Can you be fat and have an eating disorder?

I apologize if this topic has already been covered, but I need some advice.

I just realized that I might have an eating disorder. I think this has been going on for 10-15 years, at least.

I was diagnosed with diabetes 24 years ago, when I was 7. I use Novolog by pump, my last A1C was 6.7, generally my diabetes is well controlled but I do use a lot of insulin, which I think is because of insulin resistance.

I eat once a day, usually dinner. Most of the time I have a salad with grilled chicken but I also sometimes eat fish or even half a sandwich, and sometimes during the day if I get really hungry I will have a mini rice cake or a piece of turkey. My daily carb intake is under 30.

I make sure to stay hydrated, and take calcium and Vitamin D but I always feel exhausted.

However, I’m fat. Seriously. I am 5’6 and weigh 188 pounds. I am active with my two kids and I do another 45 minutes of cardio five times a week.

Is this normal? Sometimes my husband comes home and tells me what he had for breakfast and lunch, and I can hardly believe someone can eat that much. I’m afraid that if I change what I’m doing, I will get even fatter. I know I sound like I’ve completely lost my mind. Thank you.

Hello hello< If you want to lose weight you only have to eat, my friend eat and eat, breakfast, snack, lunch, snack, dinner and if you usually go to bed late other snack, you only have to pay attention to what you eat and the portions.
If you only have one meal per day your body doesn’t burn fat and my Endo. all time told me if I don’t eat properly my level of insulin soar easily.
Don’t worry, I had the same problem and I started to lose weight when I eat more.
All the best

Hi there! Just a few thoughts for you. I used to work at a treatment center for women with eating disorders, so, while I am not a medical or mental health professional, I do have some experience with this. To answer your question, you can have an eating disorder and be ANY weight. There are many different kinds of eating disorders: anorezxia, bulimia, binge eating disorder, and something called “eating disorder not otherwise specified” or EDNOS, which can be a combination of all the other disorders, or disordered eating that doesn’t necessarily fit into the other eating disorders’ criteria.

Also, the less often you eat, the slower your metabolism becomes. It seems counter-intuitive, but basically your body kind of goes into “starvation mode” thinking there’s going to be a famine, and holds on to everything you do eat, because it doesn’t know that food is readily available, and that you’re just not eating it. So, the more often you eat, the higher your metabolism will be, the better you’ll be able to use the food you eat instead of just storing it away for what your body thinks is an upcoming famine.

And finally, all that being said, diabetes comes with its very own special set of issues with regards to food. I think eating disorders or just disordered eating patterns among diabetics is actually not that uncommon, because we’re so focused and obsessed with counting every carb, calorie, fat gram, etc. I would highly suggest talking to your endo about this, but most importantly talking to a mental health professional who specializes in eating disorders.

And finally, don’t be afraid to reach out to people and ask for help. You don’t sound like you’ve lost your mind, but it does sound like you may need some help finding your way back to a more balanced relationship with food. Please try to speak with a counselor and a doctor about this and in the mean time, I know there are plenty of people on this site that can offer encouragement and advice and who have dealt with what you’re going through!

Have you had your thyroid checked? You don’t say how long you have been eating that way. But If you eat that way (and are being honest about your eating habits), and have progressively gained weight then something is going on that needs to be figured out and thyroid is one very likely culprit. Even if you gained weight before and have been eating like that for awhile you should be losing weight. I agree that isn’t a particularly healthy way to eat (for a diabetic especially), but there isn’t enough information in what you’ve shared to determine that you have an eating disorder. What I would do first, is check for physiological reasons for your weight gain, then, as others have said work on a healthier relationship with food. Many people in our culture, especially women have issues with food and body image, but those issues may not meet the full criteria for an eating disorder. And bottom line, if you do have an eating disorder: I myself have 16 years recovery from a lifelong eating disorder and now have a healthy relationship with food, weight and body image, despite getting diagnosed with diabetes 4 years ago. I have worked with many other people who were able to recover from a variety of eating disorders.

Yes, people can have various types of eating disorders and be extremely thin, normal weight for their height, a little overweight or morbidly obese. There are also people underweight or overweight for various reasons who don’t have eating disorder issues. Weight is not necessarily an indicator of eating disorder.

Zoe do you ask about thyroid because of the non weight loss? The Endo I work with mentioned the other day that research doesn’t support the notion that hypothyroid states have any impact on weight gain and/or inability to loose. I know nothing about the research but had always thought the opposite.

