH, Hannan P, Jacobs DR Jr (2008) Disordered eating and body dissatisfaction in adolescents with type 1 diabetes and a population-based comparison sample: comparative prevalence and clinical implications. Pediatr Diabetes 9(4 Pt 1):312–319. doi: 10.1111/j.1399-5448.2008.00392.x CrossRefPubMedGoogle Scholar
- 19.American Diabetes Association (2013) DKA (ketoacidosis) and ketones. IOP Publishing Diabetes. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html?loc=lwd-slabnav. Accessed 28 Novemb 2016
- 21.Takii M, Uchigata Y, Tokunaga S, Amemiya N, Kinukawa N, Nozaki T et al (2008) The duration of severe insulin omission is the factor most closely associated with the microvascular complications of type 1 diabetic females with clinical eating disorders. Int J Eat Disord 41(3):259–264. doi: 10.1002/eat.20498 CrossRefPubMedGoogle Scholar
- 23.Peveler R (2000) Eating disorders and insulin-dependent diabetes. Eur Eat Disord Rev 8(2):164–169. doi: 10.1002/(SICI)1099-0968(200003)8:2<164:AID-ERV345>3.0.CO;2-V CrossRefGoogle Scholar
- 33.Francisco R, Alarcão M, Narciso I (2012) Body image (dis)satisfaction among Portuguese adolescents and adults: contribution to the validation process of the Contour Drawing Rating Scale. Revista Iberoamericana de Diagnóstico y Evaluación Psicológica 34(1):61–88Google Scholar
- 34.Fairburn CG, Cooper Z (1993) The eating disorder examination. In: Fairburn CG, Wilson GT (eds) Binge eating: nature, assessment and treatment, 12th edn. The Guilford Press, New York, pp 317–331Google Scholar
- 37.Striegel-Moore RH, Debra FL (2002) Body image issues among girls and women. In: Cash T, Pruzinsky T (eds) Body image: a handbook of theory, research and clinical practice. Guilford Press, New York, pp 183–191Google Scholar
- 41.World Health Organization (1994) Prevention of diabetes mellitus: report of a WHO study group. World Health Organization, GenevaGoogle Scholar