“My rocky relationship with food and diabetes management”

“Diabetes sucks and having an eating disorder also sucks, so when you add them together, it doubly sucks”

Lawrence has been living with type 1 diabetes for 25 years. Lawrence’s mum noticed the signs as her father had type 1 diabetes. Early on in his diagnosis Lawrence’s mum came into his primary school to educate his classmates about diabetes and what to do if anything goes wrong. Roughly thirteen years ago Lawrence also started a rocky relationship with eating disorders.

Growing up with type 1

Growing up diabetic was… Actually, I don’t really know the end to that sentence. I have no memories of non-diabetic life to compare it to, so it’s hard to quantify the impact it had on my upbringing. What I do know is that the C-word was bandied about with regularity in the Smith household. Not that C-word (though, actually, knowing my family and their propensity for filthy limericks, yes probably that C-word too), but “control”. Every minute of every day was presided over by the invisible, unflinching gaze of my diabetes.

Wake up? Do a blood test. Run around the garden? Do a blood test. Have a sandwich? Do a blood test. Do a blood test? Do a blood test. Something that really took the fun out of attending a childhood friend’s birthday party was the ever-looming threat of hospitalisation.

My rocky relationship with food and diabetes management

As the responsibility to manage my diabetes passed from my parents on to me, I found that the only aspect of my life I felt I was in control of was my diabetes; as a result, it was what I could most readily abuse.

My relationship with my body took a tumble around this time. I want to make it clear that, although it’s indisputably part of the equation, my eating disorder wasn’t fully fuelled by the desire to be ‘thin’; the visibly physical effects were almost by-products. I was so numbed by a depression that had soaked its way into my bones, I just desperately wanted to feel something. By shedding weight and self-perceived undesirable physical attributes, I convinced myself that I was ridding myself of unnecessary barriers to my ‘true self’. Once I discovered that skipping injections and mismanaging my blood sugar levels would lead to weight loss, along with restricting my dietary intake and excessive exercise, an insidious neural pathway was established.

I didn’t have the words to ask for help, so I made my body do the talking for me. Maybe if people noticed how ill I was, maybe if they saw the cuts that were appearing on my wrists, maybe if people took note of how dwarfed I was by my clothing, maybe they’d ask if I was okay.

The road to recovery

Ironically, the long (and continuing road) to recovery began with a visit to my diabetic care team. Their puzzlement over my drastically concerning blood results led to them establishing a meal plan. Me pretending to not know the cause of my hospitalisation-warranting blood results was some of the best acting I’ve ever done. Eventually, however, the weariness and loneliness caused by my eating disorder led me to admitting that I had a problem- I had been lying to myself for so long, I didn’t have the energy to lie anymore. Even though, looking back, it’s clear that I was experiencing a mix of anorexia nervosa, depression and ‘diabulimia’ (the phrase attributed to an eating disorder fuelled by mismanaging insulin intake), it wasn’t until a health care professional blatantly stated that I was unwell and diagnosed me with an eating disorder that I fully accepted that something was wrong. Eating disorders happened to other people, no? Apparently not.

From that initial assessment, I’ve ping-ponged between multiple mental health teams throughout the years. Perhaps understandably, the teams would triage my various ailments and tackle them in accordance to greatest threat to life. The low weight, depressive thought patterns and self harm I was displaying would be a regular topic of discussion. Somewhere along the way, my relationship with my diabetes fell by the wayside. Bearing in mind that this all took place a few years back, while studies in diabulimia were in their infancy, perhaps the specialists I encountered in my times can be forgiven for not treating my diabetic management adequately. The condition was as much a mystery to the counsellor as it was to the patient.

Hope for the future

It would appear that, slowly but surely, more research is being undertaken to better understand ‘diabulimia’ and the effect it can have. When I was first diagnosed with an eating disorder, my diabetes was viewed more as an additional entry in my health log, rather than potentially the foundation from which the roots of my mental health flourished. Whilst still in its relative infancy, it would appear that more research models are moving away from the simplistic notion that eating disorders only affect women, so more men are being involved with the process. The lack of male representation when I was severely unwell furthered my feelings of isolation and otherness.

Further information and support

If you or someone you care about has type 1 diabetes and are struggling with an eating disorder you can find more information and links to resources on our Type 1 diabetes and eating disorders page. You are not alone. Also, you can visit the links below for information and support:

Diabetics with eating disorders Facebook group
Diabetics with eating disorders
Diabetes UK Helpline
Supporting someone with diabulimia