Prevalence, risk factors, and psychological therapy associated with diabulimia: systematic review in adolescents and adults

Abstract

Introduction: Diabulimia (DB) refers to the disorder of eating behavior that can manifest itself in patients diagnosed with type 1 diabetes, since they voluntarily omit to inject insulin to lose weight. Therefore, the results of the most recent research on the subject were summarized. Objectives. To review in the literature of the last five years the prevalence, risk factors and psychological therapies associated with BD in adolescents and adults. In addition, the specific objectives were a) to review the scientific literature on the prevalence and psychological therapies of BD in adolescents and adults considering the region, during the last 5 years; and b) to describe the risk factors of BD in adolescents and adults. Methodology. Systematic review of scientific literature obtained from databases such as: PubMed, Scopus, Web of Science, Lilac, and Google Scholar. Results. After the analysis of thirty-two selected articles dealing with DB, an average prevalence of 25.46% was obtained. The most frequent risk factors associated with DB are high Body Mass Index, dissatisfaction with body image, lack of family support, being female and adolescent, presenting elevated levels of body dissatisfaction and lack of social and family support, associated with negative comments about weight. The most reported psychological approach is Cognitive Behavioral Therapy, and the most effective technique is Psychoeducation, as well as Psychosocial Interventions. Conclusion. In the studies included in this review, the prevalence value is not an exact value due to the scarcity of studies; however, it could be evidenced that Brazil and England are the countries with the greatest number of investigations on the subject; in addition, according to the results of the studies reviewed, the patients in these countries had a high rate of type I diabetes, so that DB is more frequent. The risk factors mentioned in the results section appear to be an important predictor for the development of DB. Regarding psychological interventions for the treatment of BD, it can be concluded that it is necessary to incorporate longitudinal designs that allow research to evaluate the effectiveness of psychological therapies in the treatment of diabulimia, since this type of studies were scarce according to the review conducted. Study: Psychology.