Intuitive Eating and Diabetes
Even those of us less familiar with diabetes can probably pull up a few guidelines for diabetes care: regular blood glucose monitoring, cutting back on sugar and carbohydrates, constant attention to food labels, carb counting, regular exercise, and regular visits to the doctor for glucose and body weight monitoring. While all of the above are characteristics of a good diabetic, the list also highlights some of the reasons diabetics are at much higher risk for eating disorders than the general population.
Regular blood glucose monitoring can quickly turn into obsession with perfect blood glucose numbers. Cutting back on sugar and carbohydrates might help stabilize some glucose highs and lows, so the individual takes it even further, virtually eliminating these foods from her diet. Then what about fruit? What about other carbohydrate-containing foods? Where does it stop? Somewhere along the way, she learns being a good diabetic means reading all food labels, which over time turns every meal time into obsession with numbers instead of enjoying the experience of eating. The exercise regime goes from a moderate daily walk to a rigid and intense exercise schedule. When the diabetic doesn’t comply with all of these rules, she may feel overwhelming guilt and shame and turn her thoughts to how she must do better, be better, be more perfect. Even when this doesn’t spiral into a full blown eating disorder, it’s not a healthy or balanced way to live.
Finding balance as a diabetic can be challenging because the reality is diabetics need to pay attention to numbers. Because the repercussions of mismanaged diabetes are so significant, it makes sense that families and medical teams prefer the diabetic individual to err on the side of rigidity and perfection rather than risk dangerous blood glucose swings. However, eating disorders are also very serious, with the highest rate of death of any mental illness. Add diabetes to that equation and the risk of death and other complications increases exponentially. In other words, both sides of the diabetic pendulum—under managed and over managed—are dangerous. Finding a middle ground is critical.
Intuitive Eating is the middle ground. In my many years working with diabetics and eating disorder patients both in my private practice and at Center for Hope of the Sierras, I have seen this model help these individuals learn a healthy, balanced way to incorporate food into their lives while also effectively managing their diabetes. Intuitive Eating is based on the concept that our bodies’ natural hunger and satiety signals are the best guide for each of us to decide what and how much to eat. This can be a scary concept for many because we’ve been so well coached that we can’t trust our bodies, and that left to their own devices, they will only ever ask for the foods we’ve been taught we shouldn’t eat. This is not how our bodies’ wisdom functions. Sure, learning intuitive eating (or more accurately, unlearning all of the food rules we’ve picked up over many years) takes time, but it is the best way to create both a balanced relationship with food and a well-nourished body.
The best part? Intuitive eating works for diabetics, too.
With modern diabetic medication and equipment, we have the ability to make monitoring, counting and dosing highly individualized, not only to the person, but also to the meal and the day. This means the rigid counting and restrictive numbers we used to have to rely on are no longer necessary. Instead, we can base insulin dosing on in-the-moment blood glucose numbers and varied, flexible meals, which in turn gives us the freedom to implement intuitive eating as part of the overall diabetes management plan. This is critical because it reduces some of the risk factors those with diabetes have for developing eating disorders, and it’s also just a really fun way to eat.
Sure, intuitive eating as a diabetic might sometimes look slightly different than intuitive eating as a non-diabetic, but intuitive eating looks different person to person anyway because our bodies are each unique. The beauty of intuitive eating is it is highly flexible and completely individualized, so you get to experiment to find out what feels best for you, both emotionally and physically.
I care very deeply about helping people with diabetes find a way to both safely manage the condition while also living a full life, including dinners out, beach days and birthday cake. Good diabetes care doesn’t have to mean living under the thumb of strict numbers, food rules and rigidity. With support, a good treatment team and a willingness to learn to trust your body, you can keep yourself healthy physically, mentally and emotionally, with more time for the great joy of living a full, present life.
Regular blood glucose monitoring can quickly turn into obsession with perfect blood glucose numbers. Cutting back on sugar and carbohydrates might help stabilize some glucose highs and lows, so the individual takes it even further, virtually eliminating these foods from her diet. Then what about fruit? What about other carbohydrate-containing foods? Where does it stop? Somewhere along the way, she learns being a good diabetic means reading all food labels, which over time turns every meal time into obsession with numbers instead of enjoying the experience of eating. The exercise regime goes from a moderate daily walk to a rigid and intense exercise schedule. When the diabetic doesn’t comply with all of these rules, she may feel overwhelming guilt and shame and turn her thoughts to how she must do better, be better, be more perfect. Even when this doesn’t spiral into a full blown eating disorder, it’s not a healthy or balanced way to live.
