Diabetes and body image 11 February 2015 Australian adolescents with type 1 diabetes are affected by body image issues. 28% of them meet the diagnostic criteria for an eating disorder – which can range from anorexia to bulimia, binge eating, excessive exercise or nutrient restriction. What isn’t often exposed at diagnosis is how much diabetes can affect the perception of body image for people living with the condition. It affects those with type 1 or type 2 diabetes. We recently asked some of Diabetes NSW & ACT’s ambassadors to share how living with diabetes has affected their body image and here’s what they had to say: Phoebe Wild, type 1 I put on a lot of weight after my diagnosis despite following all the recommendations from my dietitian, endocrinologist and diabetes educator which had me rigorously controlling my blood glucose levels and measuring the kilojoules and carbohydrates I was eating each day. So I took up yoga, pilates and zumba and started controlling my food intake tightly in the hopes of reducing my weight gain. Eventually I was starving myself to minimise my kilojoule intake and binge eating because of sugar cravings. The day I tried to make myself throw up – I knew something had to change. The journey back from my negative body image and tight food control has been a gradual process. Over time I’ve improved my body image through my own research and I now have a lifestyle that controls my weight and BGLs healthily and lets me enjoy food. Yvonne Appleby, type 2 I had always been petite in weight and height (4 ft 9), and found it difficult to accept that I had gained 20kg in four years. For seven years I knew something was wrong and experts would only tell me to eat well and exercise. No matter what I tried I kept gaining weight. By the time I was diagnosed with type 2 diabetes, I weighed 73kg and was size 18. Shortly after diagnosis I attended an education program run by Diabetes NSW & ACT where I learned to how to eat healthier and exercise. My medication helped me regain energy, which gave me the motivation and ability to become active again. When I started dancing I wore a hoodie and tights to my first class because I was so self conscious about how I looked. I was sweltering in September! After the first class I was hooked – I’d found my passion! I started dancing 9 to 10 hours a week and combined with medication and healthy eating, I lost 15kg in eight months. Frank Lauria, type 1 I was healthy, athletic and in my second year of high school – eating a pack of Weet-Bix a day. But when I lost 14kg in a week and knew something was wrong. I was diagnosed with type 1 diabetes which affected my body image a lot. I dealt with it largely on my own because I felt no one understood and it was hard. Since finishing high school I’ve studied Civil Engineering, played competitive soccer and got married. My wife and I started a personal training business together – Recipe for Health – which was inspired from my experiences with diabetes. Melanie Galea, type 1 When I was diagnosed with type 1, I spent my fifth birthday in hospital and I think I was allowed a piece of cake. Once I was home though, things changed. My parents were doing their best to protect me. I would say that over the years though, the knowledge that I ‘can’t’ eat certain things has led me to sneaking them, hiding, and bingeing those foods. This has led to me carrying a bit more weight than I probably should at times, but then when I’ve participated in exercise regimes the weight hasn’t come off like it did for other people. Learning that weight management and insulin is a complicated road has been demotivating, especially when my blood glucose levels tend to stay more level when I stay away from intense exercise! I try to at least complete gentle exercise so that my insulin becomes more effective. In the last couple of years I’ve experienced insulin resistance, or ‘double diabetes’ which has put my insulin doses up and caused me to put on weight. I refuse to give up though and will be re-joining my boxing classes this year! Adam Waite, type 1 I was diagnosed with type 1 when I was 12, so body image was becoming a major influence in my life. I was never overweight, but I rarely took my shirt off because I felt that girls and especially my peers would laugh at me because all the other boys had a six pack and I had a tyre of fatty insulin cells around my stomach. At this point I started going to the gym and doing weights and started researching and educating myself about the relationship between constructed meal plans and diabetes. I found a coach from the United States who also has type 1 diabetes and life got better. My body weight and body fat changed – and I had the best HBA1c I’d ever had, plus my stomach went down due to less insulin and also changing sites to inject. In some ways diabetes has been a blessing in disguise as I wouldn’t be where I am today without it – Mr Australasia in the BodyBuilding Federation and a Diabetes NSW & ACT ambassador helping others! Paris Lavalle, type 1 The most difficult issues that I have encountered would be the stigma of being a diabetic. The question I dislike more than anything would be is “do you have diabetes because you were/are fat?” or “Is it because you eat unhealthy” For years, this question lowered my self-esteem. I didn’t like that people presumed that I had caused my diabetes because of some unhealthy habits, considering I was diagnosed when I was only two years old. Although I’m by no means skinny, I have never been an overly large or unhealthy person. This stigma caused a problematic relationship between my diabetes and me. There was a struggle between being healthy and having controlled diabetes, and trying to have that perfect body image by dieting and detoxing. There is also the vicious cycle with taking insulin – the more insulin you give yourself the more weight you put on but the larger you are the more insulin you actually need to take to control your sugar levels. It was hard being a teenage girl with diabetes. I would skip meals, which obviously had negative effects on my sugar levels and overall control but even worse, I skipped insulin injections for a long time because I believed reducing the amount of insulin I gave myself would help me lose weight. Now I am older, I understand that everybody is different and I care less about what other people think as long as I am happy with myself and my own body image and that being healthy and having control should be the ultimate ambition. Having this outlook has helped me achieve small goals that have allowed me to get back on track with my diabetes management, and accepting my diabetes and educating myself and other people has allowed me to teach friends, family and colleagues about type 1 diabetes and get rid of the stigma that diabetes is caused because you are overweight or unhealthy. Tasnia Adiba, type 1 After I was diagnosed with diabetes my life and perspective of myself changed in a very negative way. In the first few months of diagnosis I didn’t notice any changes but after 6 months weight piled on. I went from being 43kg to 55kg then 63kg in a matter of four years. So I stopped injecting insulin in order to keep my body weight down and I used all kinds of tricks to hide what I was doing from my endocrinologists. Fortunately I had a top endocrinologist and she saw right through what I was doing. I ended up in an adult hospital at 17 years old, depressed and in an eating disorder clinic. I was told if I did not bring my HbA1c down I would have to stay in hospital and it could affect my ability to have children. My endocrinologist adjusted my long-lasting insulin which had minimal effect on my weight. It was through this experience that I realised my self-worth and how important my health is to me. I made a commitment to myself to take better care of my body and take control of my diabetes. As you can see from this collection of stories, living with diabetes is not easy and that can partly be because people have to juggle diet including counting carbohydrates, fitting in exercise, taking medication and/or insulin. For more information about diabetes and body image or to get help to better manage your diabetes, you can call our Helpline on 1800 177 055. If you’re interested in joining the Diabetes NSW & ACT ambassador program and share your story to inspire others, send an email to [email protected].