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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.
- 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.
- 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.
- 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.
- 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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