February 10, 2023
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Diabetes often requires us to make dietary changes. But in some cases, dedication to “healthy” eating can go too far, leading to conditions like orthorexia. This is my experience.
For many of us, receiving a diagnosis of diabetes has changed the way we view food. Do you now approach nutrition differently? Are you modifying your eating habits due to concerns about diabetes complications?
Diabetes has changed my relationship with food in a drastic way. I developed gestational diabetes in 2010. This led me to eat a low carbohydrate diet to prevent type 2 diabetes for over 6 years. Despite my best efforts, I was diagnosed with type 2 diabetes in 2019.
But my diagnosis was the least of my concern. As a result of my unwavering dedication, I would later get diagnosed with orthorexia.
Orthorexia nervosa is an obsession with eating healthy foods and avoiding processed foods. This can interfere with daily functioning, leading to decreased productivity. In addition, orthorexia can cause a person to isolate themselves from social gatherings and events, especially ones that are centered around food.
A restrictive diet like this can also cause anemia, vitamin and mineral deficiencies which can lead to malnutrition, and a sluggish heartbeat. Malnutrition can affect digestive function, electrolytes, hormone production, metabolism, and immunity as well.
Managing diabetes can be challenging for people who have also been diagnosed with a disordered eating condition like orthorexia. Diabetes is manageable with dietary changes, behavioral changes, and physical activity. But having diabetes can add a whole new dimension to food stress.
Currently, there isn’t a definitive cause of orthorexia due to limited research. But social media exposure, anxiety, and a quest for health and wellness can be factors. This has merit for me since I have a generalized anxiety disorder and an interest in wellness.
The source of my orthorexia began shortly after my diabetes diagnosis in 2019. I joined a few online communities for accountability and support to improve my eating habits.
But these communities had very strict rules about eating. They recommended an extremely low carb/keto diet where rice, beans, potatoes, and grains weren’t allowed. Commercial bread and ice cream from the store (including keto) weren’t allowed, and berries, lemons, and limes were the only fruits you could eat.
Participants were only allowed to consume 30 to 50 grams of carbohydrates per day. Intermittent fasting was also promoted. We also limited food consumption to no more than four meals a day to keep the pancreas from overworking. If you posted about restricted foods, the communities would mute or block you.
I meticulously followed the guidelines. I ate the “safe” foods that included meat, cheese, eggs, and low carb vegetables. Over time, my eating habits changed as I began to take “safe” food to restaurants and events.
My A1C improved from 10.7% to 4.8% in 3 months. In 6 months, it was 4.5%. People praised my efforts and I believed I was doing well, so I continued to follow this lifestyle.
If you’re preoccupied with food or your weight, feel guilt about food choices, or engage in restrictive diets, consider reaching out for support. These behaviors may indicate a disordered relationship with food or an eating disorder.
Disordered eating and eating disorders can affect anyone, regardless of gender identity, race, age, socioeconomic status, or other identities.
They can be caused by any combination of biological, social, cultural, and environmental factors — not just by exposure to diet culture.
Consider speaking with a healthcare professional, or try chatting, calling, or texting anonymously with trained volunteers at the National Eating Disorders Association helpline for free.
The effects of orthorexia are devastating on the body, the mind, and the social life.
After eating this way for a year, the regimen became monotonous. I planned my days by my rigid eating schedule. I was an expert at reading labels. I avoided most processed foods because of their “noncompliant” ingredients. Approximately 10 foods were a regular part of my diet.
As a result, I developed a negative relationship with food. I avoided social gatherings because it took too much effort to prepare safe foods. I lacked energy and was unable to complete household tasks or be present for my family. My weight fluctuated, my hair fell out, and I had acne and brittle nails. I experienced mental health issues and always felt sad and depressed.
Despite this, I kept the same regimen. But then I got diagnosed with early-stage latent autoimmune diabetes in adults (LADA) in 2022. It was at that point that I realized I wouldn’t be able to live the way I was living anymore. So, I made the decision to seek help. I received a diagnosis of orthorexia nervosa and malnutrition in April 2022.
Managing diabetes and eating disorders is challenging and complex. Both conditions can affect your mental health. You may need help from a mental health professional, a diabetes educator, and a dietitian.
The biggest mistake I made was not listening to my original diabetes educator. The diabetes communities I joined believed diabetes educators promoted outdated diabetes food guidelines. I bought into that belief.
Be careful not to start a diet without medical clearance or follow a diet that avoids whole food groups. Getting the right diet can be tricky. You need a diabetes educator or registered dietitian who can help.
Currently, I see a diabetes educator who helps me expand my food choices. My dietitian works with me on adopting an intuitive eating style. I also have a nutritionist who helps me shed toxic beliefs about food and carbohydrates.
I’ve been feeling better since receiving treatment for orthorexia. I’m confident that I can manage my condition with help from my healthcare team.
And while I have a long way to go, I know I’m on the right path.
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