Diabetes and Eating Disorders: Worlds Collide

The pressure to stay slim is everywhere, but if an eating disorder develops in someone with type 1 diabetes, the consequences can be dire.

Health Monitor Staff
Reviewed by
Philip Levy, MD
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What can be done?
"Parents are the first obstacle I face," says Grace Shih, RD, at Stanford University School of Medicine's Lucile Packard Children's Hospital. "They say to me, 'She's a teenager. Of course she wants to lose weight.' " That perspective, in a nutshell, is the initial hurdle, according to Shih. "An eating disorder is a mental illness," she insists, "not a lifestyle choice."

Instead of pleading with someone to take her insulin, Shih recommends assembling a multidisciplinary team of health providers to address the biological, psychological and social issues involved. The team might include an endocrinologist, a mental-health professional and a dietitian. With the right kind of help, those with diabulimia can learn to see insulin omission as a problem instead of a solution.

December 2012