Yes, because of the weight gain if it happened while she was eating that little and then not losing. I haven’t read the research but everything I’ve seen and heard also says that weight gain is a common symptom of hypothyroidism. My own experience is more with hyperthyroidism. Prior to my diagnosis with Grave’s Disease I was losing 2 pounds a week, despite eating normally or even overeating until I was well below normal weight. Because they couldn’t regulate my thyroid with supression meds they had to destroy it with radiation and I now take replacement thyroid. While they were working on getting the doses right I went a bit low and gained a few pounds, but because I’m a little crazy on that subject I went to the doctor and got the dose increased before I had a chance to see how long the weight gain would continue. My gut instinct says that loss from being hyper is more consistent and severe than gain from being hypo but that is just based on anecdotal info.

Not sure what the Endo was referring to but just one course in Research Methodology and one in statistics and I have a healthy disdain for research which can be used to demonstrate just about whatever you want it to (a fact I would never tell my students!) I would be interested to know if that really was the consensus of multiple studies though, I would be very surprised if it were.

Geez. You have diabetes. You have been told all your life to watch every bite you eat. You do that. In fact, from what you say, you do that admirably. But we all also have to be honest. Many of us end up with a “non-normal” relationship to food. The fact that your husband comes home, tells you about the ginormous servings of food he ate without a care in the world. That is not you.

So let me ask you a few questions.

Do you ever deliberately eat in a way that in your heart you would describe as unhealthy?

Do you ever punish yourself for something you ate?

Do you ever binge?

Do you spend a lot of time thinking about your failures in your eating practices?

I know you think you are fat, but does your body image differ markedly from reality?

Do you spend inordinate amounts of time exercising, particularly after eating more than you think you should?

Are you plagued by a low sense of self worth

Are you prone to mood swings and depression?

Have you ever behaved in ways that inflict injury on yourself and do self-harm?

I have to tell you, nothing that you wrote suggests that you would answer yes to these questions. If you do answer yes to a bunch of these questions then perhaps you have an eating disorder. Can you have an eating disorder and be overweight. Sure. Does being type 1 make you at more risk for eating disorders. Absolutely. But it doesn’t mean you have an eating disorder.

And what mother of two kids who has type 1 and is struggling with diet and exercise to lose weight wouldn’t feel exhausted. Please, give yourself a bit of credit. I see a woman deal bravely dealing the challenges she has been dealt, I don’t see someone with an eating disorder. Think about just cutting yourself a bit of a break. Perhaps try some other directions to deal with the weight thing.

I agree about the healthy disdain for research. I will ask him to point me in the direction of this research.

Do you feel hungry and still not eat, or do you not feel hungry?

Before I was diagnosed with hypothyroidism, I was gaining weight slowly and eating very little (less than 50g carbs per day) because I just wasn’t hungry. For me both the lack of hunger and the weight gain were a symptom of being hypothyroid. Now I’m on the right dose of thyroxine my hunger is normal again, I’m no longer exhausted and my weight is stable. :slight_smile: Just a thought, you might want to get it checked if you haven’t already.

Thank you for your thoughtful response. I just want to clarify a couple of things, as my original post was all over the place. First, I meant that my husband tells me that he ate breakfast AND lunch, not necessarily any huge amounts of it. Just the fact that he eats three times a day (and sometimes snacks in between!) is the part that is crazy to me.

Yes, I do feel like the way I eat is unhealthy and I’m a little concerned with the example it sets for my two daughters. So far, they are too young to know the difference but it won’t always be that way.

I haven’t physically punished myself for something I decided to eat, but I often feel guilty.

I don’t really binge. I don’t want my blood sugar to get too high, and I’d rather not take extra insulin as I know it causes more weight gain.

I have spent large amounts of time exercising in the past, but I don’t have the time these days. I go for a walk or log some time on the treadmill most days and spend time outside playing with the kids, but I definitely don’t spend hours at the gym or anything.

I definitely have a low sense of self worth, feeling like I am not living up to my potential in every department. I would like to get to a place where I can accept what I have and what I am because I know my life is great. I probably am prone to depression, but I don’t really think mood swings are too bad.

Thank you. I will have to bring this up at my next appointment. :slight_smile: I appreciate your kindness.

Thank you, those are terrific ideas.

I appreciate your insight and experience.

This has been going on for as long as I can remember. As a little kid, I had to bring a morning and afternoon snack to school. I would hide them in my desk until a time when I could throw them out without anyone noticing. I would do this with most of my lunch as well. I wasn’t fat then, but I think I was somehow punishing myself for something.

