When we first heard the term “diabulimia,” we thought it sounded like a made up word for a mythical condition — and in a way, it is. Starting around 2007, diabulimia has become the unofficial diagnosis of an insulin-dependent person living with an eating disorder who purposely stops taking their insulin in order to accelerate weight loss. Without insulin, super-high blood sugars lead to diabetic ketoacidosis, which quickly burns off the body’s fatty acids.
Diabulimia is not a technical term recognized by psychologists, but it’s becoming a common term to describe this “compounded” eating disorder.
We took a look at diabulimia in 2010 when we interviewed Dr. Ann Goebel-Fabbri of the Joslin Center and D-blogger Lee Ann Thill about their experiences. There still wasn’t much known about diabulimia at the time, but more and more people have started to come forward with their own personal struggles.
Now, Maryjeanne Hunt, a type 1 PWD for the past 30 years, has written a moving memoir called Eating to Lose: Healing from a Life of Diabulimia, with a foreword written by the very same Dr. Goebel-Fabbri.
Maryjeanne writes beautifully about the emotional and mental struggles of striving for physical perfection while also dealing with challenges of managing diabetes. She describes in detail her mental and physical pain in struggling to manage diabetes, and also how the dieting culture, self-perceptions and self-worth, and the influence of friends and family can actually wreak havoc on our ability to live healthfully.
Maryjeanne shares how her mother’s constant roller-coaster of dieting and “cheating,” and her college best friend’s anorexia influenced her own attitudes on weight, and provided a rationale for what she herself was doing. Even though she knew the dangers of omitting insulin and the damage she was causing to her body from the high blood sugars, she writes: “It didn’t stop me. I was addicted to a partnership of polar opposites — the pleasure of eating and the high of starvation.”
Like most women, body image, weight loss, and self-acceptance are life-long battlegrounds, and Maryjeanne’s story is no different. Starting in middle school, food comforted her during emotionally stressful times. But how she paid the price with guilt, shame and self-loathing! Even though she wanted to be skinny, the author writes, she couldn’t control the temptations of food. She attempted to balance the two with binging and purging, and the occasional omission of insulin made keeping her weight down easier.
Even after she married and had children, Maryjeanne struggled with this dangerous cycle. Maryjeanne’s commitment to physical perfection went beyond just omitting insulin or purging food: exercise also became an obsession. It was a huge part of her weight loss methods, so much so that Maryjeanne eventually became a physical trainer despite her unhealthy attitude toward her body.
She writes, “I was fully committed to calorie shortage. I was so committed in fact that I often calculated with decimal precision the tiniest daily calorie consumption my newly shrunken body would require in order to continue its steady descent down the number line. I embraced hunger pains, reading them as a sign that fat cells were, at that very moment, actually shrinking. Not metaphorically, mind you. Physically. scientifically.”
I especially appreciated Maryjeanne’s frank explanation of the eating disorder phenomenon: “The truth is: not everyone who is skinny has an eating disorder, and not everyone with an eating disorder is skinny. It’s not about the size of your body; it’s not about the amount of food you eat or don’t eat. It’s about your relationship with the food; and it’s about what that does to your relationship with your body.” Powerful words, and something I think many of us (women / PWDs) can relate to.
Eventually Maryjeanne receives a diagnosis and begins treatment for her eating disorder. Diving into all the things that have contributed to her struggle with food, Maryjeanne takes us behind the scenes of recovery from an eating disorder, both physically and emotionally.
It’s a heart-wrenching and eloquently written memoir, and a story that many will relate to, not because of the eating disorder or the insulin omission, but because I think diabetes itself creates a highly disordered relationship with food.
But there is a happy ending: Maryjeanne writes that she has now been free of her eating disorder since 1997, and she has been featured in Boston area newspapers and on Oprah Radio to discuss her struggles with diabulimia.
In short, I highly recommend this book. You can get your own copy of on Amazon for $12.71. It’s also available on several eReaders.
The DMBooks Giveaway
We love sharing our book finds with our readers, so once again we’re giving you the chance to win a free copy of our latest review. Today that’s Eating to Lose: Healing from a Life of Diabulimia.
