Body Image and Type 1 Diabetes

I have this theory that living with type 1 diabetes can have the potential to lead to an unhealthy relationship with food and poor body image. I have never been "overweight" per say, usually just a couple pounds over a healthy BMI. Despite this, I am in a constant struggle over my weight. I obsess about it. Weighing myself multiple times a week. I was told by a psychologist once that perhaps diabetes is a factor because I have always been at odds with my body in a way, so I do not fully trust it.

I also have a terrible relationship with food. I have very all or nothing, black or white thinking. I either eat super healthy, or binge. If I eat Dairy Queen I say screw it and eat everything in the house, even though I am not truly hungry. Instead of just enjoying the treat.

Does anyone else have these issues?

Jessica - welcome to my world!!! I struggle all day & night with this.
I was lucky to have a health care team who recognized the signs of an eating disorder
and I am currently involved in a treatment program where I go several days a week.
I think your entry was heartfelt and courageous. thank you -

As a male, with regret I have even trouble understanding this thinking, on any level. Do men have the body image issues that you mention? Eating in a rational, healthy manner is a different question than my perception of my own body...

Afraid is may break down very differently along gender lines.

It's probably less common in males, as almost all eating disorders are.
However, being male myself, I had some problems in the past - mostly in my teens to early 20's.
I was actually called fat in school before my diagnosis, even though I had a normal weight and only had a slight excess of fat around the middle.
It started to bother me right before my diagnosis, so it sort of carried over to my diabetes as the two things happened almost at the same time. I started obsessing over eating healthy, then I would have periods of awful eating habits, like binging on junk food, and feeling guilty and starting over again with the healthy eating.
The years following my diagnosis I was really skinny, and was a bit embarrassed by that too. I would never find myself in situations where I had to remove my shirt and always wore long sleeves, because I didn't want to show my matchstick arms... Lol.

All of the stress related to food and my own body just suddenly stopped a few years ago for some reason. Not entirely sure why.

So I would definitely say diabetes helped in affecting my body image and relationship with food negatively.

Humngh... fascinating.

I've read the issue(s) many, many times on various boards over the years. Most, almost all seemed to be female generated. A new perspective... thank you for sharing it.

Been trying to remember if there was ever a time I was conscious of my body, such that awareness had a "negative" effect on my mental state, or perception of myself.

Having been T1 this long, only very recently did I NOT eat (Fasting BG tests do not count). Never having done so ever before, I had not realized I'd never deliberately not eaten before...

Now having done so, I could easily fast for a while just to learn what genuine hunger feels like.

i find that when i log and keep track of what im eating because of rogue bgs and unexplained highs i am much more obsessive about the eating, the food, the number of carbs i eat. i dont find myself binging much, but i do start getting obsessive. i look back at the log from the day before to see how many carbs i ate, thinking how i can eat less today, and then less tomorrow, and how low carb can i go, and oooh if i eat more carbs i will need to use more insulin and that will make me fat, better to eat nothing at all, better to eat less, i consult my little notebook and think about how many hours are left in the day and how little can i eat in those hours, trying to get even lower fasting readings, but ooh the reading cant be too low because then ill be low and ill have to eat and that will make me fat....its horrible to think like that. luckily i am not consistent in my logging. but i can see how diabetes makes some people go off the deep end with food issues.
before i was diabetic, i always wanted to lose 5 pounds. now there is just this fear about gaining weight becuase everyone says insulin can make you fat, that its hard to lose weight on insulin, that if i start gaining ill never stop. god i hate this part of diabetes.

My general take is that you have a borderline eating disorder and you also have diabetes. There may be a correlation, but there isn't causation.

Stuart, in Western cultures (USA, in particular) there are many, many people who suffer from eating disorders and body image problems. This is more prevalent in women than in men. We don't give a second thought to a guy who is 6' 5" and 275 pounds, other than to say, "That's a big guy!", while maybe wondering if he plays football. OTOH, if a woman were a bit overweight, we might immediately wonder why she can't be "normal". If she is skinny, we might wonder if she has an eating disorder. It seems like there are different rules for men vs. women and different rules for those who are "fat" vs. "normal" vs. "skinny".

pancreaswanted, I think that if you are matching carbs to insulin and otherwise doing well, weight gain should not be an issue.

