Ann E. Goebel-Fabbri, Ph.D. 
Dr. Goebel-Fabbri is an Instructor in Psychiatry at Harvard Medical School and an Investigator in the Section on Behavioral and Mental Health at Joslin Diabetes Center. She received her doctorate in Clinical Psychology from Boston University and completed her clinical training at Cambridge Hospital, Beth Israel Deaconess Medical Center and Joslin Diabetes Center. Dr. Goebel-Fabbri is a recipient of the Priscilla White Fellowship and has received grants for her research from the Harvard Scholars in Medicine Program and the Harvard Center of Excellence in Women’s Health.
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 multidisciplinaryclinical 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.
Selected References
Anderson AJ, Goebel-Fabbri AE, Jacobson AM. Behavioral research and psychological issues in diabetes. Joslin’s Diabetes Mellitus, 14th Edition. Kahn CR, Weir GC, King GL, Jacobson AM, Moses AC, Smith RJ (eds). Philadelphia: Lippincott, Williams & Wilkins, pp.633-648, 2005.
Goebel-Fabbri AE, Musen G, Sparks CR, Greene JA, Levenson, JL, Jacobson AM. Endocrine and metabolic disorders. Textbook of Psychosomatic Medicine. Levenson JL (ed). Washington, DC: American Psychiatric Publishing, pp. 495-515, 2005.
Goebel-Fabbri AE, Fikkan J, Franko DL. Beyond the manual: the flexible use of cognitive behavioral therapy for bulimia nervosa. Cogn Behav Pract 10:41-50, 2003.
Goebel-Fabbri AE. Detecting and treating eating disorders in diabetes. Practical Psychology for Diabetes Clinicians, 2nd edition. Anderson BJ, Rubin RR (eds). Washington, DC: American Diabetes Association, pp. 239-247, 2002.
Goebel-Fabbri AE, Weinger K, Fikkan JL, Schwartz E, Anderson BJ. Medical and psychological impact of insulin omission in type 1 diabetes: a ten year follow up. Diabetes 51(Suppl 2):A436, 2002.
Goebel-Fabbri AE, Fikkan JL, Connell A, Vangsness L, Anderson BJ. Identification and treatment of eating disorders in women with type 1 diabetes mellitus. Treat Endocrinol 1:155-162, 2002.
Goebel-Fabbri AE, Fikkan JL, Vangsness L, Connell A, Ficken A, Anderson BJ. Binge eating, body mass index, and glycemic control in women with type 2 diabetes. Diabetes 50(Suppl 2):A392, 2001.
