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Diabulimia is an eating disorder that affects people living with Type 1 diabetes. It involves the deliberate restriction or omission of insulin as a way of controlling weight. At ABBI Clinic, we provide specialist eating disorder treatment for people living with diabulimia, supporting your recovery with a tailored treatment programme built to meet your individual needs.
Diabulimia is the term used to describe the restriction or omission of insulin in people with Type 1 diabetes as a way of managing weight. Without sufficient insulin, the body is unable to process glucose in the usual way and begins to excrete it, along with calories, through the urine. This can result in weight loss, which is the intended effect for someone living with diabulimia.
The condition sits across two clinical areas, eating disorders and diabetes care, which means it can sometimes fall between services and go unrecognised for longer than it should.
People living with diabulimia may feel a great deal of shame or fear around disclosing what is happening, particularly in medical settings where the focus is often on glucose management rather than the emotional relationship with food and the body.
Diabulimia can develop gradually, and the signs are not always obvious to those around you. If you recognise something of your own experience in what is described here, please know that you are not alone, and that specialist support is available.
The signs of diabulimia can vary from person to person, and not everyone will experience all of them. Some may be physical, others more closely linked to behaviour or how you feel about your diabetes management.
You may find yourself omitting insulin entirely, or taking less than prescribed, particularly around mealtimes or following periods of eating that feel difficult.
Unexplained or consistently elevated HbA1c results, or frequent hyperglycaemia, can sometimes indicate that insulin is being restricted as a way of managing weight.
When the body does not have enough insulin, it begins breaking down fat for energy, producing acids called ketones. When ketone levels become dangerously high, this is known as diabetic ketoacidosis, or DKA, a serious and potentially life-threatening complication. Repeated episodes of DKA, particularly where no clear medical cause is identified, may be a sign that insulin restriction is taking place.
Weight loss that is not explained by changes in diet or activity may be related to insulin omission.
Diabulimia often involves a complicated relationship with the body and with food. Feelings of shame, anxiety, or distress around eating, weight, or insulin use are worth paying attention to.
Avoiding blood glucose testing, diabetes appointments, or conversations about your condition can sometimes be a sign that managing diabetes has become connected to distress around weight and eating.
Diabulimia is a medically serious condition. The long-term consequences of insulin restriction can include accelerated diabetes complications, damage to the kidneys, eyes, and nerves, and a significantly increased risk of serious illness. Reaching out for support as soon as you recognise something is wrong gives you the best possible chance of recovery and of protecting your long-term health.
At ABBI Clinic, we understand that taking that first step can feel difficult, especially when diabulimia involves both your relationship with food and the way you manage a condition that is already part of everyday life. Our approach is responsive, compassionate, and built around your whole experience, not just one part of it.
You do not need to have a formal diagnosis to get in touch. If you are worried about your relationship with insulin or your eating, we are here to listen and to help you find the right path forward.
Diabulimia requires specialist care that addresses both the eating disorder and the serious physical risks associated with insulin restriction. Your treatment plan will be tailored to your clinical needs and may include:
Individual therapy gives you dedicated one-to-one time with a specialist psychological therapist. Sessions provide a confidential space to explore the complex relationship between diabetes management, body image, and the emotional drivers of insulin restriction.
Group therapy brings you together with others in a structured and facilitated environment. Sessions focus on building coping strategies, reducing the isolation that often accompanies diabulimia, and developing a healthier relationship with both food and diabetes self-care.
Family therapy involves you and those close to you in understanding the physical and psychological dimensions of diabulimia. Sessions explore how relationships and communication can be strengthened to provide more effective support for your recovery.
A specialist eating disorder dietitian with experience in diabetes will work with you individually to develop a realistic and flexible approach to eating that supports both blood glucose management and recovery from disordered eating. This is a central part of treatment for diabulimia.
Supported mealtimes within our Day Care programme provide a structured, calm environment in which to practise eating and managing blood glucose without restriction. Your clinical team, including your dietitian, will be present throughout to support you.
A Consultant Psychiatrist will be involved in your assessment and will provide ongoing oversight throughout treatment, including consideration of any co-occurring mental health conditions and medication needs that are relevant to your care.
Our mental health nursing team plays a particularly important role in diabulimia treatment, providing regular medical monitoring including blood glucose checks, physical health observations, and clinical support throughout treatment.
Given the physical health risks associated with diabulimia, our team provides careful clinical oversight throughout your treatment. Your physical health is monitored as part of your care, and we work alongside your wider medical team to ensure that your recovery is safe and well-supported.
Looking to learn more about diabulimia? Find answers to our most commonly asked questions here or reach out to speak with a member of our team.
Diabulimia is a well-recognised clinical presentation, though it does not yet appear as a separate diagnosis in all diagnostic frameworks. It describes a pattern of insulin restriction in people with Type 1 diabetes that is driven by a desire to control weight, and it is treated as a serious eating disorder that requires specialist care.
Yes. Our treatment focuses on the eating disorder component of diabulimia. We work alongside your existing diabetes care team rather than replacing them, so you can continue to receive diabetes-specific medical support at the same time as your eating disorder treatment with us.
If you are living with Type 1 diabetes and have been restricting or omitting insulin as a way of controlling your weight, or if your relationship with insulin and food is causing you significant distress, it is worth speaking to a specialist. You do not need to be certain about a diagnosis before getting in touch. An assessment with our team will give you a clear picture of what is happening and what support might help.
With the right specialist support, recovery from diabulimia is possible. Treatment is most effective when it begins early, but it is never too late to seek help. At ABBI Clinic, your treatment plan is built around your individual needs and reviewed regularly as your recovery progresses.
