Type 2, overweight, and binge eating disorder

I’m a bit stuck. Every time I try to diet, it triggers bingeing. I’m I’m treatment for bingeing and one of the tenets is no dieting. I’m a type 2 diabetic and not on insulin or medication currently. My numbers have always been pretty good, around 5.5-6.0 two hours post-prandial. But lately I am seeing some 7.5-8.5 and it has me worried. I’ve been diagnosed for years and been on and off metformin but haven’t really benefited much from it historically. Anyway the high numbers are tempting me to try to control my food intake more but I’m afraid it will trigger me. I will be talking to my therapist about this but wondered if any others had been down this path. If you prefer to talk in private I understand that too. Sorry this post is so mixed up.

Carbs and sugar especially are even more addictive for people with Eating Disorders. If you haven't already I would suggest completely eliminating sugar (I haven't had any in 18 years as I'm in recovery from an ED also). As Helen said, cutting your carbs so they are not the center of your diet is very helpful in managing D.

However...I know exactly what you mean as dieting as a trigger. So from my ED experience what I would suggest is finding a new way of eating that you can not only live with but enjoy! Enjoying my food was an absolute mandate for me in recovering from my ED. I was diagnosed with Type 1 D 13 years after I got into ED recovery and it does make it harder. But there are ways you can eat that you will enjoy and yet will help you manage your D. The specifics of that are very individual.

It does sound like your D has progressed to the point where you may no longer be able to control it with diet and exercise alone, though by no means out of control. Perhaps it's time to talk with your doctor about some medication? Metformin isn't the only option; there are other oral meds or insulin. You don't say much about what your diet is so perhaps you can alter it a bit and start some medication and the combination will help. But, yes, dieting will be a trigger for quite awhile so don't think of food changes as a "diet" and don't make ones that will leave you deprived.

It's hard, I know.

Sorry, I guess I wasn’t clear. Limiting my food types is counter to eating disorder treatment. It falls under dieting.

Here's an interesting, if a bit sciency article that talks about the way in which various endocrinological components of T2 fit together. To me, I would conclude that you should talk to a doctor about changing your medications to control your BG first. We have seen many stories about weight being a problem but I think that those of us hanging around message boards like this one are aware that T2, particularly fighting high BG is probably at least equally, if not more dangerous. I also suspect that perhaps moderating your BG might be a "victory" that might help the "trigger" to which you are referring? I'm sorry I can't give you a better answer but the article confirmed to me the suspicion I'd developed for a while that T2 may be more evil than T1 for it's victims.

I don't know much about accepted methods of treating eating disorders, but the statement "Limiting my food types is counter to eating disorder treatment. It falls under dieting" strikes me as a sort of Catch 22.

I have eliminated all fast acting carbs from my diet for over 3.5 years in response to T2. I now understand, that for me, the fast acting carbs were very addictive. Continuing to eat the food triggering the problem is like telling an alcoholic that it's OK to continue drinking, they just have to limit their consumption to one drink.

Zoe's experience in eliminating a food group in response to an eating disorder suggests that in some cases it may be the only strategy that will work.

Everything falls under dieting. Limiting food choices is dieting but it works. They are giving you proven methods of satiety, methods that fill you, that give you energy. Exceedingly worth a try!

Ask your doc to rethink therapy to get your numbers in the normal range. The tighter the range the better you'll feel.

I agree with BadMoon, Misty and not only do I have 18 years recovery from an eating disorder but in my career as a Counselor I've worked with many other people who do. BadMoon nails it when he talks about foods that are triggers because they are both psychologically and physically addictive. Eliminating those foods, or drastically cutting them is not" dieting" as your goal is not weight loss it is to treat one aspect of the eating disorder itself. Eating disorders are complex multi faceted things. They are physical, psychological, emotional and even spiritual. If you have a food that is physically addictive you need to confront that physical addiction. I've done a great deal of psychological work on the roots of my eating disorder but none of it would mean anything if I was still eating sugar. I don't eat sugar, I binge on sugar. So I choose not to eat it at all and it works out just fine, I no longer miss it.

You mention your therapist.No offense, but If you are still struggling with your eating disorder you might consider an eating disorder program which has more specific understanding of physical aspects of ED, or ideally a program for Diabetics with ED's though I know those are few and far between.

Balancing an ED and D is just that...a balancing act. I got into recovery by learning to eat 3 meals a day, nothing in between, no sugar at all, but otherwise whatever I felt like. With D, things are less black and white and that's hard for us.

Every time I say diet I end up eating at McDonalds.

I do not diet, I have a food plan set up for me, including foods I like. I had some celery dipped in salsa this afternoon for a snack as an example. Hope this helps. Nancy

Zoe,

I'm curious...what do you use for treating lows? I've been trying to avoid sugar, but since I have an erratic schedule and can't carry enough juice boxes around with me, I've been using starlight mints to treat lows...they work well and they don't call my name when I'm not low, but they really are straight sugar. I'm a compulsive overeater and had been doing well for years, but recently derailed, and I'm thinking of totally giving up sugar. I'd like to totally give up food, but that's not an option . So what do I carry with me that's lightweight and acts fairly quickly?

