The diabetic's relationship to food

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1

Yesterday, I tried to explain my food issues to my husband (a non-diabetic and absolute darling). I told him, “Imagine you are 8 years old and in the hospital. Every time you were sick up to that point, you got better. The illness went away and life went back to normal. But, when you were in the hospital and you said to the doctor, ‘When I leave here, I’ll be able to eat cupcakes and pizza’ and he says, ‘NO! This is never going away’, it’s hard for that child to understand. It’s hard for a child to understand why they have to measure every bit of food that goes into their mouths, or bring their own food to a birthday party. And when you “can’t have” something, or “can’t have” MORE of something…well, that makes it difficult to ever resist food when it’s available.”

This is a problem I’ve been struggling with for a few years now. First, rewind 25 years…I was 8 years old, the year was 1984. I didn’t realize it until reading Dr. Richard Bernstein’s book (I can’t find it right now, so can’t tell you the title), but some of the things I take for granted today in taking care of my diabetes were brand new then…blood testing, controlling diet…there are many, many things that have changed since I first developed Type 1 diabetes. I used to test my urine AND blood sugar (which thinking of it now makes little sense…but the urine testing was probably so ingrained by that point that it remained “in vogue” for a while). I used to inject animal-based insulin, and took regular and NPH varieties. The dietician created a plan that included milk, fruit, vegetable, starch and protein exchanges. Now, I take synthetic Humalog and Lantus in place of the old animal-based R and NPH, no more urine testing (in fact, blood testing takes 7 seconds! The smallest blood sample known to man can be tested! The machine fits into a pocket! Heck, it almost fits into a wallet!) and when I saw a dietician a few years ago, the way the diet worked had COMPLETELY changed. It all had to do with counting carb, protein and fat grams…not compartementalizing all foods consumed into the exchanges I’d learned about in 1984.

But I digress.

As an 8-year old, I know the term “can’t have” came up quite a bit. “I can’t have birthday cake.” “She can’t drink regular soda.” “You can’t have more than 5 of these crackers.” My teenage rebellion was “cheating on my diet”. Food became an obsession that has endured 25 years. I will now eat well PAST the point of feeling full…where I’m literally hunched over in my chair (still eating) because my stomach hurts so much from being overstuffed. If it’s on my plate, it’s getting eaten. My plate ALWAYS ends up being the cleanest in any gathering. I go to restaurants and peruse the menu for what looks like it will come with the most food. I’m not sure if I ever felt hungry when I was young after finishing all I was “allowed” at a meal…but the way I act around food now, you’d think I had survived the worst famine and was still compensating for the experience.

I feel sad now to feel this way. I know my parents tried everything they could to make things “normal” for me. The first Easter after my diagnosis, my mom called the dietician to see if there was any Easter candy that could be fit into my diet (yes! 6 jelly beans=1 fruit exchange, 1 ounce hollow chocolate=1 starch, 2 fat exchanges (if I remember correctly)). My mom bought a book of diabetic recipes so she could make, among other things, cranberry sauce that I could eat. We always had pound cake or angel food cake for my birthday. My whole family ate the same foods I did. There might have been a few extras they would eat that I couldn’t (sugary cereals for my brothers, cookies or snack cakes for lunches), but for the most part, we all did the same thing. Except, of course, my food was weighed/measured, and if I wanted more, I couldn’t have it.

This unhealthy attitude about food is one you’ll see in many non-diabetics, as well. Would I have had the same issues if I didn’t contract diabetes? Who can say? All I know for sure is this:

  1. I had the greatest parents in the world, who both felt unnecessary guilt that I contracted diabetes (it was prevalent on both sides of my family)
  2. I am lucky to have contracted diabetes when I did, so that I’m even alive to SAY I got it 25 years ago
  3. I am lucky to have had the medical professionals I did…the dietician, the doctors, the nurses, the subsequent doctors, nurses and dietician who taught me everything I needed to know to make the right decisions, even if I chose not to
  4. What has happened in my past has made me who I am…it is up to me to decide what choice to make now to mold my future.
  5. I recognize the issues I have and take responsibility for them. How can I not, when I’m completely aware of their existence? No amount of M&Ms or cheddar & sourcream potato chips will make me feel any better, any more free or any less stressed.

I guess in closing, if you have food issues, you’re not alone. But food doesn’t have to be the enemy, or an addiction. And yes, it’s much easier to say than to do.

2

Brilliant.

And I completely relate. People never understand when I have described not knowing hunger for most of my life. Low an hour after a meal but you’re stuffed? Still had to eat. Insulin on board and you only want to eat half the plate? You ate all of it anyway. I felt like I had to multi-course meals as a kid when everyone else was fine with skipping a meal (not on NPH you didn’t!) or eating just a small meal. I think I went a decade before I knew what it was to feel hungry.

I, too, struggled with the dietary changes as they kept applying them to how Type 1s should eat (but not telling us unless you thought to ask at your appointments!). Portion sizes and carb counts of products I regularly bought changed and I kept counting my exchanges and carbs incorrectly for years. No wonder my control got worse! And when I switched to carb counting off the exchange plan, I felt this huge release and ate like a crazed caged animal released into the wild at age 16 - pizza, cookies, cake, burgers! - just take insulin for the carb count I was told! I was never “heavy” but I was certainly “overweight” and starting to become self-conscious about it.

When I was in college and the Atkins craze started to take off, it was “Oh, no, not for Type 1s. Have some more bread. Would you like a bolus of insulin and a second helping of weight gain with that?”

Eating is a big crazy game that I have always reluctantly played. It’s been a long road to get to where I am today.

3

i can relate to your suffering and even say i understand it. i was diagnose when i was 12 and i hated when people told me no i couldnt eat this or that when everybody else could, it didnt make sense. Then i would start lying about the blood sugars to authority figures because it was suppose to be 80 - 120 which being a diabetic you know it can often fluxuate more easily than not. As i got older i realized i could do what i wanted because there was no one around to tell me NO, or you CANT and i sort of rebelled against it all and ate candy and sweets when i wanted and ate well past the point of being full. Now i am almost 20 years old and i struggle with what i consider a mild eating disorder, and yes its hard. but i find it helps enjoying meals with loved ones around a table in a happy loving mood and practicing gratitude for it in a meditative or prayer like way. it helps for me, i just know i dont really like to eat alone so much i end up eating faster and consumer far to much.

4

As someone who also struggles with my relationship with food, I understand every word and emotion you have shared. I even joke with my doctor that diabetes is a “doctor sanctioned eating disorder.” She laughs at that but it is not funny, it is very true. As a mental health professional, I struggle with this issue with clients. Many of them have been diagnosed as Eating Disorder Not Otherwise Specified because these eating and emotional issues do not fit the mold of eating disorders we have. We can become irrational in our thinking of all the shoulds and oughts we think when it comes to food and diabetes care. Therapy can help with this, as can medication. I see improvements in my clients as well as in myself.