Managing Type 1 Diabetes With a History of Anorexia

By February 26, 2013

Last year I was diagnosed with type 1 diabetes. I’ve been in recovery from anorexia for 3 1/2 years but I now have to count carbs and be aware of calories, fats and my weight. It’s everything I’ve been learning not to do for almost 7 years now – I was anorexic for almost 30 years of my life. It’s very stressful and I find myself trying to lessen what I eat or lessen my insulin so I don’t gain as much weight. Do you have any suggestions because I can’t seem to find resources on my own.

Dear Visitor:

My heart goes out to you. It is understandable that you are feeling stressed and overwhelmed.

Managing Type 1 Diabetes is especially challenging for those who have had a history of anorexia—it is no wonder that you are having difficulty finding balance. You worked hard to break free from food preoccupation, yet now must plan your meals and snacks carefully in order to keep your blood sugar levels under control. You most likely lost weight before you were diagnosed (since your body wasn’t utilizing glucose properly and you were unhealthy), and it probably unsettled you to regain that weight once you started insulin.

You are not alone in your struggles. For many years, health care practitioners who specialize in diabetes have recognized that diabetes and disordered eating often go hand-in-hand. More recently, the term “Diabulimia” has been used to describe those who will reduce or skip insulin doses to try to lose weight (or attempt to overeat/binge without weight gain).

Manipulating insulin for this purpose is a dangerous practice; there are multiple health consequences as a result of chronic high blood sugar levels. In the short term, you will feel fatigued and get dehydrated, but in the long run, you are increasing your risk for complications such as neuropathy (nerve damage), blindness, kidney disease, and circulatory problems that can lead to amputations. I am not trying to scare you—just remind you of the importance of good blood sugar control.

First and foremost, I urge you to seek professional counseling again to get the support you need to work through this. You should reconnect with your most recent treatment team, but also explore the possibility of a consultation at a teaching hospital or large diabetes clinic, where they may be more familiar with your challenges and needs. Call around and ask lots of questions before you decide.

In the meantime, remind yourself of the following:

  • Although there is not yet a cure for diabetes, you can manage it and keep it under control in a balanced way. Maintaining good blood sugar levels will enable you to live an active lifestyle and minimize or prevent future complications.
  • Any weight you regain due to improved blood sugar control is a sign of restoring your body to good health—not a sign that you are going to continue gaining weight.
  • Good nutrition and careful meal planning does not have to lead to obsession and restriction again. It’s not black and white. The information you have learned is a gift to keep you healthy.
  • Put your energy into making healthy food choices to maintain good blood glucose control—not to manipulate your weight. Be grateful for the wonderful variety of foods you can choose from, instead of focusing on dietary limitations.
  •  Insulin injections are keeping you alive and allow you to live a full, productive life. Your body deserves the best care you can give it. Reducing insulin dosage just to be at a certain size is not worth the risks to your health, well being, and longevity.

In addition, it may help to view selected videos in our “Practical Recovery Tips” section, to refresh your memory of some of the strategies and techniques that helped you in the past. Although diabetes makes it more complicated, you still need to identify negative thoughts and replace them with the truth. I wish I could recommend more resources to help you. If you (or anyone else reading this) find comprehensive material specific to diabetes and eating disorders, please let me know.

Don’t hesitate to be honest and open with those who are helping you manage your diabetes, so you can get the best support and care possible. Overcoming your past struggles proves that you are a strong person. With help, you can find a place of balance again.