It can be very difficult to tell if a friend or family member has developed an eating disorder such as diabulimia. People affected by the condition tend to hide it, often very successfully.
And it can be even more difficult to talk about it with them. But if you are concerned, it’s important that you do so that they can get the support they need.
Signs of diabulimia
There are some signs that might suggest someone has a problem.
However, not everyone with diabulimia will show all of these signs. And it’s important to remember that there are other reasons for some of them, including growing up and developing, not knowing how to look after diabetes properly, depression or a feeling that diabetes is getting on top of you.
These are some of the signs of diabulimia:
- losing weight, or weight going up and down
- a high HbA1c
- going into hospital frequently with DKA or high blood sugar levels
- having high blood sugar levels a lot – this can lead to someone passing urine a lot, feeling thirsty, tired, getting thrush or genital itching
- getting some of the complications of diabetes when you’re still quite young
- injecting in secret, or not wanting to inject
- not wanting to be weighed, eg at clinic appointments
- not going to diabetes appointments
- not testing blood sugar levels, or not wanting to test
- feeling depressed or anxious
- for women, irregular or stopped periods, or a delay in periods starting
- changes in appetite
- an encyclopaedic knowledge of calories and what different foods are made up of (although this can be particularly tricky to identify, as activities such as carb counting are a key part of managing diabetes for many people).
How to talk to a friend or family member
If you’re worried about a friend or family member, it can be difficult to know how to talk to them about diabulimia.
You’re likely to be worried about bringing up the subject. You don’t want to make anything worse, and you don’t want to say the wrong thing. You might feel angry or disappointed with your friend or family member because you can see the danger they’re putting themselves in, or despairing that you can’t help them.
It’s completely natural to want to ignore it and hope it will go away. But diabulimia is really serious, and can make someone very sick very quickly, people have even died of it. So it’s best to bring it up if you’re worried.
You know your friend or family member so you know how best to bring things up with them. And here are some tips to help:
- prepare what you’re going to say and when
- find a time when you’re not cross or upset with them, and you know you’re not going to be interrupted
- don’t judge or blame them, and let them know that you’re talking about it because you care about them and you’re worried.
Try not to feel like you’ve failed if they deny there’s a problem, or upset if they get angry with you. It might be because they’re ashamed of what they’re doing or want it to stay secret. But at least you’ve opened the door. It might well spark something with them – if not now, sometime in the future. And you’ve showed you care about them.
They might be relieved that you’ve noticed – they might desperately want help but not know how to ask for it.
Where to go for support
Encourage your friend or family member to get help and support because it’s really difficult to get through diabulimia by yourself. Reassure them they aren’t on their own with this. You’re there and so are the other people who care about them. And there are people who know exactly what they’re going through.
Here are some places to go for support:
It's important to encourage your friend or family member to talk to their doctor or nurse. Ask them if they’d like you to go with them for support. More and more diabetes units are becoming familiar with diabulimia, and so are GPs and eating disorder specialists. Diabulimia requires careful treatment from a team of specialists, and some dedicated recovery programmes are now up and running in the UK.
The national charity Diabetics with Eating Disorders (DWED) was set up to directly address diabulimia and other eating disorders in those with Type 1 diabetes in 2009. On the website you can access specialist information, keep up with the latest developments, request training for your Healthcare team and there is an online forum where you can chat to others in the UK who are going through the same thing.
Diabetes UK Helpline
We’re at the end of the phone if you ever want to talk – whether you have diabetes yourself or are concerned about someone who does. Our Helpline has dedicated, trained counsellors to listen and to help.