The biggest change was when I was pregnant with my now 18 month old. I was too sick to eat for the entire pregnancy, but my doctor didn’t believe it because I gained 50 pounds. The problem was the increase in my insulin needs during pregnancy. I took 6 units of Novalog per hour as a basal. My baby weighed just over 5 pounds at birth (full term). After she was born, I was able to drastically reduce the amount of insulin I was taking for a couple of months, but as time went on I had to increase it again. I had lost 35 of the pregnancy pounds before needing more insulin, and as soon as I had to take more, it started coming back.

I have had my thyroid tested, and will continue to do so, but at this point it isn’t the problem.

I’m also taking Symlin and have lost 12 pounds since starting it about six weeks ago, so I am happy about that. But my endo said it works best when used multiple times per day, and because I don’t eat multiple times every day, I can’t do that. I think that was what prompted my original question. It’s like I’m afraid of food.

Though those are all good questions, and I tend to agree with BSC that you don’t sound like you have a classic eating disorder, none of us can either diagnose you with an eating disorder, or tell you that you don 't have one just from an online conversation. I still feel that checking your thyroid would be an important first step. But if you continue to have concerns by all means talk to a therapist, one who has experience dealing with issues of food and weight, a Type 1 if at all possible. You also might consider a Type 1 support group because I think many of us would relate and understand. Whether you suffer from an eating disorder or just some of the feelings related to those issues and how they impact a Type 1 diabetic, talking about it could definitely help!

Thank you so much. I have had my thyroid tested, but it was a year ago and it is probably time to repeat it. I haven’t recently gained weight, I just can’t seem to lose it. However, I rarely feel hungry. Maybe once in the middle of the day, but nothing I can’t push away.

As others have suggested you should get yourself checked for other medical conditions. Assuming it isn’t that, then my next recommendation would be to spend a week carefully logging everything you eat along with insulin and BGs. This log is only for you so you need to be brutally honest. You’ll need a scale to measure everything (battery powered digital scales are cheap these days). Careful logging is time consuming, but since you only eat once a day and you eat at home it won’t be bad. If you’re eating a salad weigh the ingredients as they’re going in the bowl - don’t assume just because it’s a lettuce that you don’t have to count the calories. If you make your own salad dressing weigh the ingredients of that and the amount you use. If you use a store-bought dressing weigh the bottle before and after. Here’s a link to look everything up at: CLICK HERE

Don’t put anything in your mouth without weighing it first. Make sure you include anything eaten during the day to treat low BG - if your basal rate is off you may be consuming more than you think just keeping your BG normal. I found it easier to keep my logs on a computer - nothing fancy, just a notepad file or excel file if you’re motivated.

Once you have a full week you’ll have a good breakdown of how many calories, how many carbs, how much protein and fat you’re eating every day and you’ll be able to look for patterns in your BG along with what you’re eating. I’ve had T1 quite a bit longer than you; but in all that time I had never really done this logging until a year and a half ago. It was a revelation and helped me improve my control significantly. If you don’t do this, then its all guess work. If you get this info and need help analyzing it there are books that are great resources (Pumping Insulin, Think Like a Pancreas, etc) or come back here and ask specific questions. Good luck!

Lack of energy/ tiredness is also a symptom of hypothyroidism. Weight gain is a symptom, but may also be related to lack of energy (no energy to exercise?). NIH lists it as a symptom as well.

You may also be tired from not eating enough. I haven’t experienced this myself, but I’ve had docs and dieticians tell me that if I don’t eat enough carbs I won’t have as much energy. I’ve always had plenty of carbs (maybe too many??), so I haven’t been able to test that one out!

You said you use a lot of insulin, and probably have insulin resistance. It might be worth talking to your endo about taking Metformin, because it has a tendency to prevent weight gain, and some people lose weight on it, because it cuts down on the insulin resistance.

Insulin resistance tends to be associated with overweight – I honestly don’t know which comes first, but if you can deal with the insulin resistance, your weight may come down naturally. At least you should consider talking to your doc about it.

When you have your thyroid tested, insist that your doctor test free T3 & free T4. Most just check TSH level & that’s basically useless. Go armed with the facts in case your doctor resists Thyroid problems are quite common in women & especially with diabetic women.

Hi Erin - just a thought - I am not 100% sure that extra insulin really causes weight gain.

I’m currently 14 weeks pregnant and for the past 14 weeks, have been on double the amount of insulin pre-pregnancy. Breakfast is the worst, I need three times the amount of insulin I needed before.

Yet despite having to double/triple my insulin, my total weight gain after 14 weeks has been 100 grams.

So I think it’s more complicated than that.