#: 631206 S8/Complications  [DIABETES]
    25-Aug-96  13:26:00
Sb: #ANOREXIA & DIABETES
Fm: Jeffrey Schevitz 100637,1515
To: all

I recently met a German woman between 35-40 who has been a diabetic for 15
years and anorexic for 10. She is using a pump. She has had psychological
help for several years but says she is not seeing any more progress for about
half a year. I would like to help. I promised I would ask if anyone knows of
research or experience on the connection between these two illnesses.  I
suspect that the fear of complications of diabetes leads to an exaggerated
attempt to not raise blood sugar by absolute limitation of carbohydrates.
  Who can help? 

There are 2 Replies.

#: 631328 S8/Complications  [DIABETES]
    26-Aug-96  00:11:17
Sb: #631206-#ANOREXIA & DIABETES
Fm: Len Strazewski 73710,2552
To: Jeffrey Schevitz 100637,1515

I can't help, just offer a horror story. A close friend and professional
colleague was both insulin-dependent and diabetic. When I met him about 10
years year ago he was a robust young man of 21, about 6'3" and 190 pounds.
About five eyars later he was diagnosed as diabetic but has already been
anorxic for a few years. His weight was about 130 and he was very thin but
seemed okay physically otherwise. About two years ago he relocated and I hd
not seen him face to face for a while...but was discovered in a diabetic
coma. Too much insulin for his diet.

He suffered some brain damage and his short term memory and someof his skills
(he was an artist) eroded.  A month ago, he was found dead in his department
by friends. Cause was heart failure due to complications of both diseases. A
friend who saw the body said he was a walking skeleton. he was 31.

len

There is 1 Reply.

#: 631426 S8/Complications  [DIABETES]
    26-Aug-96  07:50:33
Sb: #631328-ANOREXIA & DIABETES
Fm: Dave Groves Wizop 76703,4223
To: Len Strazewski 73710,2552

Len,
   I believe that diabetics represent the ONLY group of MEN in which anorexia
has ever been considered a potential problem.

#: 632278 S8/Complications  [DIABETES]
    29-Aug-96  01:03:27
Sb: #631426-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: Dave Groves Wizop 76703,4223

Dave,

John Lennon developed anorexia after being called "the fat Beatle".  Athletic
men may also develop anorexia if they feel under pressure to match a
particular weight ideal for which their bodies aren't suited.  Any male in a
profession where there are particular weight "classes", including performers,
flight attendents, etc are also at risk for developing eating disorders,
including anorexia, when their jobs are in jeopardy due to pressures from
superiors and co-workers to "fit-in".

The problem is that men typically are reluctant to come forward and admit
that they have a problem with an eating disorder.  Eating disorders are still
considered a "woman's problem" and men who have them are laughed at.  ATM,
those who treat eating disorders and who are aware of the reality of male
anorexics, bulimics, and compulsive overeaters are comparing the eating
disordered male to the alcoholic female of 20 years ago:  in the closet and
afraid to come out.  As with alcoholic women in the past, there are not the
support and therapy services for eating disordered males.  In fact, many
eating disorder therapists interpret the development of eating disorders
through feminist theory, where a woman develops an eating disorder in
response to society's emphasis on her physical appearance.  While this
explains John Lennon's anorexia, it certainly doesn't explain the vast
majority of eating disorders in men. <sigh>

Currently, 90% of all those in therapy for eating disorders are female, 10%
are male.  One report I read said that as it becomes more acceptable for men
to admit to having an eating disorder, these ratios will change, probably
about 60% female and 40% male.  This is closer to the ratio of men to women
who are in therapy for alcoholism (about 60% male and 40% female).

Angela

#: 632354 S8/Complications  [DIABETES]
    29-Aug-96  02:51:03
Sb: #632278-ANOREXIA & DIABETES
Fm: Dave Groves Wizop 76703,4223
To: Angela Chiffy-SYSOP 73513,2026 (X)

Thanks, Angela.  Certainly all the mis and dis information about food for
Type I diabetics and the fact that without it we can skip insulin sometimes
and the availability of ketosis as a bulimic factor are part of the problem.
The "eating is bad for diabetes" concept remains all to clear and I will bet
that the more "conscientious" and "compliant" a diabetic has been, the more
likely s/he is to develop severe eating disorders.  I am far to skinny for my
health or comfort and know it, but I still do not eat as much, often or
regularly as I would like to.  I do recall that the study of kids with
diabetes being 80% likely to suffer psychiatric diagnosis included a note
that whatever the proper psych terms are for it, their body images did NOT
match their real bodies.

