In 1980, there were fewer than six million people in the United States living with diabetes. I was one of them. I was diagnosed with the disease in 1971. By 2004, the number of Americans with diabetes had grown to nearly 16 million. Just four years later, that number climbed to 23.6 million. Today, at 25.8 million strong, the diabetes epidemic is costing our country over $200 billion dollars a year in healthcare expenses, and is expected to cost $3.4 trillion by the end of this decade, making it one of the most urgent public health issues of our time (American Diabetes Association, January 26, 2011; United Health, November 23, 2010).

Insulin is the cornerstone for treating Type 1 Diabetes. According to the American Diabetes Association, diabetic women are nearly three times more likely to develop an eating disorder than non-diabetic women. An estimated 30-40 percent of female teens and young adults with Type 1 Diabetes have developed or will develop an eating disorder.

Diabulimia, as the disorder is known today, is the dangerous and often fatal practice where an individual with Type 1 Diabetes alters or omits insulin for the purpose of weight loss.

Diabetes is a disease where the pancreas, one of the body’s organs, discontinues insulin production. Insulin is the body’s only means of turning sugar into usable energy. No insulin means no energy—for anything from healing and growing to thinking and running. Without insulin, we cannot survive for very long. Non-diabetic people produce insulin automatically, but those with Type 1 Diabetes (Juvenile Diabetes) must inject insulin into their bodies to stay alive.

In the absence of adequate insulin, glucose (sugar) accumulates in the blood. It is necessary for our bodies to have a certain amount of sugar in our blood so that it can supply energy to the cells in our bodies as needed. A normal (non-diabetic) blood sugar range is 80 ml/dl—120 ml/dl. When sugar accumulates in the blood, the non-diabetic body knows to signal the pancreas to produce appropriate amounts of insulin to keep it in the ideal range.

The non-diabetic pancreas is quite intelligent and does this all on its own. But when excess sugar accumulates in the blood of a person with diabetes because the dose of insulin is either insufficient or nonexistent, the diabetic body produces ketones, which use up the body’s fat for energy at a much faster rate than calorie restriction and/or exercise.

I know what you’re thinking: If you’re like most women in this country who put weight loss right up there with love and money, ketones probably sound like a dieter’s panacea! Well, they are . . . . and they’re not. You see, in addition to rapid fat-loss, the body also loses muscle tissue and fluid pretty quickly too. The entire process, called diabetic ketoacidocis, is a potentially life-threatening condition that produces high concentrations of toxins in the blood and causes extreme vomiting and intense dehydration.

On the other hand, when the blood sugar drops too low—like when a meal has been skipped or delayed, exercise was more vigorous than planned, or when the insulin dose happened to be too high for the conditions of the time—quick acting carbohydrates like table sugar, fruit juice, or candy become an urgent life-saving remedy.

Here’s the bottom line: While most people achieve weight loss by eating less, I was able to achieve the same goal by eating more, as long as I remained ‘diligent’ about off-setting a binge with an omission of insulin. But like all eating disorders, diabulimia is extremely dangerous and causes physical, emotional, and psychological turmoil.