Diabulimia

Diabulimia Adolescent girls diagnosed with Type 1 diabetes appear to experience a significantly increased rick of eating disorders compared to those without diabetes. Common risk factors for developing an eating disorder include weight gain and a history of dieting and dietary restraint. Type 1 diabetes intensifies these risks due to the tendency to gain weight following the initiation of insulin therapy and the necessity of focusing on food to successfully manage the condition. In addition to their general susceptibility to eating disorders, patients diagnosed with diabetes are uniquely vulnerable to developing diabulimia. Diabulimia, a combination a diabetes and bulimia, is the term used in academic literature and the media to describe the deliberate avoidance or limitation of insulin to control weight. The omission or restriction of insulin results in the purging of calories through glycosuria, which causes weight loss. Efforts are currently being made to include diabulimia as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Warning Signs: Obsession with body size & shape Rapid weight loss Preoccupation with food intake Frequent micturition Hyperglycemia Recurrent ketoacidosis Ketone smell on breath & in urine Poor metabolic control despite appearance of compliance Refusal to let others observe insulin injections Prevention Although not currently recognized as a medical or psychiatric diagnosis, the acknowledgement of diabulimia by healthcare and medical providers is integral. If left undetected, it can cause early on-set kidney failure and retinopathy and ultimately be fatal. Early identification is important as prevention, therefore regular screening for diabulimia should be a fundamental part of diabetes care. A possible tool physicians can use is the Revised 16-item...

Orthorexia

Orthorexia Defined Dr. Steven Bratman, a general physician and contributor to the natural eating movement, first coined the term orthorexia nervosa in 1997. The disorder is defined as a pathological obsession for biologically pure foods. This fixation on a healthy diet and intense fear of eating anything contaminated can result in elimination of entire food categories, malnutrition, weight loss, and intense social isolation. It is important to note that the desire to eat healthy goods is not pathological itself; the disorder lies in the obsessive, persistent approach to diet along with the withdrawal from life this food habit causes. Orthorexics dedicate a large amount of time to the planning, purchase, preparation, and consumption of food considered to be healthy. Their eating behavior generates a feeling of superiority, and they may refuse to eat away from their home. Ultimately the quality of food consumed is more highly valued than social relationships, personal values, or career plans. Although the term has existed for almost twenty years, studies on orthorexia are not sufficient enough for it to have valid diagnostic criteria. Therefore, it is not included in the DSM or ICD-10. Two diagnostic tools do exist, Bratman’s Orthorexia Test (BOT) and the ORTO-15; however, there is a need for increased reliability in these instruments to allow for a more thorough investigation of the disorder. Orthorexia in comparison to anorexia nervosa Patients with orthorexia, like those with anorexia, give food an immensely disproportionate place in the scheme of life. Orthorexics and anorexics share obsessive personality traits as well as the denial of feelings, conflicts, and bodily signs of fatigue and weakness. Despite these...