#: 633522 S8/Complications  [DIABETES]
    01-Sep-96  13:14:09
Sb: #632354-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: Dave Groves Wizop 76703,4223 (X)

Dave,

>>  The "eating is bad for diabetes" concept remains all to clear and I will
bet that the more "conscientious" and "compliant" a diabetic has been, the
more likely s/he is to develop severe eating disorders.  <<

Not just that, but also parents attitudes contribute greatly to the
development of eating disorders.  Parents who INSIST on their child having
"perfect" blood sugars, restricting eating so the child won't gain weight or
forcing more food down the child's throat because the dr or nurse educator
says that this is the amount of food the child is "supposed" to eat (outside
of an insulin reaction, of course) are more likely to lead their kids down
the path to disordered eating. <sigh>  Then, don't forget the pressures on
young women to be extremely thin, especially in this day and age of Kate
Moss.  We both know insulin is a potent weight gaining horomone.  Imagine a
diabetic female who is under pressure from family and/or friends to be thin
while maintaining good control of her diabetes.  When she is in good control,
she finally gains a few pounds.  If she's anorexic or has anorexic leanings,
this is a nightmare for her because of the weight gain.  If she's not in good
control (and therefore, not gaining any weight), she's getting lectures from
her parents and her dr to control her dm better. <sigh>  It's a terrible
double bind she's in.

>>  I am far to skinny for my health or comfort and know it, but I still do
not eat as much, often or regularly as I would like to.  <<

It's important that at least you recognize you are WAY too skinny. <hugs>
Anorexics in the middle of their disease are unable to see themselves as
skinny and will frequently tell people how much they hate to see the "rolls"
of "fat" on themselves.  I can imagine that some of your not eating as much
or as regularly as you would like or should stems from all the years after
your diagnosis where you were told that to eat such-and-such food would make
you blind and you were called "bad" for being "non-compliant".  This is very
much like what happens with some chubby kids.  I know, because it happened to
me.  I had the distinct displeasure of watching my half-sister Sara go
through the same thing last time I visited my father.  Anytime I took a bite
more than what my parents thought I should have, I was ridiculed, made to
feel guilty, made to feel as if I had done something truly terrible.  It's
not easy to overcome that long-instilled feelings of guilt. <hugs>

>>  I do recall that the study of kids with diabetes being 80% likely to
suffer psychiatric diagnosis included a note that whatever the proper psych
terms are for it, their body images did NOT match their real bodies.  <<

There's body dysmorphic disorder, but in general, that does not occur in
people who have eating disorders.  Basically, body dysmorphic disorder is
where you focus on one part of your body that you don't like.  Let's say you
think you have buck teeth.  Whether you do or not isn't important, but the
fact that you think you have buck teeth and you think that they make you ugly
is the essence of body dysmorphic disorder.  In contrast, most people with
eating disorders who have problems with body image see their WHOLE body as
terrible.  It's not just an anorexic's thighs which are fat, but her whole
body seems dripping with layer upon layer of fat.  It's called body image
distortion, and most anorexics will continue to have problems with this for
the rest of their lives.  FWIW, a study I found (Steel, Lloyd, Young, and
MacIntyre, 1990) showed that after 1 year with type I diabetes, there is a
significant change in body image which may predispose these diabetics to
eating disorders in most of the patients.  However, this is not unusual for
our culture. <sigh>  Most American women typically overestimate their body
size and think that the size body which men prefer is one to two sizes
smaller than their current body size. <sigh>

Angela

#: 631405 S8/Complications  [DIABETES]
    26-Aug-96  06:59:46
Sb: #631206-ANOREXIA & DIABETES
Fm: Bruce Beale 100345,3667
To: Jeffrey Schevitz 100637,1515

Jeffrey,

 It is a terrible problem with Type 1 adolescent girls. Insulin is the
perfect drug for the anorexic.


#: 632279 S8/Complications  [DIABETES]
    29-Aug-96  01:03:32
Sb: #631405-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: Bruce Beale 100345,3667

Bruce,

If you haven't seen the DSM-IV, the American Psychiatric Association has
decided to include insulin manipulation among its eating disorders.  It's an
Eating Disorder, NOS.  Specifically, they classified insulin manipulation as
a sub-type of bulimia rather than anorexia.

