OET 2.0 Listening Practice – Diabulimia by Dr. Annalise Keating

OET 2.0 Listening Practice – Diabulimia by Dr. Annalise Keating


Hello my name is Annalise Keating and I’m a gastroenterologist working with a multinational team to raise awareness of a relatively obscure condition called Diabulimia.

The name is derived from a mixture of diabetes and bulimia, as it describes the situation where type one diabetics develop the behavioural characteristics that are common to the aforementioned eating disorder. As insulin restriction is a significantly more dangerous act than calorie purging, the sooner something can be done about the countless lives being lost because of Diabulimia, the better. To put things in context, it is estimated that approximately 300,000 people in the Canada are living with type 1 diabetes. Whilst the exact number of people living with Diabulimia is unknown, alarmingly, up to 40% of sufferers (who are mainly female) aren’t taking enough insulin to survive. With that acknowledged, it would be remiss not to mention that those affected are not exclusively women.

A recent German study suggests that 11.2% of boys aged nineteen and under are using intentionally depriving themselves of insulin in a drive to be either thin or thinner. Yet despite the widespread reach of this condition, it is not as visible as other similar disorders, such as anorexia or bulimia nervosa. Part of the reason the condition is so low-profile, is the fact that the condition is not a recognised medical or psychiatric term, but rather it highlights the practice of reducing or eliminating insulin in a bid to lose weight.

As diabetes sufferers cannot produce insulin but need it in order to survive, the practice of restricting their intake with the aim of losing weight incredibly dangerous. Suffers develop incredibly high blood sugars, which has the potential to produce multiple, irreversible diabetic complications. This can include neuronal, retinal and renal damage. The most common symptoms of the disease includes irritability, decreased concentration and motivation and diabetic ketoacidosis; all of which are analogous to diabetes. Rather eerily, by making the decision to cease treatment, suffers are essentially turning the clock back on their condition.

I work in conjunction with colleagues who do a lot of work with various outreach groups and friends and family of people with insulin dependent diabetes mellitus. This type of outreach work was sparked by the many case studies of young people whose lives have been claimed by the disease. One such account is of the life of Megan, a twenty seven year old, who took her life after battling with the disease. Typically of people with the condition, Megan developed an unhealthy pre-occupation with food. She also became increasing uncomfortable taking her daily medication, comparing injecting her insulin to injecting fat into her body. Her sporadic insulin restriction then became a greater feature of her life. The unhealthy preoccupation with her diet led her to the discovery that despite not lowering her food intake, because she had drastically reduced her medication, she was losing weight.

The weight loss is a result of the body’s cells failing to absorb blood sugar, with the consequence of prolonged, elevated blood sugar in the individual. This causes the organs to be saturated in glucose. Such consequences are so severe and irreversible that early detection is a governmental priority.

The UK’s NHS clinical team have been involved in producing the NICE guidelines on eating disorders, devoting part of the report to managing people suffering from an eating disorder and diabetes concurrently. The guidelines have been distributed nationally in a bid to tackle the illness. Furthermore, the organisation is integrating psychological services with GP practices by placing 3,000 new mental health therapists in surgeries. In addition, other private and charitable organisations are also keen to play their part. A prominent example includes Jacqueline Allan, founder of national charity Diabetics With Eating Disorders. Allan is presently campaigning for the omission of insulin for weight loss purposes, to be recognised as a mental illness. The theory is that increasing the condition’s, visibility it will become easier to engage multidisciplinary teams including endocrinologists, mental health professionals and specialists like myself, who specialise in the condition, to provide a 360 degree treatment service. Until that is achieved, however, the road to medical and psychological recognition continues.