News and Updates
January 01, 2018
Adjusting Expectations In ED-DMT1 Recovery
Happy New Year!
In an effort to help everyone start off 2018 on a helpful and positive note we wanted to share our most recent Real Recovery Talk video: Adjusting Expectations in Recovery.
We hope you find it helpful!
November 19, 2017
What Is My "Heathly Weight?"
This question is often running through the mind of someone working on recovery from an eating disorder. We recently came across an wonderful blog post from Tiffany Mei Haug, MS, RDN, EDOC addressing this topic:
"Dear Eating Disorder Dietitian, What IS my healthy weight?
November 17, 2017
This is an age old question and I know it feels so important.
I'm sincerly sorry for all the answers you’ve been given to this question in the past that have led you to believe the answer is a single static number.
And even if it is for now, it won’t always be the same number. So here is my best effort to answer this question that burdens you, because society has taught you that it matters most. Actually I would go 10 steps further to say that society has taught you that it is your life’s mission (it isn’t).
Deep breath, & here we go:
A healthy weight in the broadest sense factors in the weight your body naturally settles at when you are nourishing and moving (or not moving) your body in a way that makes sense for you at any given stage in your life.
A healthy weight is a place where your physical health is not placed on a pedestal of superior importance above all other aspects of your health (psychological, emotional, relational, and spiritual).
A healthy weight is a place where you did your very best to feed your family consistently this month, in a way that made sense within your grocery budget.
A healthy weight is a place where you are receiving meaning from your life outside of your weight.
A healthy weight is a place where you can go on a 2 week camping trip with friends and be able to eat those canned beans and grilled cheese sandwiches and move or not move in a way that doesn’t isolate you from spontaneous social experiences.
A healthy weight is being able to give yourself permission to sleep in a little bit longer this morning and skip the gym since your 6 year old was up all night and you desperately need the sleep.
A healthy weight is whatever amount of weight a mother needs to gain for her pregnancy (and whatever happens after), according to her body’s own innate wisdom.
A healthy weight is being able to have that sample of dumplings at Costco without mentally adjusting how this will impact your lunch or snack.
A healthy weight is saying yes to that free yoga class at that cool studio your friend invited you to, even though it's not the run you had originally intended for today.
A healthy weight is dynamic.
A healthy weight is nuanced.
A healthy weight is compassionate.
There is no "perfect" healthy weight.
Yours most sincerely,
Tiffany Mei Haug, MS, RDN, EDOC is an eating disorder registered dietitian and blogs at Freedom With Nutrition.
October 29, 2017
The Eating Disorders Institute Graduate Certificate program at Plymouth State University
The Eating Disorders Institute Graduate Certificate program at Plymouth State University offers a 15 credit program for graduate credit. The Eating Disorders Institute (EDI) is designed to provide professionals with research-based tools, techniques and strategies to use in medical treatment, mental health counseling, nutrition counseling or education and outreach work. This Graduate program is ideal for those interested in becoming a Certified Eating Disorders Specialist in behavioral health, nutrition, or nursing.
Plymouth State is the only approved site in the country to offer a 12-credit eating disorder core curriculum which satisfies the International Association of Eating Disorders Professionals (IAEDP) requirement towards future certification. Plymouth State offers the only Masters in Education program in the country with a 15- credit focus on Eating Disorders. The experienced faculty are current practitioners in the field of eating disorders.
For more information about this program contact Mardie Burckes-Miller: firstname.lastname@example.org
October 18, 2017
"Yoga For Diabetes: How to Manage your Health with Yoga and Ayurveda" By Rachel Zinman
In "Yoga for Diabetes", Rachel shares her personal journey and her hard-won wisdom gained from her own experience of yoga and diabetes. Finally we have a book written by an accomplished yoga teacher with diabetes herself who points the way to regaining health and well-being for people of all ages and types of diabetes!
October 06, 2017
The Affordable Insulin Project
When you don't have prescription insurance, or have a plan with a high copay or high deductible, affordable access to insulin can seem beyond your reach. Although there are several programs that can assist those who need insulin,(either through discount, copay, or patient assistance programs) navigating through these options can often be confusing and frustrating - until now! The Affordable Insulin Project can help you determine what program is best for you!