Angela

#: 632381 S8/Complications  [DIABETES]
    29-Aug-96  05:48:05
Sb: #632279-ANOREXIA & DIABETES
Fm: Bruce Beale 100345,3667
To: Angela Chiffy-SYSOP 73513,2026 (X)

Angela,

 It has not been classified in this country but it is associated with both
conditions.

#: 633523 S8/Complications  [DIABETES]
    01-Sep-96  13:14:12
Sb: #632381-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: Bruce Beale 100345,3667 (X)

Bruce,

True. <sigh>  Eating disorders are dangerous enough without adding diabetes
into the mix.

Angela

#: 632090 S8/Complications  [DIABETES]
    28-Aug-96  10:38:12
Sb: #631206-ANOREXIA & DIABETES
Fm: A. Agnew 103612,2247
To: Jeffrey Schevitz 100637,1515

Jeffrey,

I am not a doctor or a psychologist.  I am a diabetic and I am an anorexic.
There are some things which she may or may not feel are helpful.

First of all, anorexia is dealt with (by and large) in the medical community
as a failure on the part of the patient.  Threats of hospitalization, etc.
are common.  This is NOT what an anorexic patient needs. They aren't doing
this to be perverse.  They're doing it because they can't help it.

Another thing I have discovered over the years (and I am at normal weight) is
that it doesn't matter whether I eat one meal every 3 or 4 days or 3 meals a
day.  I am anorexic.  It's like alcoholism.  An alcoholic who isn't drinking
is STILL an alcoholic.  It's not whether I am eating or not it's how I FEEL
about eating and my body image that defines my anorexia.

She needs to feel that she is an ok and worthwhile person.  She needs to have
some control over areas of her life not related to her physique and health. 
How people go about this must of necessity be a very individual thing.

Diabetes poses various problems.  One is "hidden anorexia" where weight loss
is very minimal due to the use of insulin.  Cessation of insulin to induce
ketones is another problem and is now specifically categorized as a  purging
method.  For a pump user, diabetes control can become damn near perfect
because if the basal rates are correct and there's no bolusing and meals then
stability becomes easier.  Anorexia is VERY dangerous with diabetes.  I know
of one young lady (she was patient 0 in the diabetes and eating disorder
studies) who was unconcious after a hypoglycemia episode for 3 days and is
now brain damaged.  She has been battling severe anorexia for a number of
years.

Lastly, it's not really just one thing that leads to anorexia.  It's a
combination of diabetes control issues, self image issues, food becoming
something other than something to be enjoyed, and the mixed messages we get
from family, friends, doctors, and the media.

Ariel


#: 632321 S8/Complications  [DIABETES]
    29-Aug-96  01:55:32
Sb: #632090-ANOREXIA & DIABETES
Fm: Dave Groves Wizop 76703,4223
To: A. Agnew 103612,2247

Amen, Ariel.


#: 633543 S8/Complications  [DIABETES]
    01-Sep-96  13:16:02
Sb: #632090-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: A. Agnew 103612,2247

Ariel,

>>  Anorexia is VERY dangerous with diabetes.  I know of one young lady (she
was patient 0 in the diabetes and eating disorder studies) who was unconcious
after a hypoglycemia episode for 3 days and is now brain damaged. She has
been battling severe anorexia for a number of years.  <<

I happened to pick up a new book at the library from (amazingly enough) the
ADA.  It's written by Richard Rubin, Ph.D. and Betty Page Brackenridge and
called, "Sweet Kids:  How to Balance Diabetes Control & Good Nutrition with
Family Peace".  There's a chapter devoted to eating disorders and diabetes.
They state that people who have bulimia "usually have chronically high blood
sugars, and they may end up in the emergency room with ketoacidosis due to
omitting insulin." (p. 188)  Diabetics with anorexia or even subclinical
anorexia have the opposite problem.  Like patient 0, they "usually have low
blood sugar levels most of the time, and they may even need to be
hospitalized for recurrent and severe bouts of hypoglycemia.  There is
evidence that people with eating disorders tend to have problems with
virtually all parts of the diabetes regimen:  blood sugar testing, taking
insulin on schedule, following a meal plan, maintaining adequate blood sugar
control, fitting exercise into their treatment and so on." (p. 189)

