I don’t have a good relationship with food. I have to work harder at eating more than I do almost anything else. I know that’s true for many people with type 1 diabetes, and why wouldn’t it be?
It’s a mental calculation every time we even think about putting something containing carbs in our mouths. What’s my blood glucose now? When did I last take insulin? Do I need to correct? How many carbs does this have? Is it going to spike my levels or take a while to absorb? And after all that, you either have to stick a needle in you or fish out your pump and dose appropriately. That’s not a normal relationship by any standards.
My experience with food feels more complicated than that (if it’s possible!) Four years ago, I weighed 215lbs (almost 98kg or nearly 15.5 stone). I’d let my weight creep up and ignored what I was eating as long as I could get decent blood glucose readings. This was less than 6 months after I’d somehow run the London marathon (weighing a lot less). My reflection in the mirror finally persuaded me to do something about it and in three months I was down to 182lbs (83kg or 13 stone).
I’d always thought that losing weight was the hardest thing to do when you’re dieting, but actually maintaining any kind of progress really took it out of me and eight months later I was almost back where I started, feeling totally demoralised. And so I did nothing about it for about 12 months. Along with all the complexities that diabetes adds to eating, I started to view food as an enemy. But of course the thing many of us reach for when we feel a bit low is food (because it’s delicious) and if you’re in a position where food is your best friend and nemesis at the same time, your relationship with it becomes more complicated.
Finally, something changed – I can’t remember what it was. Another unflattering glimpse of my reflection most likely, coupled with a desire to change. I’d entered another marathon and was determined I could run faster than my exploits over two years before. I decided that actually losing a lot of weight would help me more than anything else. Not lugging extra kilos of body fat around makes a big difference. I embarked on a diet with a really strict calorie intake and a lot of exercise, and it worked! I lost 45lbs (20kg or over 3 stone) by the end of the year. It was hard work, but I actually felt good about myself for the first time in a long time. I was at my lowest weight since I’d been diagnosed over 12 years previously, my blood glucose control was good (and I was running faster than ever too).
Now came the hard part – sustaining weight loss. I’d tried once before and hadn’t managed it and I was determined to do better this time around. I decided that I was probably at too low a weight to make sustaining it sensible in the long term. I was eating around 1400 calories a day, running 20-30 miles a week plus other ad-hoc exercise. I allowed myself a bit of a rise to keep some semblance of quality of life, but focused on what I was eating (and portion size too).
And it kind of worked for quite a long time. Putting aside blips for holidays and Christmas, I managed a fairly steady weight for almost 18 months, eating pretty well, exercising regularly, and actually feeling pretty pleased (and dare I say, happy with my own body image).
Recently it fell apart again. I had a running injury that stopped me exercising as much as I used to, which in turn pushed me back towards my comforter-in-chief… food. A lot less exercise and a lot more food pushed my weight up at the start of this year to a point where I avoided the bathroom scales because I knew I’d hate the reading it gave me. That reminded me of how I was with my diabetes about six years after diagnosis… I stopped testing because I didn’t feel in control of the results and I put it all out of my mind.
I know from experience that nothing good comes from that denial. I felt (feel?) guilty about what I eat if it’s full of calories, but eating something like that gives me such a rush it’s hard to stay on track. It’s almost like an addiction in some senses, and sticking to a plan of eating healthily requires an incredible amount of willpower. Trying to convince yourself you don’t need one more hit of fat, sugar or salt takes a lot of effort.
My weight is currently back on the way down, and that feeling of control has returned (with my weight, and diabetes in general). I feel like I can only operate at extremes though – full on culinary hedonism, or the strictest diet I can imagine. Having a metabolism that seems to not need much fuel to keep the lights on doesn’t help either. But even having lost 11lbs in the last month, I still look at my reflection and think I could probably lose a couple more…
I don’t think it’s easy to interact with food when you have diabetes. I don’t know how typical my experiences are when it comes to the frustrations of balancing my intake with how I see myself. I think as a community we talk a lot about managing the highs and lows of blood glucose (and the everyday aspects of diabetes), but we talk less about how food makes us feel… Maybe it’s because most of us don’t need to. Or we don’t know how to. I might be an outlier when it comes to managing food, but I suspect I’m not.
I’ve delayed writing this blog for a long time – mostly because I wasn’t sure I had the right words to express how it affects me. That said, ‘guilt’, ‘denial’ and ‘frustration’ are words that are all too familiar when it comes to diabetes so perhaps they were there all along.