My diabetes case is a little complicated since I have both type 1 and type 2, so basically I need a lot of insulin, and insulin itself can lead to weight gain. I’ve been heavy my whole life, and I’ve had trainers, dietitians, and been enrolled in programs as early as 7, but nothing ever helped. The threat of being diagnosed with diabetes has always been framed as life or death to me.
Before I was diagnosed with T1D, I had lost 1/3 of my body weight in a very short period of time. This is typically a dangerous symptom of undiagnosed diabetes. Regardless, the whole world couldn’t stop congratulating me on how amazing I was for dropping an unhealthy amount of weight so quickly. Once I was diagnosed and started insulin treatment for T1, some of the weight started creeping back. This was terrifying because I was scared of what people would say, like that I regained all this weight because I didn’t stick to whatever weight loss regimen I must have been on. I got to the point where I was measuring the calories in spices that I was adding to food, or where I wouldn’t eat for as long as possible just so I wouldn’t need to take as much insulin.
All people with diabetes hate hypoglycemia (low blood sugar), but for me, it was the added layer of having to eat “unhealthy” foods like juice or candy to quickly raise my blood sugar, that drove me insane. And when I had hyperglycemia (high blood sugar), I felt that I failed, and I had eaten “unhealthy” foods to have led me to that point. Because there was always a number that I could look at for my blood sugar, I was making lots of value judgments on how good or bad I had been based on that number.
While on the surface I kept my weight relatively stable for about a year, eventually my eating disorder behaviors caught up to me. I started developing debilitating stomach ulcers from keeping my stomach empty for too long, so I had to change the way I was eating to include more carbs. Eventually I started gaining a bit of weight, and it felt like a personal failing. I felt so trapped by my various medical restrictions. I felt that if I were just stronger (whatever that means), I’d be able to overcome it.
I began meeting with a personal trainer every day and I was working out with as little as possible in my stomach — just enough to prevent another ulcer. My weight still didn’t change, but my mental health and my performance at work and my personal life took a nosedive.
Around this time, I was seeing a new therapist who has type 1 diabetes herself, and she happened to be trained in eating disorders. After a few meetings, she could tell something was wrong and recommended I seek a higher level of care. She presented me with a list of Partial Hospitalization Programs (PHP) that she thought would be a good fit, and they had to have at least a little experience with people who live with diabetes. PHPs are usually 6-7 days a week, 8-10 hours daily. In PHPs, you meet with therapists, a psychiatrist, nurses, dietitians, and social workers in individual and group settings for usually 6-12 weeks, but sometimes longer.
Unfortunately, even within the eating disorder recovery world, there’s a lot of stigma toward people in larger bodies. Initially I was placed on a binge eating unit despite not actually partaking in binges. Eventually, I was transferred to a different program that more matched my own individual ED behaviors.
Additionally, I was often the only male or only person of color in the cohorts, and it was clear that a lot of the group material and literature was constructed without people like me in mind. Having diabetes of course added an additional layer of complexity. Unlike other patients, I was allowed to keep my phone so I could monitor my blood sugar. I would have to study labels intensely to get accurate carb counts while other patients were told to completely disregard them. I would have to leave the group early before meals so I could bolus. Occasionally, I would run into awkward situations with staff members who hadn’t been briefed on my situation, and I would have to find ways to discreetly explain what was going on. Essentially, it was another way that I was different from my fellow patients, and it was another way I felt isolated.
Regardless, I met many amazing people through the programs and learned a lot about myself and mental health in general. It’s still a journey to this day, but I’m a lot better off than I was before.
Currently, I meet with a dietician weekly who specializes in working with people who have diabetes and eating disorders. Being able to work with someone so specialized has been incredibly helpful — I feel heard and validated, and I’m able to get advice that is crafted for someone with my needs.