They also describe a young woman with dm and anorexia who was so afraid of
gaining weight and developing complications that she refused to eat more than
1100 calories/day, her meter readings were around 60 mg/dl and for 2 years,
had A1c's below the lower limit of normal. <sigh>  Her fears so consumed her
that she couldn't ease up on herself. <sigh>

As for treatment, have you ever read the book "French Toast for Breakfast" by
Mary Anne Cohen?  She's a recovering bulimic and is a professional
psychotherapist who specializes in eating disorders.  In the opening of that
book, she describes a colleague's method of "helping" people overcome their
urge to binge.  He places the patients in a hypnotic trance and then tells
them to imagine their favorite binge food as it's going in their mouths. Then
he tells them that there are worms in the food and if the worms get in their
stomachs, they will be ripped to pieces by the worms.  Now tell me, is that
REALLY therapy?!?!  Yeah, right!

Angela

#: 633898 S8/Complications  [DIABETES]
    02-Sep-96  10:42:59
Sb: #633543-ANOREXIA & DIABETES
Fm: A. Agnew 103612,2247
To: Angela Chiffy-SYSOP 73513,2026 (X)

Angela,

>>so afraid of gaining weight and developing complications that she refused
to eat more than 1100 calories/day<<

Hell I don't eat that much NOW.  When I was anorexic I never went over 900
cals a day and for a time not over 500.

It's amazing to me what some people consider to be therapeutic.  <shudder>

Ariel


#: 635933 S8/Complications  [DIABETES]
    08-Sep-96  22:10:22
Sb: #633898-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: A. Agnew 103612,2247

Ariel,

When I was first dx'ed, I was sent to a dietitian who designed a 1500 cal/day
diet with only 20% fat for me to eat.  On it, I lost weight.  And more
weight.  And more weight until I stepped on the scales and was down to 88
lbs.  At 4'9", you would think I would have not been able to weigh 88 lbs
while eating a 1500 cal/day diet.  My dr told me I could "stop losing weight"
at 106 lbs (as if saying "stop losing weight" is going to make weight loss
stop <weak grin>) and was amazed that I hadn't stopped losing weight.  He
threw an 1800 cal/day meal plan from Lilly at me with 30% fat and said if
that didn't work, I could increase my daily caloric intake to 2000 or 2200
cals/day.  I gained about 5 lbs on 1800 cals/day, much less than he'd
expected.  However, the only reason I gained that weight is because Lee
became um, very persuasive about my snacks.  She really made me re-work my
snacks.

During this past February where I was having so many problems, there were
days where I figure my caloric intake didn't exceed 450 cals.  Maybe close to
400, but nowhere near 500.  I've found that when I'm angry or very depressed,
I don't want to eat and won't.  I "know" I should eat, but...<sigh>

It is amazing what some consider to be "therapeutic".

Angela


#: 636030 S8/Complications  [DIABETES]
    09-Sep-96  10:34:19
Sb: #635933-#ANOREXIA & DIABETES
Fm: A. Agnew 103612,2247
To: Angela Chiffy-SYSOP 73513,2026 (X)

Angela,

They tried to put me on 2000 cals when I was pregnant.  I said "trust me you
don't want to do that" but they made me try it.  The next check up they
changed it to 1500.  <g>

I probably fried my metabolism with the "dieting" somewhere along the way.
Now I'm stuck with it.  <g>

Ariel

There is 1 Reply.

#: 636252 S8/Complications  [DIABETES]
    10-Sep-96  00:52:43
Sb: #636030-#ANOREXIA & DIABETES
Fm: Dave Groves Wizop 76703,4223
To: A. Agnew 103612,2247 (X)

Nah, you'd still be the envy of most of the girls at Sammy's girl.

There is 1 Reply.

#: 636373 S8/Complications  [DIABETES]
    10-Sep-96  13:51:40
Sb: #636252-#ANOREXIA & DIABETES
Fm: A. Agnew 103612,2247
To: Dave Groves Wizop 76703,4223 (X)

<major blush>  Thank you.

#: 637500 S8/Complications  [DIABETES]
    14-Sep-96  01:40:15
Sb: #636030-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: A. Agnew 103612,2247

Ariel,

During the first few months after my dr put me on 1800 cals/day, I was almost
always feeling stuffed, uncomfortable, and just didn't eat that much.  I
really didn't feel like I had much right to complain, though, since I had
told my dr that I was tired of losing weight and being hungry all the time.
Increasing my caloric intake was his primary solution.  I kind of doubt he
thought before hand that I just might have a hard time eating all that food.

