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Eating Disorders

(see chapter by Wendy Satin Rapaport in PRACTICAL PSYCHOLOGY FOR DIABETES CLINICIANS as well as second edition by A.Goebbel-Fabbri )

Unfortunately there is a higher risk factor for young people with diabetes to develop an eating disorder. (So think “prevention” if you are newly diagnosed)

Certainly this can be seen by individuals underdosing or omitting insulin as well as other symptoms unrelated to diabetes per se: intensive exercise, food and weight preoccupation, extremely low calorie meals, and periods of restrictive and/or binge eating, depression, and secrecy.

The mental health person should work with your doctor closely.

Meanwhile… keep working on the task of coping with diabetes. It can be broken down into smaller steps so that it does not feel so overwhelming. Instead of looking at coping as whole, break it down into smaller components and you will find it more manageable.

  1. First, recognize and accept whatever feelings you may be experiencing in the moment. Doing so promotes self-knowledge, which in turn allows you to understand your feelings and reactions, as well as those of others close to you.
  2. Then learn to desensitize yourself. You can do this by reflecting on your feelings and momentarily stepping back from them. Sometimes it is tempting to react out of anxiety, hurt or anger. In such situations, try to slow down your reaction and respond with objectivity rather than reactivity. In other words, try to balance your emotional reaction with a rational reaction.
  3. Then take the time to anticipate situations that may challenge you. Think about common scenarios you encounter that may call for a response on your part. Write them down if you need help keeping track of them.
  4. The next step in this sequence is to prepare ahead for typical situations you may anticipate. Just as you carry an umbrella when rain is expected, you can plan in advance how you will react to challenging events and people. Then, when you encounter these challenges, you can put your plan into action rather than having to come up with a solution totally by surprise.

Self-talk dialogue—after eating “too much” (and exactly WHAT IS TOO MUCH?)

Oh, I am so full. I ate too much.

Stop it. You are content. Feel the satisfaction.
Breathe. Let go of the guilt. Breathe.
Feel the food giving you energy and pleasure.
It is only one meal. And it was a good one.
Breathe.

But I ate too much.

Relax. Don’t take away the pleasure with chastising.
Learn to feel and like the fullness.
Learn to feel and like the pleasure.
Breathe.
Don’t bloat yourself on guilt.
You will moderate with zeal
……At the very next meal.



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