The Affordable Insulin Project offers tools, resources, and data so that people impacted by today’s rising health care costs can positively influence the affordable access to this life essential drug.
"We believe that all Americans with diabetes should have affordable access to insulin. We believe that patients must be an integral part of the discussion at every step of the supply chain, from manufacturers and employers to Pharmaceutical Benefits Managers (PBMs) and the government."
We Are Diabetes fully supports the mission and initiatives of The Affordable Insulin Project!
September 28, 2017
Real Recovery Talk: How to Talk Yourself out of a Binge.
We Are Diabetes Executive Director Asha Brown talks about the difficult (and often unavoidable) struggle of talking oneself out of a binge in our newest Real Recovery Talk video: How to talk yourself out of a binge.
August 29, 2017
T1International is doing some amazing things to advocate for the T1D community! Their mission is to work towards finding sustainable access and affordability of insulin, diabetes supplies, medical care and education for all people living with type 1 diabetes. Want to help support this amazing organization's mission? Start by signing their Type 1 Diabetes Access Charter! This Charter will be used to bolster type 1 diabetes advocacy efforts worldwide. It will show the world that there are many voices united in support of these rights. It can be used to influence the actions of governments and organizations so that policies can be changed and the rights of people with type 1 diabetes can be prioritized. Make sure to check out their Resources page for a ton of options for you to utilize in your own advocacy efforts! We especially love their Advocacy Toolkit, which offers clear step by step guidelines on how to safely and effectively advocate for the cause you feel most passionate about in the DOC!
August 21, 2017
Free Educational Webinar: Diabetes and Eating Disorders: Not Just "diabulimia" August 24th 1-2pm CT
Center for Change is offering a free Webinar this week! This Webinar is lead by the outstanding Jenaca Beagley, NP-C, CDE, who is part of Center for Change's ED-DMT1 Treament Team.
You can register for this event here
July 02, 2017
Diabetes and Eating Disorders: Yoga as an Adjunct
This article is contributed by Beverly Price RD, MA, E-RYT 200, CEDRD-S. Thank you, Beverly!
Individuals with Type 1 diabetes have a higher-than-normal prevalence of eating disorders. In 2013, the National Institutes of Health (NIH) reported, from a review of literature, that 12-58% of young women with type 1 diabetes overeat, while 37% omit or restrict their insulin in order to control their weight. Similarly, a study of adolescents ages 12-21 found that 10.3% of females in their sample reported skipping insulin and 7.4% reported taking less insulin to lose weight. In terms of males, a study showed males with type 1 diabetes to have a higher drive for thinness as compared to males without diabetes, which may be a risk factor for further development of disordered eating. Further, research suggests that males may be more likely to exercise than to diet for weight loss, and boys who participate in sports that emphasize weight or leanness, such as wrestling or diving, may be at higher risk for disordered eating behaviors.
Why the prevalence?
Because diabetes and eating disorders involve attention to one's body, weight management, and control of food, some individuals develop a pattern in which they use their diabetes to rationalize or mask their eating disorder.
Let's look at a snapshot in the life of an individual with diabetes:
In addition, let's look at the dichotomy ("the Yin and the Yang") of diabetes with an eating disorder:
- Frequent testing of blood sugar
- Continually staying on top of food that is consumed
- Counting carbohydrates
- Attending nutrition education programs
- Multiple doctor visits
- Learning the technology to use a blood glucose meter
- Using a needle not only to test, but to inject insulin multiple times a day
- Having people monitor records and state of health continually
- Being considered "different" by peers
- Monitoring during sports
- Special snacks during the day
- Loss of control of one's own body
- Feeling scared at times
"Control" is a central issue in both diabetes and eating disorders. Individuals with diabetics may feel guilty, anxious, or out of control if their blood sugar swings more than a few points. Individuals with eating disorders may feel the same way if their weight fluctuates. The control needed for the individual with diabetes, followed by the mixed messages that individuals with diabetes and co-occurring eating disorders receive, have the propensity for the diabetes to spin out of control when coupled with the eating disorder.
