Her heart was racing, pounding against her small chest.
Now she was awake again, her bladder unbearably swollen.
Williams pulled herself from the bed, so dizzy she could hardly stand.
She reached in the dark for her purse, which held the drug she so desperately neededinsulin.
“I was so scared to sleep in my room alone,” she recalls.
“I was afraid I was not going to wake up in the morning.”
A bang out 1 diabetic, she had been skipping insulin injections for months.
Normally, most of what you eat is broken down into glucose, the sugar that fuels your cells.
The result can be blindness, kidney failure, heart disease and nerve damage.
It’s not just that patients gain back the weight they had lost before diagnosis.
They sometimes gain more, as insulin injections alone can pack on extra pounds.
“This behavior is like playing Russian roulette with your health.
Some doctors even call it “diabulimia.”
Pizza, beer, ice creamnone of it can be processed by the body.
Nor do diabulimics have to go through the pain of self-induced vomiting.
“And yet the problem is growing.
This can rob somebody of their eyes, their kidneys, their liver and even their life.”
Erin Williams wasonly 11 years old when her pancreas shut down and stopped making insulin.
But the next day, she was still feeling sick.
A simple blood test showed that Williams’s blood sugar was nearly eight times the normal level.
Then he sent the crying girl straight to the hospital, where she passed out from sheer exhaustion.
“I was hysterical,” she remembers.
“I didn’t understand why I got diabetes and nobody else in my family had it.
I felt like I had done something to deserve it.”
No longer could Williams eat whenever she felt the urge.
Her entire schedule rotated around food, her glucose meter and a syringe.
It wasn’t long before her reflection began to change, too.
Although this weight typically dissipates within a few weeks, it can be traumatic.
“It’s hard to put on 10 or 15 pounds in a week.
I thought it was never going to stop,” she says.
“When you’re first diagnosed with diabetes, you’re used to being underweight.
Insulin becomes your enemy.
You don’t even want to have it anywhere near you.
You feel like these are your fat shots.”
Given the country’s ever-more-skeletal beauty ideal, many young women already struggle to accept and love their body.
Like all eating disorders, diabulimia becomes a way to regain control.
Sufferers may even give up treating the disease altogetherthe ultimate form of denial.
She swung between periods of bulimia and anorexia, when she subsisted solely on water and Diet Coke.
But by age 17, she became depressed and began to skip her insulin, too.
“And even then, I felt like I had been defeated.”
Of course, such behavioris incredibly risky.
The youngest of the women who had died was only 25; the oldest 42.
But the damage to their body had already been done.
“I was nauseated and sick all the time,” she says.
But she was seeing drastic results on the scale: In one month, she lost 30 pounds.
“It was almost like being on Valium,” Williams says.
And she became terrified of the immediate weight gain she saw each time she went back on her shots.
Her limbs became so puffy that if she touched her calf, the pressure mark would remain for hours.
At her lowest point, Williams was sleeping 20 hours straight on weekends and weighed a mere 89 pounds.
“My friends obviously knew that I was struggling with something,” she says.
“But they couldn’t put their finger on it.
It wasn’t anorexia or bulimia, so what the hell was going on?”
Although her parents suspected she was skipping doses, she denied it.
As Williams slept, a molecular war was taking place inside her body.
The body released hormones that break down fat stores, releasing by-products called ketones.
In essence, Williams’s body had become toxic to itself.
Unfortunately, whendiabulimics are finally ready to seek help, it can be hard to find.
And yet she says no doctor ever confronted her about what was triggering these episodes.
But she did not raise her insulin dose in accord with her overeating.
“I’d give myself insulin for what I should have eaten,” she explains.
“It’s a pull-yourself-up-by-the-bootstraps mentality,” she says.
“The mental-health part of diabetes can’t be ignored,” she says.
“Patients feel shameful about omitting the insulin and about eating.
It takes them so long to trust somebody and tell them what’s really going on.”
Conventional eating disorder centers are also ill-equipped to handle the unique needs of diabetics.
Once blood sugar levels are under control, women are able to meet face-to-face with other patients like themselves.
“They all feel they are the only people in the world with this.
Certainly,nottalking about diabulimia has done little to prevent women from picking it up.
“Don’t do your shot,” her friend told her.
“You’ll get thinner, you’ll drop off the weight and you’ll look great.”
Now 28 and a single mom, Plourde tries to stay healthy for her 6-year-old daughter, Shaylyn.
She keeps a Post-it note by her bed that reads “Remember to do your shot.
Your daughter counts on it.”
“Summer comes around, and there are weddings to go to,” Plourde says plaintively.
“Or you want to look good in a bathing suit.”
Erin Williams hasspent the past nine years struggling against her self-destructive habit.
After her frightening bout with DKA, Williams’s parents admitted her to an eating disorders program in Illinois.
But without any other patients with whom she could relate, she felt misunderstood and alone.
I wish I could do that,'” she says.
She’s wearing a cast on her foot, frustrated that she can’t swim with everyone else.
She sits on the water’s edge, soaking up the sun.
Yet she still struggles with the temptation to skip her insulin.
“Every single day, it’s a battle,” she says.
“But I don’t want to be 40 years old and be blind or on dialysis.
I want to have kids and get married.
What I was doing before was not a life at all.”
She exhales slowly and lowers her voice.
“You’re not invincible forever,” she says softly.
Photo Credit: Bill Diodato