Oh well. <s>  Between the dieting and the dm, I'm sure something did change
your metabolism. <s>

Angela


#: 637592 S8/Complications  [DIABETES]
    14-Sep-96  10:13:13
Sb: #637500-ANOREXIA & DIABETES
Fm: J. Garcia DDS-SYSOP 104125,502
To: Angela Chiffy-SYSOP 73513,2026 (X)

This was on the Medscape news this AM .

Joe

  Eating disorders have become so common that they should be
  considered in the differential diagnosis of all young women
  presenting with weight loss and/or new medical problems. In up
  to 15% of the cases, a missed diagnosis or inadequate treatment
  can result in death.



#: 638486 S8/Complications  [DIABETES]
    16-Sep-96  21:17:07
Sb: #637592-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: J. Garcia DDS-SYSOP 104125,502

Joe,

Thank you for this update.  I'm not sure I entirely agree with this
assesment, though.

>>    Eating disorders have become so common that they should be
      considered in the differential diagnosis of all young women
      presenting with weight loss and/or new medical problems.  <<

All young women?  What about women under the care of a doctor who has
encouraged a weight loss program due to severe obesity?  What about young
women who haven't been dx'ed with diabetes and are losing weight due to the
diabetes?  Diabetes most certainly is not an eating disorder, though
pressures from society and some medical professionals may bring out eating
disorders at a later time.  It's unfair to classify all young women who lose
weight as having an eating disorder.

Angela
 
#: 638532 S8/Complications  [DIABETES]
    16-Sep-96  22:29:05
Sb: #638487-ANOREXIA & DIABETES
Fm: Paula D.-SYSOP 73021,567
To: Angela Chiffy-SYSOP 73513,2026 (X)

Dear Angela,

    It's awful the way some things stay in our memories and keep coming back
to mind, like the comment made to you this summer.  The world will be a much
nicer place when people stop commenting on other people's bodies and
disparaging folks with mean-spirited remarks about body size -- large or
small.   Defining others or ourselves by outward appearance is such an
unhelpful and foolish way of seeing people.

    Here's hoping that whoever called you "fat" figures that out someday soon
and comes to see you as you really are -- a slim woman who would be as lovely
larger or smaller!

                                                                  Paula

     
#: 640415 S8/Complications  [DIABETES]
    21-Sep-96  00:03:20
Sb: #638532-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: Paula D.-SYSOP 73021,567

Paula,

I probably would have told this person to go take a flying leap if I also
didn't see myself as still heavy.  I was heavy for years, and I still see
myself that way.  When others say I'm still heavy, well, it reinforces the
perception I have of myself. <sigh>

I doubt the two people who called me fat this past summer (and who basically
said I was "in denial" for trying to walk away from them) will probably not
change their minds. <sigh>

Angela

#: 638667 S8/Complications  [DIABETES]
    17-Sep-96  09:33:39
Sb: #638487-ANOREXIA & DIABETES
Fm: A. Agnew 103612,2247
To: Angela Chiffy-SYSOP 73513,2026 (X)

Angela,

Yes but if I lost 5 pounds I'd STILL want to lose 5 pounds.  Do you feel that
way about 10 or 15?  I've lost 2 pounds in the past 2 weeks because I'm
having to take decongestants (may as well be amphetamines).  But I still
wanna lose 5 pounds. <g>

Ariel


#: 640416 S8/Complications  [DIABETES]
    21-Sep-96  00:03:25
Sb: #638667-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: A. Agnew 103612,2247

Ariel,

>>  Yes but if I lost 5 pounds I'd STILL want to lose 5 pounds.  Do you feel
that way about 10 or 15?  <<

Yup.  When I was originally dx'ed with dm, my dr had jokingly said, "What are
you going to do, stay at 88 lbs for the rest of your life?"  At the time, I
didn't think I could even get to 105 lbs, yet here I am, about 92 lbs.  And I
want to lose more.  I think, "82 lbs would be better.  I ought to lose 10
more pounds by my birthday".  I'd still want to lose more weight even after
82 lbs, because something tells me that once I got to that weight, I'd still
feel fat and I'd still see myself as fat.

I know this, though:  my dr would yell at me if I dropped that much weight.
Oh well.