Finding balance as a diabetic can be challenging because the reality is diabetics need to pay attention to numbers. Because the repercussions of mismanaged diabetes are so significant, it makes sense that families and medical teams prefer the diabetic individual to err on the side of rigidity and perfection rather than risk dangerous blood glucose swings. However, eating disorders are also very serious, with the highest rate of death of any mental illness. Add diabetes to that equation and the risk of death and other complications increases exponentially. In other words, both sides of the diabetic pendulum—under managed and over managed—are dangerous. Finding a middle ground is critical.
Intuitive Eating is the middle ground. In my many years working with diabetics and eating disorder patients both in my private practice and at Center for Hope of the Sierras, I have seen this model help these individuals learn a healthy, balanced way to incorporate food into their lives while also effectively managing their diabetes. Intuitive Eating is based on the concept that our bodies’ natural hunger and satiety signals are the best guide for each of us to decide what and how much to eat. This can be a scary concept for many because we’ve been so well coached that we can’t trust our bodies, and that left to their own devices, they will only ever ask for the foods we’ve been taught we shouldn’t eat. This is not how our bodies’ wisdom functions. Sure, learning intuitive eating (or more accurately, unlearning all of the food rules we’ve picked up over many years) takes time, but it is the best way to create both a balanced relationship with food and a well-nourished body.
The best part? Intuitive eating works for diabetics, too.
With modern diabetic medication and equipment, we have the ability to make monitoring, counting and dosing highly individualized, not only to the person, but also to the meal and the day. This means the rigid counting and restrictive numbers we used to have to rely on are no longer necessary. Instead, we can base insulin dosing on in-the-moment blood glucose numbers and varied, flexible meals, which in turn gives us the freedom to implement intuitive eating as part of the overall diabetes management plan. This is critical because it reduces some of the risk factors those with diabetes have for developing eating disorders, and it’s also just a really fun way to eat.
Sure, intuitive eating as a diabetic might sometimes look slightly different than intuitive eating as a non-diabetic, but intuitive eating looks different person to person anyway because our bodies are each unique. The beauty of intuitive eating is it is highly flexible and completely individualized, so you get to experiment to find out what feels best for you, both emotionally and physically.
I care very deeply about helping people with diabetes find a way to both safely manage the condition while also living a full life, including dinners out, beach days and birthday cake. Good diabetes care doesn’t have to mean living under the thumb of strict numbers, food rules and rigidity. With support, a good treatment team and a willingness to learn to trust your body, you can keep yourself healthy physically, mentally and emotionally, with more time for the great joy of living a full, present life.
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Dr. Lorraine Platka-Bird; PhD, RD, CDE
Dietitian, Nutrition TherapistDr. Lorraine Platka-Bird received her doctorate from Michigan State University in 1980 with a major in human nutrition and a minor in psychology. She became a registered dietitian in 1982. As a dedicated professor in the Nutrition and Dietetics Department at the State University of New York for 19 years, Dr. Platka-Bird taught a wide variety of courses including Weight Management, Medical Nutrition Therapy, Nutritional Biochemistry, Sports Nutrition, Human Physiology, Nutrition Across the Life Span, and numerous related courses. During this period of time Dr. Platka-Bird was granted some of the most prestigious teaching awards offered in the State University system.
Dr. Platka-Bird has been counseling individuals with eating disorders for over 25 years. She takes a holistic approach to treatment, considering all aspects of physical, mental, social, emotional, and spiritual well-being. In addition to helping clients develop a healthy relationship with food, Dr. Platka-Bird helps individuals minimize eating disorder thoughts and behaviors, improve self-image and self-esteem, and develop healthy coping skills and life skills to improve overall quality of life.
Dietitian, Nutrition TherapistDr. Lorraine Platka-Bird received her doctorate from Michigan State University in 1980 with a major in human nutrition and a minor in psychology. She became a registered dietitian in 1982. As a dedicated professor in the Nutrition and Dietetics Department at the State University of New York for 19 years, Dr. Platka-Bird taught a wide variety of courses including Weight Management, Medical Nutrition Therapy, Nutritional Biochemistry, Sports Nutrition, Human Physiology, Nutrition Across the Life Span, and numerous related courses. During this period of time Dr. Platka-Bird was granted some of the most prestigious teaching awards offered in the State University system.
Dr. Platka-Bird has been counseling individuals with eating disorders for over 25 years. She takes a holistic approach to treatment, considering all aspects of physical, mental, social, emotional, and spiritual well-being. In addition to helping clients develop a healthy relationship with food, Dr. Platka-Bird helps individuals minimize eating disorder thoughts and behaviors, improve self-image and self-esteem, and develop healthy coping skills and life skills to improve overall quality of life.
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