Maryjeanne Hunt: When diabetes and body image collide

Maryjeanne Hunt

There is no shortage of concern among health care professionals regarding the growing diabetes epidemic of recent decades. In 1980, there were fewer than 6 million people in the United States living with diabetes. I happened to be one of them, having received my diagnosis in 1971. By 2004, that number had grown to 16 million, and just four years later took its leap to 23.6 million, costing our country $176 billion in health care expenses, according to the American Diabetes Association.

Because research has clearly linked poor lifestyle choices to the onset of type 2 diabetes, we might deduce that these numbers are a pathetically preventable medical calamity. For type 1 diabetes however, genetic factors, not lifestyle choices, are to blame.

Insulin is the cornerstone for treating type 1 diabetes. Had it not been for the accelerated medical advances of insulin therapy during the last century, type 1 diabetes might have remained a death sentence. Thanks to insulin, it is possible today for type 1 diabetics to live a full and healthy life.

But there is still a hidden demon that lurks deep in the dark corners of many young diabetics' psyche, especially the female ones. Its name is body image.

According to the American Diabetes Association, an estimated 30 percent to 40 percent of female teens and young adults with type 1 diabetes have developed or will develop an eating disorder.

Diabulimia, as the condition is known today, is the often-fatal practice of omitting or altering insulin in order to produce weight loss. With insufficient insulin, the body is unable to use food for energy, so it breaks down fat and muscle tissue and tries to eliminate excess sugar through frequent urination. The result is dramatic weight loss and severe dehydration. The combination of type 1 diabetes and poor body image is a toxic marriage. I know. For 22 years, I used to be a product of that marriage.

The value of any life experience -- whether it shows up as a deep sense of timeless happiness or as an epic medical tragedy, as a momentary flutter of elation or a passing battle with Murphy's Law -- ought not to be appraised by its residue of drama, but by its fruits.

My voyage through that ugly time was not without its fruits. Ironically, it was the very gravity of warped body image that drew me toward fitness 25 years ago and serendipitously transformed my health. But there were richer fruits to be consumed than improved physical health.

Having come through the other side of that eating disorder, healed and whole, has impacted the way I parent, teach, coach and train. Broken relationships have been glued together with more profound closeness. And though having the courage to stand face-to-face with the ugly truths I would find in the center of that cruel place, I would do it all again.

Somewhere in that darkness, I found the greatest treasure a person can find: a deep connection with the true self that is inside every single one of us. It was there all along.

Some of the warning signs of diabulimia include the following:

- Obsession with weight and/or dieting

- Excessive or irrational desire to exercise

- Label-reading that is disproportionate to ongoing necessary insulin adjustments

- Sudden increased urination and weight loss

- A1C levels that are inconsistent with self-reported blood sugar results

- Apparent isolation during mealtimes

- Fruity-smelling breath

If you observe any of the above symptoms in someone you know with type 1 diabetes, seek medical attention immediately.

Maryjeanne Hunt is a personal trainer, weight management coach and group exercise instructor at Gold's Gym in Millis, Mass., and Lady of America in Natick, Mass. Contact her by e-mail at or visit her Web site,