Angela


#: 641690 S8/Complications  [DIABETES]
    23-Sep-96  09:58:20
Sb: #640416-#ANOREXIA & DIABETES
Fm: A. Agnew 103612,2247
To: Angela Chiffy-SYSOP 73513,2026 (X)

I don't know what goes on in our heads sometimes.  When I lose 5 lbs. I don't
look at the scale and go "cool!! you look terrific!!"  I stand there and
think that if I was able to lose 5 then surely I can lose 5 more and THEN
I'll look terrific.  But when 5 more goes the pattern is repeated.  I KNOW
it's twisted thinking even when I'm engaging in it.  But I can't seem to stop
it.  I was able to stop weighing myself though which has helped tremendously.
I get on the scale maybe once a week or once every 2 weeks.  I used to get on
the scale 3 or 4 times a day.  Sheesh.

There is 1 Reply.

#: 641764 S8/Complications  [DIABETES]
    23-Sep-96  13:30:23
Sb: #641690-#ANOREXIA & DIABETES
Fm: Mark Wilden (Type I) 76516,2402
To: A. Agnew 103612,2247 (X)

>>  I stand there and think that if I was able to lose 5 then surely I can
lose 5 more <<

I know exactly what you mean.  But in my case, it's a good feeling, and
encourages me to keep on trying to get more healthy (and, I admit, better
looking).  I'd love to go under 200 lbs!!

Of course, this is a different situation from that of many, many women who
are trying to attain a social (and sexist) ideal, rather than working on
their health.  They are victims.

There is 1 Reply.

#: 642198 S8/Complications  [DIABETES]
    24-Sep-96  09:41:50
Sb: #641764-ANOREXIA & DIABETES
Fm: A. Agnew 103612,2247
To: Mark Wilden (Type I) 76516,2402 (X)

Mark,

I can see that it might be a healthy attitude for someone who needs to lose a
few pounds but even then it can get very destructive.  If that attitude
doesn't change at some point (the non-positive one, I mean) then you end up
eventually looking like a concentration camp victim.

I think the worst I ever was was 103 pounds my first year of college.  I had
a 23 1/2" waist.  I wish I had it back.  <g>  But the fact is I'm now pulling
30 on a trailer hitch, I've had a child, and I would look like death at that
weight.  Ah well.


#: 648033 S8/Complications  [DIABETES]
    07-Oct-96  11:52:09
Sb: ANOREXIA & DIABETES
Fm: Angela J. Chiffy 73513,2026
To: Mark Wilden (Type I) 76516,2402 (X)

[Reply to message #641764, which is no longer available]

Except Ariel has been battling anorexia for years in addition to type I dm.
It's not a good thing for Ariel to stand on the scale and continue to think,
"I need to lose 5 lbs more" after she's already lost 5 lbs yet was
underweight at the start.


#: 648063 S8/Complications  [DIABETES]
    07-Oct-96  11:53:35
Sb: ANOREXIA & DIABETES
Fm: Angela J. Chiffy 73513,2026
To: A. Agnew 103612,2247

[Reply to message #641690, which is no longer available]

I know exactly what goes on in my head.  All while I was growing up I was
told I was fat and ugly (well, all that I can remember).  I still see myself
the same way in spite of the fact that I was able to fit into a pair of
relaxed fit size 1 Lee jeans this week when my brother, sister-in-law, my
s-i-l's mother and aunt, and I went shopping at the Lee outlet in Reading,
PA.  I still see myself that way in spite of the fact that my scales have
read 88-90 lbs.  What can I say?  After nearly 20 years (from about the age
of 10) of being told you're fat and ugly, you don't know any other way to see
yourself.


#: 633521 S8/Complications  [DIABETES]
    01-Sep-96  13:13:49
Sb: #631206-ANOREXIA & DIABETES
Fm: Angela Chiffy-SYSOP 73513,2026
To: Jeffrey Schevitz 100637,1515

Jeff,

Welcome to the forum.  I hope you've found some of the suggestions made by
Dave, Ariel, and others helpful.  They are all pretty much on-target!

>>  She has had psychological help for several years but says she is not
seeing any more progress for about half a year.  <<

Hmm, your friend hasn't seen any progress in 6 months?  While I know I may
get "slammed" for this, I feel I must ask:  Has your friend _talked_ to her
therapist about her feelings?  The sad fact of the matter is that many eating
disordered patients have very low self-esteem and have a difficult time
asking others for help filling their needs and wants.  Sadly, diabetes
compounds this problem. <sigh>  If she hasn't discussed her lack of progress
with her therapist, I would strongly urge her to do so.  If she has, I hope
the therapist is willing to work with her to change the course of therapy to
encourage continual progress.  If not, then I would suggest finding another
therapist who is more willing to find new directions to take her therapy.

