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Diabulimia: the world’s most dangerous eating disorder

BMJ 2019; 364 doi: (Published 01 March 2019) Cite this as: BMJ 2019;364:l982
  1. Ingrid Torjesen
  1. The BMJ

Diabetologists are teaming up with mental health professionals to work out a new approach to changing dangerous behaviours for weight loss, reports Ingrid Torjesen

Diabetes and mental health teams on the south coast of England and in London have joined forces in pilots funded by NHS England to tackle what the media call “diabulimia,” also described as “the world’s most dangerous eating disorder.”

Diabulimia is an eating disorder in which patients with type I diabetes restrict insulin to lose weight and which can lead to early onset of serious diabetes complications such as blindness and amputations. It is most common in young people aged between 15 and 30, particularly women, and involves a complex interaction of factors—such as insulin, blood glucose, emotions, and body image—that cross diabetes care and mental health.

Dasha Nicholls, chair of the Royal College of Psychiatrists’ eating disorders faculty, said: “Because diabetes forces you to focus on what you eat, it’s not unusual for that to get tangled up with feelings about food, weight, and body image. That can become …

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