When Do You Call It An Eating Disorder?
And when is it diabetes?
January 2010 — I want to expand on a recent dLife Update | Newsletter topic (February 26, 2010, Vol.6 No. 8). "In The Spotlight" featured a survey on the possibility of having an eating disorder. Eating disorders have been on my mind lately, but not in the traditional diabulimia/bulimia/anorexia ways that often jump into focus when someone sees or hears about "an eating disorder".
When I think of an eating disorder, my mind automatically jumps to young girls, typically teenage or young adult, and the mental image that tags along is that of someone much too thin. In that split-second mental reflex, that too-skinny young girl thinks she is overweight and is using dangerous behavior to lose weight.
Forgive me. I know my associations are stereotypical, mostly inaccurate, and very unfair. I know very little about eating disorders.
I am male, in my mid-thirties, overweight, and have lived with type 1 diabetes for almost 30 years. Type 1 diabetes has set me up to fail in my relationship with food. It's never talked about, and I think it's probably more common than any of us might think.
I grew up using Regular and NPH insulin. These two types of insulin had some pretty nasty and awkwardly timed peaks that forced me to eat at certain times of the day, rather than when I was hungry.
Growing up like that hurt me. Think about it: I had to battle my natural instincts to not eat when I wasn't hungry. I had to purposefully deaden my urges to stop eating or not eat. It didn't matter what my body wanted to do.
I'm glad that today we have insulin types that allow for more flexibility. I hope that kids growing up with type 1 diabetes these days will be allowed to naturally find their food balance.
But even with these newer insulin types, we have other eating issues that work against us. Within the past couple of years I've learned about another hormone that plays a big role in this complicated food relationship I fight with. Amylin.
Amylin is another hormone that is created in my broken beta cells. It is usually created and secreted right alongside insulin, both in a constant background (basal) flow and surges (bolus) when I eat something. Amylin has two jobs that really affect my broken relationship with food. One, it slows gastric emptying, which is a fancy way of saying that it slows digestion. Two, it triggers a feeling of satisfaction in the brain. In other words, it makes me feel satisfied, often times with much less food.
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...