>>  I promised I would ask if anyone knows of research or experience on the
connection between these two illnesses.  <<

A study by Steel, Lloyd, Young, and MacIntyre (1990) all at the Royal
Infirmary in Edinburgh, Scotland was done to investigate how eating attitudes
change in the first year after a type I diabetes diagnosis had been made.
They found that after only 1 year, there were significant changes in people's
body image which may predispose them to developing an eating disorder later
on. <sigh>

>>  I suspect that the fear of complications of diabetes leads to an
exaggerated attempt to not raise blood sugar by absolute limitation of
carbohydrates.  <<

While this may play a role, I don't think it's the be-all and end-all.  In
non-diabetics, feminists suspect anorexia develops as a result of society's
pressures on young women to be bone-thin like super model Kate Moss.  Insulin
is a potent weight-gaining horomone, and in young women susceptible to
developing anorexia, even the potential of gaining weight through insulin use
may lead to irrational fears and an eating disorder.  In a new book from (of
all people) the American Diabetes Association, Richard Rubin, Ph.D. and Betty
Brackenridge report on a young diabetic woman with anorexia.  She reduced her
daily caloric intake to 1,100 kCals/day.  She tested frequently, and
virtually all of her blood sugars were reportedly around 60 mg/dL (about 3.3
mmol/L).  For 2 years, her A1c's were BELOW the lower limit for normal.
Naturally, she had a lot of insulin reactions, and needed emergency personnel
more than once to treat severe hypoglycemia brought on by her eating
disorder. <sigh>  Why did she do this?  Because she feared gaining weight.
<sigh>

I know for me, it's not fear of complications which prevents me from eating
at times.  It's a fear of being fat.  It's looking in the mirror and not
seeing the 92 lb body the scales say I have, but seeing a 134 lb body I used
to have.  It's feeling fat, even when others are telling me I'm not.

But it's even more than that.  This past February, I went through a very
difficult time.  I had major problems with my employer and I had frequent,
sometimes verbally violent, fights with my family.  On one particular
afternoon, I had spent over 1 hour with the managing director, the personnel
director and the personnel coordinator of my company.  The entire time was
devoted to yelling at me, telling me what a horrible person I was.  I sat
there and took the verbal abuse.  When I left, I had to walk back downtown
(about 1/2 mile away) when it began to rain -- freezing rain.  Overall, it
was a very depressing situation, but instead of becoming upset, I swallowed
all those negative feelings down.  After placing a couple of phone calls from
the state library, I walked to a shopping center near by.  I hadn't eaten in
about 4-5 hours, and with all that walking, I should have been hungry, but
when I smelled that food, my stomach clamped up and I couldn't eat.  I sipped
a little herbal tea, place another phone call, threw the rest of the tea out,
and proceeded home on the bus.  When I got home, I curled up on the couch,
still refusing to eat, and fell asleep.  I slept for about 4 hours, and
refused to eat until sometime around 11:00 PM when some friends of mine
finally insisted I eat.

Why did I do that?  I'm a reasonably intelligent person.  I have a bachelor's
and a master's in psychology.  You'd think of all people, I'd KNOW better!
Now that I've had some time to think about it, I can see how my behaviors,
irrational though they may be, were an attempt to control a situation which
was out of my control.  In a way, you could say my employer had forced her
negative evaluations of my conduct "down my throat" (sort of the same way
some drs force the word "non-compliant" down many diabetics' throats?).  My
not eating could be seen as a protest, a way to say to the world, "You can't
shove your garbage down my throat!  Only I control what goes in me, not you!"
Since I couldn't "spit back" the nasty comments which were being made to me,
I would simply refuse to take anything in.  Naturally, it's not logical, but
who said eating disorders were logical? <weak grin>

In that context, self-starvation is about control.  But it's _still_ more
than that.  The major bone of contention between me and my employer had to do
with my diabetes and its management on-the-job.  At one point during the hour
rant, my employer asked me if I had anything to say.  I blurted out (almost
in tears) that I felt the company would rather I pretended I didn't have
diabetes.  That statement led to another round of angry words directed at me
by the director.  I had made their lives miserable by having diabetes, and
having diabetes made my life miserable.  I was "obviously" a "bad" person for
having caused all this trouble.  So, my three Tuesdays in February where I
starved myself became my punishment for having diabetes.