I was just recently diagnosed with Type 1, but years ago I realized I had very disordered eating habits, much like you describe. At the time, I was starting a new career as a personal trainer and felt the pressure to have the ideal, athletic and lean body so I measured all my food, counted carbs, protein and fat and even obsessed over water intake and supplements. All that obsessiveness led to binge eating, and rarely being able to just sit down and enjoy food. I've moved past it over the past year or so, but it was hard work. And now that I have this new diagnosis, I'm concerned that the need for counting carbs and obsessively monitoring my BG, etc will trigger that disordered eating again! Ugh.

I would agree with other commenters that it might help to see a professional - maybe together you can work out a way to manage your T1D without it negatively affecting body image and your relationship with food. But I totally understand where you're coming from - it's hard not to, when you kind of HAVE to obsess a little bit to maintain control over your BG. I can give you one piece of advice and that is to get rid of your scale at home. Save weigh-ins for the doctors office, there's no need to obsessively weigh yourself all the time. Weight fluctuates frequently, especially for us women, and it's perfectly normal. If you're concerned about weight gain, pay more attention to how your clothes fit and how you feel.

yeah mike, the weight gain isnt an issue, as i do lots of sport and eat well, insulin is just about right. its just the thinking, the obsessive thoughts about how it would be better to eat less carbs, eat less, period, the feeling virtuous about eating very little.

This is hard. It really. really is.

I had 3 years of individual therapy 2 of group to start working through my disordered eating habits and denying myself insulin to try to control my weight. I still argue with the voice in my head that says I'm not good enough or I'm too fat. The swings between binge eating and restriction have definitely decreased as my self-confidence increases and I learned to value what my body can do for me. I have to focus on body positivity to feel good and I do that by physically challenging myself with exercise and surrounding myself with people who do the same. You are not alone in these issues. It helps to talk about them with anyone who will listen and provide positive and therapeutic feedback.

Jables, i hope you have continued success! it must be very challenging!

Thank you so much for your post! I struggle as well. I have used an app called My Net Diary D on and off for years, and it always leads to obsessive thinking like you described. I see I am eating too many carbs or calories, so I start manipulating my diet to get the "right" amount of various things, calories, carbs, etc. I am trying really hard to focus on mindful eating, but it is hard to do with diabetes. We have to at least know the carbs of what we are eating, and we have to eat for reasons other than hunger at times.

Thank you so much for your comments! It definitely is work to find the balance needed to manage type 1 diabetes without being obsessive. I am working with a psychologist. She is helping, I will be good for a couple days, but then slip back into old habits.

I have cut back on weighing myself. It is more so every couple weeks, than multiple times a week. I would save it for the endo, but their scale weighs 5-6 pounds heavier than my own scale at home. I was weighed there last week and it totally freaked me out. I weighed myself at home for reassurance, but then tucked it away. Baby steps

Thank you so much! It is very hard but like you said, self love and acceptance seems to be the key.

ok, so thats an app i wont be using!

its a double edged sword. youre doing something good-being mindful and logging and making sure to keep bgs where they should be, but it comes with the craziness of the obsessing. i know when i am doing it, but i just cant stop looking at the little book and planning on eating less!

i think its a great idea to weigh yourself less. removing all of the things that allow you to think/obsess about weight is positive.
i never weigh myself. it just makes me think and worry and want to stop eating. not like there is weight gain or anything. but if its the same as 6 months ago, it makes me think i am on this slippery slope of starting to gain weight.
when my endo or the team at the hospital want to weigh me i tell them no. my endo has just accepted this and doesnt ask anymore.
the last time i was at the hospital, the nurses would not go any further before weighing me. i was so freaked out that i was ready to leave. sweating and everything. and i thought, this is ridiculous, what am i, a 16 year old

If you absolutely have to get weighed at the doctors office, maybe step onto the scale backwards and ask the nurse to not say the number out loud. I know it can still be scary, but at least you won’t have a number to obsess over.

i will do that next time. its so weird, as a teenager i was never obsessive about my weight. i think with all the numbers and things we have to control it makes it easy to freak out about losing control of anything...