Entering for your chance to win is as easy as leaving a comment!
Here’s what to do:
1. Post your comment below and include the codeword “DMBooks” somewhere in the comment (beginning, end, in parenthesis, in bold, whatever). That will let us know that you would like to be entered in the giveaway. You can still leave a comment without entering, but if you want to be considered to win the book, please remember to include “DMBooks.”
2. This week, you have until Monday, Jan. 16, at 5pm PST to enter. A valid email address is required to win.
3. The winner will be chosen using Random.org.
4. The winner will be announced on Facebook and Twitter on Tuesday, Jan. 17, so make sure you’re following us! We like to feature our winners in upcoming blog posts, too.
The contest is open to anyone, anywhere. Good luck!
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i love DMBOOKS! and this sounds like one every PWD should read.
I would love to read this book. DMBooks.
Thanks for the review. I’m always looking for something new in the field and this sounds like a book I would enjoy.
DMBOOKS I am very interested in this subject and thank God everyday that I never discovered it during my own “disorderly” years.
Thank you Marjeanne for this book. Finally someone is bringing this issue to light. I’ve suffered from diabulimia for 8 years and been hospitalized countless times for diabetic ketoacidosis with A1cs too high to measure. So much goes into it besides body image -its a very complex eating disorder. They understand the bulimia I had years before but not diabulimia. As such, I’ve found it very hard to find treatment for this disease.
Most doctors have no clue what this disease is. Some think it’s a suicide attempt. I’ve had to explain it on more than one occasion to doctors in and out of the hospitals. Many doctors will refuse to treat diabulimics. The line I most often here is that if I’m not willing to treat my diabetes, then they refuse to treat me. But the issue is not merely physical, it’s a mental disorder that must be addressed on several levels in a team approach. Yet many doctors are unwilling to recognize this nor want to take the time to understand and work with the diabulimic. I have found only two doctors that have helped me in this struggle that I would like to name here (at risk of breaking my anonymity)- Dr. Satish Garg at the Barbara Davis Center and Dr. Timothy Vachris at Texas Sports and Family Medicine. They have gained my trust through patience and understanding, making great efforts and going out of their way to help me.
The other issue at hand is that most therapists no nothing about type 1 diabetes. Not only do they not understand how the physical disease works, they have never heard of diabulimia. Thus sessions are spent educating the therapist instead of receiving help.
Books like this will help start a discussion and raise awareness. I hope that for those who might suffer from diabulimia in the future they will find more help than I have. I hope that those who work with diabetics and those with eating disorders will educate themselves and find treatment options. I hope that in understanding this disease perhaps we can prevent it or at least prevent the outcome – anything from retinopathy to death.
As for myself, I don’t know if I’ll find a path to healing as others have. I am working on it every day.
Thank you Maryjeanne and thank you Diabetes Mine for posting about this book.
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DMBOOKS!! I would love to read this!
Can’t wait to read! DMBooks
DM Books. I would love to hear her story.
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Wow, I would love the chance to read this and experience what she was going through.
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Sounds fascinating…
Thanks for sharing about this book, I would love to read it! DMBooks
As a social worker and advocate for persons with diabetes, I’d love to read this book. Thank you tp the author for writing it and sharing personal experience. DMBooks
It is so helpful to hear about others struggles and how they have overcome. It is so easy to fool ourselves and easy to berate ourselves…. “still don’t have it figured out”. Thank you for this book! DMBooks
Correction: Foreword, not Forward, by ….
I would love to win this book. I myself have struggled with this myself. DM Books!
@Pat – thanks! So you scour the internet copy-editing random posts? Wow… we could use you on a daily basis, I’m sure
First I’ve heard of this disorder, so I’m grateful to DMBooks for this review. A a therapist, and T2 for 2 1/2 years now, I can begin to understand the complexity of what the author went through. Her struggle and eventual success over such a debilitating and all-encompassing combination highlights her evident resiliency.
I saw the term (diabulemia) in another publication and was amazed that a name has been given to this crazy method of weight loss. I believe it’s been around forever–I call it “purposeful miscalculation of carb intake”; but, diabulemia sounds much more official. Would love to receive this “DMBooks” publication!!