I have many friends in the Diabetes Online Community who have Type 1 diabetes. Laddie Lindahl is one of them. You can find her blog at Test Guess and Go. Over the course of reading each other’s blogs we became friends on Facebook and, thanks to Laddie, have met in person. Laddie approached me recently with an idea that I found intriguing: what if a type 1 and a type 2 had conversations about what it’s like to live with diabetes and some of the myths surrounding this disease. Are we really all that different? Let’s find out.
Laddie: For the first Type 1/Type 2 conversation, I figured that I wouldn’t shy away from a difficult topic: Weight. Weight is the elephant in the room in most discussions and arguments between people with Type 1 diabetes and those with Type 2. Weight is synonymous with blame, guilt, and ignorance.
Many people with Type 1 diabetes are thin and some of us were almost skeletal when we received our diabetes diagnosis. When you have Type 1, it is easy to associate being thin with “Not My Fault.” If you become comfortable in this thought process, the next logical step is to become comfortable with the stereotype of Overweight = Type 2 = Their Fault.
A long time ago I learned to stay out of the Type 1/Type 2 wars and keep my mouth shut. That doesn’t mean that I didn’t believe a lot of the stereotypes. I’m not going to be virtuous now and say that I have totally seen the light. No, I’m going to say that I just don’t know.
In recent years I have read a lot of research that indicates that Type 1 and Type 2 are just different manifestations of inflammation and autoimmunity gone astray. Maybe just a flip of the coin made me Type 1 instead of Type 2. I have a friend who was diagnosed with Type 2 several years ago. She has always struggled with her weight. She and her husband go on the same diet. He loses twenty pounds and she loses one. She wonders whether the abnormalities of metabolic syndrome and Type 2 diabetes are responsible for her weight problems, not the result of her weight problems. She might be right.
I am very thankful that except for an occasional extra five or ten pounds, I have never struggled with being overweight. In my many years participating in the DOC, I have learned to be less judgmental and I have gained more understanding of the issues that those with the "other kind" of diabetes face. In the last two years I have gained 5 pounds that I have been trying to lose. I’ve had no success. Do I think that it would be easy to lose 50 pounds or 100 pounds. No way. I can’t even lose 5 pounds.
Many people with Type 2 diabetes struggle with weight. Many people without diabetes struggle with weight. Many people with Type 1 diabetes struggle with weight. When I read the definition of weight in my dictionary app, I only see that weight can be measured in things like mass, thickness, gravity, and load. I don't see judgment. I don't see criticism. I don't see blame. We can learn something from that.
Kate: The subject of weight and diabetes is certainly a good place to start our conversations. Laddie hasn’t shied away from what is usually a very controversial subject. Our society is obsessed with weight: how to lose it, how to remain pencil thin and blaming those who carry too much.
I have struggled with excess weight for most of my adult life. I was a thin child and teenager. I married at 20 and once I began having children, the weight just crept up. I always thought it was because of the pregnancies and my inability to take off the “baby weight”. Whatever the reason, it was difficult to lose. Fast forward to my diagnosis of type 2 diabetes at age 50 and cue the guilt. It doesn’t matter that I’ve spouted, quite often, about how our type 2 dxs aren’t our fault; the guilt is still there. “If I had just lost weight earlier.” “If I’d just worked a little harder.” It’s easy to blame ourselves. Here’s the thing: diabetes, regardless of type, is NOT the patient’s fault! Yes, those of us with type 2 are often overweight or obese, but so are millions of other people and they don’t have diabetes. Sometimes it’s hard to remember that when the media is waving the fat shaming in our face.
I was diagnosed nine years ago this summer. I have educated myself and made some significant changes to my diet and lifestyle. (That doesn’t mean I’m always perfect. Far from it.) I did manage to lose some weight early on, but things have changed in the last year. Even though I now eat very few processed carbs and more veggies; even though I exercise for 30 minutes nearly every day, I am gaining weight. It could be due to a myriad of hormone issues: thyroid, female, insulin…but in the end it doesn’t matter what the reason is for my inability to take the weight off. I’m trying as hard as I can and it won’t budge. Is that my fault? I don’t think so.
