Ann E. Goebel-Fabbri, Ph.D.
Dr. Ann Goebel-Fabbri is a clinical psychologist at Joslin Diabetes Center and Assistant Professor in Psychiatry at Harvard Medical School. Her role at Joslin integrates teaching, research and treatment focused on disordered eating behaviors in patients with type 1 and type 2 diabetes. Her work covers the spectrum of eating problems from food and insulin restriction to binge eating and obesity.
Dr Goebel-Fabbri has lectured at local and national academic conferences and presented her work in peer-reviewed journals. She is involved in NIH-funded multi-center clinical research focused on non-surgical weight loss strategies for improved health outcomes in type 2 diabetes.
Women with type 1 diabetes are more than twice as likely to develop an eating disorder as the general public. The symptoms of eating disorders specific to this population include insulin omission and insulin underdosing (skipping or reducing necessary insulin injections to control weight).
Research indicates that insulin omission and reduction increase the risk of long-term microvascular and macrovascular medical complications of diabetes—such as nerve damage, kidney disease, cardiac disease and eye disease—and may also increase mortality rates.
Dr. Goebel-Fabbri is a clinical psychologist whose research focuses on the relationship between diabetes and eating disorders. In her own studies and in collaboration with others, Dr. Goebel-Fabbri seeks to better understand how eating disorders affect long-term medical complications in women with diabetes and what types of interventions might help improve health outcomes in these high-risk patients.
In collaboration with Katie Weinger, Ed.D., R.N., Dr. Goebel-Fabbri completed a 12-year follow-up of a cohort of 470 female Joslin patients with type 1 diabetes. This study investigates the natural course of insulin omission and underdosing as a means of weight loss over time.
The study also examines how these behaviors affect psychological and functional health, quality of life, diabetes-related distress, diagnoses of eating disorders and long-term complications of diabetes.
In the future, Dr. Goebel-Fabbri hopes to undertake a treatment outcome study to determine whether interventions specifically tailored to treat issues related to insulin omission and other eating disorders in women with type 1 diabetes can improve overall health outcomes in this population.
People with type 2 diabetes also appear to be at higher risk of developing eating disorders, particularly binge eating. It remains unclear whether the binge eating leads to weight gain and type 2 diabetes, or if events occur in another order. Dr. Goebel-Fabbri is the chief psychologist for WhyWAIT[, a Joslin program created expressly to address the unique weight-management needs of people with type 2 diabetes. A multidisciplinary clinical research team is studying the effectiveness of this program for delivery in routine diabetes care.
Dr. Goebel-Fabbri serves as the Behavioral Consultant to the Joslin team of the Look AHEAD (Action for Health in Diabetes) Study, a multicenterclinical trial, funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), that examines the impact of weight loss and physical activity on cardiac outcomes in adults with type 2 diabetes.
She is also the supervising Behavioral Psychologist to the Joslin team of the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study, a multicenter research trial funded by NIDDK. This project aims to improve medical and behavioral treatments for children and adolescents with type 2 diabetes.
Dr. Goebel-Fabbri discusses eating disorders among women with type 1 diabetes:
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Page last updated: December 12, 2013