- "Maintain your weight, blood sugar, and exercise! (numbers, numbers, numbers!)"
- "Count your carbohydrates!"
- "...but eat intuitively, do not count, measure or weigh… and let go of the control."
Complications of Diabetes with an Eating Disorder include:
Treatment for individuals with Diabetes and Eating Disorders
- High blood glucose
- Diabetic Keto Acidosis
- Multiple organ failure
- Low blood glucose when starting the refeeding process
The best treatment is a team approach with a knowledgeable, experienced and skilled treatment team including:
Addressing the underlying psychological issues, along with restoration of physical health are key interventions. This includes weight restoration and stabilization, through balanced, varied, and healthy meal plans that provide adequate calories and nutrients along with blood glucose control, and balanced exercise. Medication management, with the use of psychiatric medications to address depression, anxiety, is also the cornerstone of treatment.
- Physician - Endocrinologist and Potentially a Psychiatrist
- Registered Dietitian
- Licensed Mental Health Therapist
- Certified Diabetes Educator
What about Yoga?
For someone with diabetes and an eating disorder, the benefits of yoga can be a powerful adjunct to treatment. Yoga can help an individual by heightened awareness and improved perception, body acceptance and appreciation, the ability to begin to feel vs masking emotions and begin to let go of control through confronting their fears. Yoga teaches mindfulness. Individuals learn to experience the taste, texture, and other sensual qualities of food and begin to enjoy and appreciate food for its nourishing qualities.
Yoga targets the sympathetic nervous system, which in turn can help to lower heart right and blood pressure. The regulation of the nervous system can aid in the management of anxiety and depression. Yoga also works on the parasympathetic nervous system to regulate metabolism and emotions. In addition, yoga can raise gamma amino butyric acid (GABA) levels in the brain responsible for calming the nervous system. Yoga's work on the cerebral cortex, can improve decision making, aid in irrational thought process and reduce impulsive behaviors.
If an individual with diabetes and an eating disorder is planning on starting a regular practice of yoga, medical clearance needs to be obtained along with a baseline blood glucose, A1C, blood pressure, weight and behaviors. The individual needs to check blood glucose levels before and after yoga. The dietitian can help the patient manage a meal plan in relation to the intensity level of the yoga practice. In addition, since yoga involves all body parts, including the feet, the individual needs to understands the importance of checking their feet after each session to make sure that they are not irritated.
By the basic breathing techniques and simple movements, that yoga can offer an individual with diabetes and an eating disorder, individuals may find it easier follow a food and lifestyle plan, while becoming more aware and in tune with their condition and behaviors. The end result is improved disease management.
BEVERLY S PRICE is a certified eating disorder registered dietitian and IAEDP supervisor, experienced registered yoga teacher and IAYT certified yoga therapist. Beverly is recognized for bringing mindfulness-based yoga to the eating disorder treatment community along with yoga therapy training programs in eating disorders for professionals.
June 09, 2017
We Are Diabetes National Provider Network: Amy Ornelas RD, CEDS Serving San Diego, CA.
Amy Ornelas is a Registered Dietitian and Certified Eating Disorders Specialist. She has had the pleasure of working exclusively with people who struggle with disordered eating and exercise for the past 10 years at the residential, partial hospital, intensive outpatient, and outpatient levels of care.
Utilizing a non-diet approach, principles of intuitive eating, and mindfulness, Amy works with clients collaboratively in order to help them reclaim their mind-body-food connection and rediscover the joys of eating. Aside from her career in dietetics, Amy is also a yoga teacher and loves to use this modality to help people reconnect with and understand their intuitive drives for movement and rest.
Amy graduated Cum Laude from San Diego State University with a BS in Foods and Nutrition and received her clinical training at the VA Healthcare Dietetic Internship in La Jolla, CA. She is a current Board Member Elect of the International Association of Eating Disorder Professionals and has been featured as a nutrition and eating disorders expert on the news, internet radio, healthcare videos, medical websites, in many published news articles, and as a guest speaker at several conferences.
Amy believes that nutritional recovery is not about going without; it is about going within and learning to work with your body in a whole new way. She is deeply passionate about helping others find their peace with food and a newfound appreciation for their bodies.