Ruth

I think you should try lower carb maybe? The most important thing is to get your bg as well as the binging under control whatever you do because that is going to have serious effects over time. As others have said, I would try to figure out how to use the metformin and or other drugs as well as exercise to work with whatever food you decide works best for you to keep your bg under control as much as you can. I have just started on symlin because I feel constantly hungry on insulin and this is helping to control my hunger during meals. Many people with D use it for this and to lose weight also.

I use glucose tabs, Ruth. They work really quickly and you can figure out the exact dose. But more important, I think of them as "medicine" not candy. I had been totally off sugar for 13 years when I was diagnosed, including reading ingredients on labels. I was horrified that I would have to eat something that was pure sugar (glucose). But I think of them as medicine and don't think I am "eating sugar" but taking my medication to treat a low. When I hear people talk about "over-treating" and going high I recommend using glucose tabs and thinking of them the same way. When people complain "they don't taste good" I explain they aren't supposed to, they're medicine.

Thanks for responding, Zoe. Unfortunately,I can't stand the glucose tabs...they actually make me gag. And aren't they the same as sugar? I hear you, though, on thinking of them as medicine...that's how my starlight mints are. In the many years that I've been using those to treat lows, I think I've only ever had one when I wasn't low maybe once or twice (in 20+ years.)

So guess I'll just keep using those, but try to keep other sugars out of my diet. Going on three days of abstinence now, and hopefully tomorrow will be another good day.

Ruth

Good luck, Ruth. Have you considered OA for support? They have online meetings now too which makes it easy.

Thanks for your suggestions. I am working with my doctors on a plan now.

Yep, Zoe...I'm a long-time OA member, and have lost about 20 pounds. I just had a major break in abstinence over the past couple of months but I seem to be back on track now, thank goodness. I've also found it a bit of a problem to figure out the food issues, and much as I love my sponsor, she feels uncomfortable discussing food with me because of my diabetes. And admittedly, I sometimes get tired of hearing "three meals a day, nothing in between" when sometimes a low will really trigger me. For the most part, my lows are not severe, and a couple of mints suffice to treat them, but those occasional severe lows, especially if they happen when I'm going to need to get behind the wheel of a car soon, usually send me into a feeding frenzy. thank goodness they don't happen often! The reality is...my disease is powerful and it wants me to think having lows are the reason for losing abstinence, but that's really not true...it's ME that causes my abstinence loss. Thank goodness my OA home groups are wonderfully non-judgemental.

Ruth

Good for you, Ruth! And I'm glad you're back on track. I didn't lose my abstinence but got pretty shaky recently so I've been going to some online meetings. It's amazing isn't it, the convoluted deceptions our fertile little brains can come up with!

Yep, ED and D are a hard combination! When I got into recovery I learned to not obsess about food - a lot of OA members are too rigid for me - now I have to do just that!

I am soooo grateful that I don't get the symptom of feeling super hungry when I'm low. When I started hearing that happens to many I thanked my stars I didn't have that particular variable! Keep up the good work!

I know how you feel.I was diganosed a year ago.I have been really good in the beginning then hurricane sandy hit.I gained 53lbs.That's more than when I was pregnant.I feel angry,lost confused.My Mother,Father and Brother all had diabetes type 2 and heart disease and high cholesterol.I keep on asking why me ,why so young.They all passed.I don't want to die.I want to LIVE!!!I am scared.I am glad I am not alone.I WANT TO DO ALL I CAN.But what is wrong with me?

I am a compulsive overeater,formerly in OA with a lot of success. I did grey sheet back then in the 80"s and lost a lot of weight, but didn't really know what the program was all about. All I knew was that I lost 80 lbs, had made new friends, and had a new body. Fast forward and I gained all of it back because I quit going to meetings and dumped the program. Now all those years later, and being a full blown, non conforming diabetic, it is really scary. OA is all I know, and I know it works. I need to find a more gentle food plan because the absolute rigor of grey sheet will not work for me anymore. I have been trying it off and on for years without even one day of back to back abstinence. I am an addict, no doubt about it. I need to find a food plan, that works with my diabetes. I take a hand full of pills and 10 units of Lantus before bed, but my numbers were 174 this morning...too high. I still teach full time but wonder how long I can keep this up, not taking care of me. Any suggestions would be gladly appreciated. Thanks for listening..Pat in Phoenix

I know how you feel, Pat. When I was desperately battling my ED, way back when I went to OA and it felt extremely rigid to me. Between reading I was doing and knowing myself, I was able to "take what you need and leave the rest" and find what worked for me. My abstinence is "three meals a day with nothing in between and no sugar". Other than that I eat what I enjoy, and enjoying my food is required so I don't feel deprived. I had 13 years in recovery when I was diagnosed with Type 1 and it made me change a lot of things, and almost reverse gears - we have to "obsess about food" to a certain extent! I made the adjustment but recently at 18 years in recovery I've hit a rocky place again due to weight gain. So I've started going to online OA meetings again. Perhaps you can find a meeting that is less rigid, or a sponsor who supports you (one with D would be great!) and take the support from the program and find your own food plan.

As for the high numbers. If that is common for you, it sounds like you may need more Lantus and/or to split your dose. You say you "take a hand full of pills and 10 units of Lantus". Perhaps your body is telling you that you need to have a meal insulin as well?