My hope is that your friend will find a good therapist who can help her or
that she can find the strength within to talk with her current therapist to
overcome her current impass.

My hopes and prayers are with you both. <hugs>

Angela


#: 644979 S8/Complications  [DIABETES]
    29-Sep-96  17:11:46
Sb: #ANOREXIA & DIABETES
Fm: Cynthia MacIntosh 76152,1426
To: Mark Wilden (Type I) 76516,2402 (X)

Hi Mark,

    >>>>>I'd love to go under 200 lbs!!<<<<<

  Does this make any sence to you....... I was 180 when we went on summer
vacation & during that time I did a lot of walking<with cane>
instead of a tram for disabled. I get home after 2 vacations & go to
doctor & find I am back up to 200 lbs?!! I was told muscle weighs more
than fat??????????????? only problem is my medium sized belly is
much larger!!!!! I was even doing crunches & situps while Mac was
driving down the road in our RV!!!!! I have been trying so hard to
get rid of *Mac's pillow* that now I am very ticked off & don't know
how to get rid of it.... neurologist has said .. NO more situps! cause
my back has started with a different pain.  So what do I do?????"

Keep smiling....

Cindy  ;>)  < trying to help others & trying to keep smiling>

There is 1 Reply.

#: 645122 S8/Complications  [DIABETES]
    29-Sep-96  20:08:17
Sb: #644979-#ANOREXIA & DIABETES
Fm: Mark Wilden (Type I) 76516,2402
To: Cynthia MacIntosh 76152,1426 (X)

Yup, muscle weighs more than fat.  However, if you're exercising aerobically
(rather than doing things like weight training), you'll be losing fat faster
than you gain muscle, so you should still lose weight.  But the true measure
is not what you see on the scale, it's what you see in the mirror. :)

Walking isn't necessarily that beneficial for losing weight.  To do that, I
have to reach an aerobic threshold, where I'm puffing and sweating a little
bit.  Walking alone isn't bad, of course, but it's not going to lose you much
weight.

Yes, I don't believe in situps.  It's too hard on your back.  But crunches
are fine.  Understand, though, that crunches don't really burn fat--they just
improve the muscles underneath the fat.  So if the fat's still there, you
won't get much improvement in your looks.  On the other hand, I found that a
toned (though still overweight) midsection helped my appearance somewhat,
since I was better at sucking in. :)

As for your unexplained gain, there are so many factors, not least of which
is diet.  In my case, going on a very low-fat diet, coupled with daily
exercise, gave me the best progress.

The stomach is a very difficult area, isn't it?  I'm practically down to my
college weight, but I _still_ have a bit of a tum on me.  That's age and
metabolic changes for you, I guess.

I have a test:  when I'm taking a shower and I look down, do I see, errr,
well, my genitals?  (I have a shorter name for this test).  When I started my
regimen, I failed this test.  Now, I pass with flying colors. :)

There is 1 Reply.

#: 646602 S8/Complications  [DIABETES]
    03-Oct-96  17:50:53
Sb: #645122-#ANOREXIA & DIABETES
Fm: Cynthia MacIntosh 76152,1426
To: Mark Wilden (Type I) 76516,2402 (X)

Hi Mark,

  >>>>>if you're exercising aerobically (rather than doing things like weight
training)<<<<<

Sorry, can't do either, not with my bad back. As a matter of fact my
neurologist has told me to stop the sit-ups! I was doing crunches too
but right now I don't think I could even do those!

  >>>>>When I started my regimen, I failed this test.  Now, I pass with
flying colors.<<<<<

Well, ummm, I ah would be happy just to see my feet!! <grin>

Cindy  ;>)  < trying to help others & trying to keep smiling>

There is 1 Reply.

#: 646673 S8/Complications  [DIABETES]
    03-Oct-96  20:52:42
Sb: #646602-ANOREXIA & DIABETES
Fm: Mark Wilden 76516,2402
To: Cynthia MacIntosh 76152,1426 (X)

It's not out of the questions that those situps injured your back.  I hate
'em!

When I was in high school, we had to do one of those fitness tests:  how many
situps we could do in a minute.  My score:  0.  My partner held my feet, and
I just laid back and relaxed. :)