Diabulimia

In today’s diet obsessed world of calorie-counting-whole-grain wonder foods it is shocking to find a diet where the more one eats, the more one loses. Most who struggle with their weight, and even those who don’t, would sign up in an instant for this type of diet. Not having to exercise and the ability to eat whatever one wants, the sweeter the foods the better is a major selling feature. However, this diet is only accessible for those lucky few who suffer from insulin-dependent Diabetes mellitus (IDDM), otherwise known as Type 1 Diabetes.

IDDM is an endocrine disorder and those individuals who suffer from IDDM are unable to produce adequate amounts of insulin. Insulin is a hormone that is produced by the beta cells in the pancreas and it functions to regulate the amount of glucose, or sugar, in the blood stream by prompting the body tissues to convert glucose into fuel (Lemberg, 1999). Individuals with IDDM need to use exogenous insulin and consistently measure blood glucose level, eat a well balanced diet, and exercise regularly (Crow, Keel, & Kendall, 1998). When insulin is not administered to these individuals, they become hyperglycemic which means that they have too much glucose in their blood. Chronic hyperglycemia in these individuals can result in several complications including damage to nerves in the peripheral and autonomic nervous systems causing abnormal or decreased sensation, damage to the retina in the eye which can cause vision loss or blindness, damage to small blood vessels, and damage to the kidney which can result in chronic kidney failure that may result in need for kidney dialysis.

The most severe complication of diabetes is diabetic ketoacidosis and occurs when the body is without sufficient insulin. This is a life threatening condition and requires immediate medical care. This condition changes the acid-base balance, or pH balance of the blood. Blood has a normal pH range to be between 7.35 and 7.45, ketoacidosis causes the blood to drop below 7.35 becoming more acidic. This acidic shift in the blood causes the proteins in human cells to denature, or to become damaged. This causes widespread tissue damage which can lead to organ failure and if left untreated, death .

The treatment procedure for IDDM is exogenous insulin therapy where the individual monitors her blood glucose levels and injects insulin every day. Unfortunately, a common side effect of insulin therapy is weight gain. In today’s society, the media and popular culture has placed a stigma on obesity and those who are overweight. Overweight and obesity prevalence in children and adolescents is increasing rapidly and is becoming a worldwide epidemic (Cole, Bellizzi, Rlegal, & Dietz, 2000). The prevalence of being overweight is increasing for children and adolescents in the United States. Approximately 17 % of adolescents, ages 12 to 19 were overweight in 2001 to 2004 (National Center for Health Statistics, 2006). Yet, even as more individualss become overweight, the standard for attractiveness remains thin and fit (Fallon, 1990), and overweight people are stereotyped as lazy, lacking self-discipline, and mentally slow. In addition, the overweight individuals often internalize these views and develop poor self esteem (Allon, 1982).

It could be estimated that as many as half of all adolescent girls have tried dieting. Due to media portrayal of what is beautiful the desire for thinness is apparent in young females as young as preadolescent girls ages 9 -10. It has been estimated that more than 90% of those with eating disorders are females. Often the desire to have the “idea” body is the main reason why women and adolescent girls diet, and this desire is what drives the disordered eating (Long 2005).

Anorexia nervosa and bulimia nervosa are the most common eating disorders, and are listed as conditions in the DSM-IV. Anorexia nervosa is a condition where people intentionally starve themselves and exercise excessively in an attempt to lose weight. Often the individual will have a distorted image of their body; they often think that they are overweight when they are actually underweight or even emaciated. Individuals with bulimia nervosa use a different strategy to lose weight. These individuals consume large amounts of food then to rid their bodies of the excess calories they induce vomiting, abuse laxatives, use enemas, or exercise obsessively. Often the phrase “binge and purge” is used to describe this condition. As with anorexia, these behaviours are often carried out in secret (Long, 2005).

Although not yet specifically categorized specifically in the DSM-IV, diabulimia is related to these disorders because ndividuals with bulimia nervosa and some individuals with anorexia nervosa use behaviours such as vomiting to try to compensate for ingested calories. Instead of using these strategies, individuals with IDDM are able to intentionally omit their insulin dose. If the individual with IDDM does not take her insulin dose after eating a meal the calories in the food will enter the blood stream causing hyperglycemia. The excess glucose in the blood is eliminated by the body in urine that is filtered out through the kidneys and not used to for immediate fuel for the body or stored in fat cells for future usage.

Eating disorders that meet DSM-IV criteria are about