Monday, April 07, 2008

Intuitive Eating with Restrictions

Editor's note: I received this message last week from a reader I'll call Karen. I responded to her directly but would appreciate my readers' input. Please comment if you have any suggestions or recommendations for Karen.

Hi, Dr. Stacey - I was introduced to your blog through a link on Disordered Times. I love the blog for a lot of reasons - but one of them is just knowing that I'm not alone in my struggles with eating and how I feel about it and even how to do it.

I'd be very interested on your opinion, if you ever have cause to give it, on how folks like me, who have a medical condition that requires an "abnormal" relationship with food, can work to be at peace.

I'm currently really ambivalent about calorie restriction, food logging, dieting in any way - the fatosphere has given me the confidence to say, hey, why should this take up so much of my time and energy, but the social reality of having lost some weight, and the impact of years of negative thinking about my body and all of that argue against giving up the diet I'm currently on. (I'm not supposed to call it a diet - but I think anytime you're restricting or changing your food intake based on some external, artificial measurement, it's a diet, and call a spade a spade!)

But, even if I do manage to kick the diet habit - I still have to write down and be conscious of every goldanged thing I put in my mouth, because I have Type 1 diabetes, and I have to play my own pancreas here, and if I don't know how many carbohydrates something has in it, I can't take my insulin appropriately, and my blood sugar will be screwed up. (It gets screwed up enough even when I do know, or think I know!)

I think for me, it might never be possible to have a comfortable relationship with food for that reason. I know a lot of us feel the same. I'm currently looking for ways to make my peace with that and to find a healthy way to be a food logger and carb counter (if not carb-restrictor). But I wonder - is it even possible? And, if it isn't, if disordered eating is always going to be a part of our lives, why isn't it part of a standard treatment plan for diabetics? I meet with a nutritionist - a very weight-nonjudgmental one, I must say - but no one ever talked to me about how this could affect my life and my psyche. I engaged in "diabulimia" off and on for years and years - I still battle it often - to control my weight and never knew I wasn't the only one until just recently. I'd love for there to be some kind of plan for diabetics to work with therapists or social workers on the impact of how their relationship with food and eating will be impacted.

Sorry this is a bit rambling. Just wanted to say thanks for the blog, and mention something that might be of interest on a slow blog day. :)


azusmom said...

Hi Dr. Stacey!
There's an online group for Intuitive Eating on Yahoo. I would encourage her to go on and read the messages, or even post her question there. There are wonderful folks there, and many of them have dietary issues, including Diabetes. It's free, there are no product tie-ins, and she doesn't have to buy anything. I've been using these boards for over a year, and find them very helpful.

Meowser said...

I don't necessarily think having a medical condition that requires avoidance or limitation of certain foods constitutes an "abnormal" relationship with food. It's really just another piece of information to be considered: what can my body process and what can it not process, and in what amounts, and how do I feel (mentally and physically) after I eat it, both right afterwards and later in the day or the next day after it's gone through my system?

I know (or know of) very few people who just eat "anything and everything," even if they are staunchly anti-diet in the weight loss sense. Almost everyone has their limits on what they can take in before they make themselves ill or unable to function at their baseline. But that varies a great deal from one individual to another. A one-size-fits-all way of eating doesn't exist.

Logging is just another way for you to track that data. But you have to reclaim it as such. It's a log for your personal information only, so you can fuel yourself in the way that works best for you. It's not something you have to wave in front of anyone's face and say, "See, I'm being good."

Anonymous said...

I have always been an intuitive eater (raised in anti-diet household and refused dieting friends as a teen), and have made drastic changes in my diet--to vegetarian and then vegan for ethical reasons, getting rid of sugar and fried foods for health reasons (I no longer get menstrual cramps, and really can't consider sugar food since this realization), and gradually increased fresh fruits and veggies in my diet. So it IS possible--I had the luxury of making changes slowly over time, but basically I learned to associate a certain way of eating positively or negatively. I was ten when I started relating the bacon I loved to a living pig--over time bacon became unappealing, and not food. It's a pig! I ate sugar many times after realizing it gave me cramps, but gradually came to remember that sugar=pain, and I am not interested in that. Resisting candy (though I was a former sugar-holic) is not a battle for me. I don't want it. I didn't stop eating it until I didn't want it, so there was never deprivation or restriction. Being forced to eat it would feel like punishment.

A BIG part of intuitive eating is realizing how something will make you feel. I don't know how you can work this in exactly, but I know it can be done. People often don't believe me when I say I don't want something, but I really don't. Discipline doesn't work, using your brain does.

Fauve said...

In terms of "intuitive eating", I am working to realize that continually bingeing on huge amounts of sweets is not what it is. However, I also know that when I try to become thinner, I often start to overeat - at some point. It's not easy; excesses of either direction (too little/too much) are probably common.
However, I think the true concern here is not with intuitive eating, but rather: the "diabulimia" that Karen has. I didn't know what diabulimia was until I googled it. It appears to be a very disturbing pattern in which a diabetic is not administering enough insulin to take care of the diabetes, in order to lose weight. Like any sort of bulimia, it's truly a deal with the devil. It's a really bad "bargain" to make. It enslaves a person, even though it *seems* like a way out, at first. Getting well from the diabulimia (and working hard to not do it anymore) is the Most important issue for Karen. I think it's vital for her to realize what her true struggle involves. It isn't about eating, per se, but rather: the diabulimia. Women often decide to kill themselves (over time, with eds) to not get heavy. I empathize with the deep fears that drive them to self-destruct, but it's really tragic. In doing yourself in, how can your true intuition be evoked for guidance with your eating? After all, intuition is Not just inside your head but is also grounded in your body. If you are destroying your body, you are also ruining your intuitive connection to it. You must work to stop hurting yourself with the diabulimia first.

Anonymous said...

Wooowww..I've recently stumbled on to a bit of Anorexia, myself and just found out my 4 year old Daughter is Type1 Diabetic.

Kinda hittin' close to home, didn't want her growing up heavy like I was but certainly didn't want her developing E.D.'s, getting harder and harder everyday. Just trying 2 manage her Diabetes which had us completely shocked.

May I just say that I LOOOVE this blog?!?!?!

JoLaine said...

I am a Wellness Life Coach supporting my clients in intuitive eating and I found this blog when looking for information for a new client with diabetes. This is very helpful and I thank you for your work. Though I dont' have diabetes, I've thought of some of these issues. I'm a vegetarian and I don't consume caffeine which means, NO CHOCOLATE! People are usually more amazed that I don't eat chocolate than that I haven't had meat in 25 years! But it isn't a struggle for me. Caffeine doesn't agree with my body and there are plenty of wonderful treats out there that don't contain chocolate. I approach it from an abundance mentality. I have yet to feel "deprived" because I don't eat chocolate. I think the thing that makes it easy is when I decide that it is my choice - not some restriction placed on me from outside.