Finding adequate eating disorder treatment is challenging. When you have an additional chronic illness such as type 1 diabetes, there are added complications. Some individuals with eating disorders and type 1 diabetes (ED-DMT1) encounter professionals who spread common myths about diabetes, insulin, and weight, like the pervasive notion that insulin makes you fat, or that those with type 1 diabetes should avoid carbohydrates. On the other hand, eating disorder professionals may not understand the importance of carbohydrate counting for people with type 1 diabetes, as their goal is to steer people away from reading food labels.
As you can see, diabetes and eating disorder treatment isn’t always compatible. It takes a specialized team to be able to harmonize eating disorder treatment and diabetes management. But such specialized programs are few and far between. Patients with ED-DMT1 are often unable to attend such programs and so many have no choice but to become their own experts and develop their own treatment team.
Here are some tips for patients who are seeking treatment for ED-DMT1:
1. Bring resources:
As mentioned, often eating disorder professionals know little about type 1 diabetes and vis versa. As the patient, you may need to do some teaching to inform your providers about ED-DMT1. When you make the decision to approach your doctor about your eating disorder, bring information about the link between diabetes and eating disorders (We Are Diabetes has a resource page and a list of academic articles on the subject). Likewise, when you seek eating disorder clinicians, it can be helpful to bring information about diabetes. The Juvenile Diabetes Research Foundation (JDRF) has free handouts patients can bring to their eating disorder clinicians. The material you provide can facilitate a conversation about an issue that few providers are well-informed about.
2. Assemble a team:
With a complex illness like ED-DMT1, treatment requires several professionals with different expertise. Typically, this team consists of an endocrinologist, diabetes nurse educator, dietitian, therapist, and psychiatrist. Your own team is unique to you and should address the issues that pertain to your circumstances. Additionally important is finding providers that you connect with and feel comfortable discussing personal physical and mental health issues. Through a laborious endeavor, it is imperative to find a team that works for you.
3. Learn the eating disorder lingo:
When I first entered treatment, the people around me were using all sorts of acronyms and terms I didn’t recognize. It may be helpful for you to familiarize yourself with general eating disorder treatment terminology to feel more comfortable with the path ahead of you.
4. Be your own advocate:
It’s vital to stand up for yourself and speak up to get the treatment you need and deserve. As discussed, many doctors and other clinicians are not equipped to address the needs of a person with an eating disorder and diabetes. Although it may be incredibly difficult to even start a conversation with your doctor, much less to give them a pile of resources and educate them on the illness, it is important to be firm and advocate for yourself. If you find this to be too challenging, bring someone along with you to appointments who can help you out.
5. Surround yourself with support people:
An essential part of your team includes family members, friends, and partners. The process of getting into treatment and finding providers can be time-consuming, frustrating, and exhausting. It’s important to have a support system to lean on when you feel overwhelmed. Individuals who have recovered from eating disorders have found that support people were instrumental in their recovery.
It takes time and patience to find a treatment program that works for you. As difficult as it is to find clinicians and doctors with knowledge and experience on both issues, there are specialized treatment programs designed to address the needs of people with ED-DMT1.
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