Many people with type 1 are weary of being told that “if you lost a bit of weight you could probably get rid of your diabetes.” Guess what, so are those of us with type 2. The myths that revolve around diabetes and too much sugar, too little exercise, too many pounds are just that – myths. No matter what the diabetes type, none of us did this to ourselves. None of us asked for this disease. Quite a few of us, with diabetes and without, could benefit from losing weight, so why does society and the media vilify those with type 2 diabetes for needing to lose pounds?
Yes, I used to love to eat pizza. Yes, I used to take a donut from the box in the break room at work. Yes, I ate fast food and processed foods. Yes, I used to eat bread. Yes, I bought into the travesty that was the Food Pyramid. Yes, I have type 2 diabetes. Other than the diagnosis, how am I much different than the majority of Americans?
Laddie: I have learned enough about Type 2 diabetes not to blame the individual. I don’t think that there is a magic formula to becoming overweight and I certainly don’t think that being thin is a virtue, although popular media often tries to convince us otherwise. I do know that when I gain unwanted pounds, I feel sluggish, frustrated, and full of guilt for my perceived weakness.
I blame society for much of the increase in average weight of our population. Many people, unfortunately including a lot of children, lead a much less active life than did their parents and grandparents at the same age. Too much TV and video game time has turned many of us into couch potatoes. Many children live in environments where it is not safe to walk to school or play outside unsupervised.
Bad food is everywhere and often is less expensive than quality food. I believe that carbs are wonderfully delicious and highly addictive. More than once I have admitted to being incapable of eating carbs in moderation. No chocolate chip cookies is easier for me that just one chocolate chip cookie. No chocolate-covered donuts is easier for me than just one chocolate-covered donut. No potato chips is easier than just one. Also we are starting to see studies that indicate that the ubiquitous low fat heart-healthy diet is in fact responsible for making us heavier and less healthy.
As Kate mentions, there are many people who are overweight but don’t have Type 2 diabetes. Weight is one trigger for Type 2 and we need more knowledge about the other triggers. We read statistics on the huge increase in the number of people with Type 2 and the increasingly younger ages at which it is showing up. But interestingly enough, the incidence of Type 1 is also increasing. There is a lot of bad stuff going on in our environment. Let’s dedicate ourselves to looking for answers rather than slinging blame on those who need our respect and support.
Kate: Laddie and I are on the same page when it comes to unhealthy carbs being addictive. I am also someone who is better off having none rather than a “reasonable portion”. It’s difficult to deny yourself things that are soooo good, but it’s important that we remember to put our health first and fleeting pleasure second, at least the majority of the time.
I believe that our society puts too much focus on weight and not enough focus on health. As someone who has thought about weight my entire adult life I feel that it would be easier to make healthy changes if we were told that our diet needed to change for health reasons and stop focusing on losing weight. Being told that you need to lose weight when it’s obviously something that doesn’t come easily is daunting, at best. Being told that certain foods are bad for your health might make it easier to give them up. I’m constantly reading on reputable websites (and the blasted media) that “if people with type 2 would lose a few pounds, their diabetes would be easier to control (or worse, go away!)”. I would rather hear that we need to stop eating unhealthy foods and be told to begin a healthier lifestyle. If we did that then the weight loss should naturally follow. So many “diabetes-friendly recipes” (I abhor that term) continue to focus on carbs rather than weaning us from things that cause our blood sugars to spike. There is also a movement in the medical community toward thinking that maybe the diabetes is to blame for the weight gain and not the other way around, in people with type 2. Dr. Peter Attia’s TedTalks video outlines that very topic quite well.
In the end, everyone, regardless of diabetes dx, would benefit from a healthier lifestyle. Everyone would profit from less focus on weight. I’d love to see less finger-pointing and more camaraderie and understanding. A united diabetes front will do more good for all and possibly begin to swing the tide back to more understanding of our diseases.
Laddie: Kate and I covered a lot of ground in our first Type 1/Type 2 Conversation. Weight is not always easy to talk about, but we managed to share our thoughts and hopefully learn a thing or two from each other.
I believe that we shouldn’t shy away from difficult topics in the diabetes online community. At the same time we need to work to be respectful and supportive of each other. If I ever write anything insensitive, hurtful, or just plain wrong, I hope that Kate or someone else in the DOC will call me on it. Just be nice about it and I promise that I will learn from you. And I will apologize. And I will be a better person for it.
Kate has chosen the topic for our second Type 1/Type 2 Conversation which will be published next Tuesday, July 15. Rumor is that it contains some fishing photos.... I hope you’ll join us.