By Quinn Nystrom

I’ve struggled with an eating disorder since I was 12 years old. I was a competitive figure skater and remember back to the year when I started comparing myself to the other skaters, equating my weight to how good I’d be at the sport, and putting myself on a strict diet regimen. The following year I was diagnosed with type 1 diabetes. My new strict regimen was now made up of multiple finger pokes a day, multiple insulin injections daily, and strict times that I’d be eating and how much I’d be eating at each sitting. This added obsession with food and numbers to not just me, but now my family and medical professionals, was too much pressure for me. What had started the year before as anorexia, had now turned into bulimia. I struggled in silence. Not just for a short time, but for a long time. It wasn’t until I was 24 years old that I first entered an eating disorder treatment program. Why so long? To be honest I think it was part denial, and another part was because the only time I heard people talking about eating disorders and type 1 diabetes was when they referred to it as “diabulimia”, which only discussed insulin omission as the symptom. Since I had never used insulin omission, I felt that must mean I didn’t have an eating disorder, maybe just a dysfunctional relationship with food. It wasn’t until I entered treatment that I learned that women with type 1 diabetes are at a 2.5 times higher risk of getting an eating disorder than a woman without diabetes. I also learned why we may be at a higher risk:

  • Diabetes treatment recommendations give attention to carbohydrate counting and portion control,
  • encourages perfectionism and frustration with blood glucose ranges,
  • symptoms of depression and anxiety may develop,
  • weight gain can be associated with improved HbA1C,
  • higher risk for depression,
  • negative feelings about weight and shape and fear of weight gain,
  • feeling deprived of food choices, dietary restraint that can lead to binge eating cycle. *

Learning about why I was at a heightened risk, made me feel less alone. It also made me feel less shameful that I just simply “chose” to have an eating disorder. I was able to better understand why I was more prone to this diagnosis. The reason why I prefer the term ED-DMT1 is because I believe it covers the spectrum of various symptoms that someone with type 1 diabetes struggling may use in their eating disorder. It’s not just specific to insulin omission.

The theme of this year’s National Eating Disorder Awareness Week is “Let’s Get Real”. When I was struggling in treatment, my mother would send me letters and have this phrase on it, “Secrets make you sick.” For 12 years I had suffered in denial, silence, shame, guilt, and despair. I didn’t believe there was another life that I could live. It wasn’t until going to treatment, along with my family and friends support, that I realized there was a wonderful life to live out there. I just needed to be honest with my struggles, accept help and believe that I was worth it.

*Taken from Ann Goebel-Fabbri’s book “Prevention and Recovery from Eating Disorders in Type 1 Diabetes”.