National Eating Disorders Association

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Managing type 2 diabetes and an eating disorder/recovery


I'm curious to hear from others who have managed type 2 diabetes and eating disorders. My ED presents in different ways, restrictive/avoidant on one end, and overeating/binging/eating "rebelliously" on the other. Having diabetes reeeeeally complicates recovery, as a lot of conversations around diabetes management involve talking about food and its effects on diabetes. I'm also in a fat body (that I love) and have a lot of distrust of medical professionals' advice (i.e. are they giving me this advice because of my size? would they tell someone in a thinner body but with all the same symptoms/lab results/etc. the same thing? etc.).

I did an intensive outpatient program last fall, but it was one that wasn't particularly informed about diabetes. My dietician had to do a lot of her own digging to help me properly. I'm a little worried that much of what I learned through the program has actually led to a worsening of my diabetes, which always triggers both sides of my eating disorder (first I want to restrict to help my numbers, then I want to rebel against that restriction, etc.). I'm left with no ED treatment currently, because my insurance stopped covering outpatient services at the program I was attending, and my therapist kind of convinced me to just jump and find something new, but I haven't felt equipped to doing that.

I'm exhausted and feeling super discouraged.

I’m so sorry you’re having so

I’m so sorry you’re having so many issues finding competent care! It honestly horrifies me how many dietician either don’t know about EDs or don’t know about diabetes, because they are so connected! One of the things a lot of diabetes dieticians don’t realize is that the restriction of intake is actually a leading causal factor in the development of insulin resistance, and therefore type 2 diabetes! You are absolutely to trust your judgement when they make such assumptions and base their “recommendations” on weight or size. So many are actively causing harm, as it seems you have experienced. I’m so sorry you’ve had to go through so much when you are working so incredibly hard to recover.
I would highly recommend trying to find a dietician who has experience in both diabetes care and EDs. I know they can be difficult to find. But maybe you could start by trying to find someone who operates with under an anti-diet mindset? There are so many ways to help manage blood sugar/diabetes that don’t include restriction of intake. More dietitians really need to understand that. Another idea is to question any diabetes dietician you do see whether they’d have the same recommendations for you if you were in a smaller body, or asking them what they would recommend someone else. There is so much weight stigma in that field, especially in regards to diabetes, and it is actively causing harm.
You deserve care and guidance with recommendations that will actually HELP you. I’m so sorry you haven’t been able to get that so far. One way to maybe find someone, or at least start the process, is to look for someone in the HAES (Health At Every Size) community. I know I have learned so much since getting into that community and the politics of weight stigma and marginalization, especially in the context of eating disorders. I wish we could make specific recommendations for people on this forum, but know that I am rooting for you. You are deserving of care, healing, and recovery.