For a person who doesn’t have diabetes, I know a fair amount about it. My partner has Type II diabetes, and so do a number of my close friends. For myself, I have been “pre-diabetic” (a term defined by your blood sugar numbers) for over eight years now, which makes the “pre” a little suspicious. My best friend for part of grade school was a Type 1 diabetic.
What I know about eating disorders is more academic. Although I have occasionally indulged in what people might call “binge” eating, I have never been anorexic, or bulimic. I’ve never been a serious dieter, though I’ve done a reasonably good job of controlling my carbohydrate intake since my blood sugar numbers started to go up in 2007. At the same time, the work I’ve done with Laurie both for our books and here at Body Impolitic has made me very aware of eating disorders, both from the personal story and the scientific data perspectives.
So I was struck by Bryce Covert’s excellent essay, “I Thought I Was Over My Body Issues, until I Got Diabetes.”
When I found out I had Type 1 diabetes, I had just finished eating a slice of pound cake. I still had powdered sugar stuck to my fingertips when the phone rang.
In the months before that phone call, I had become insatiably hungry. I would finish eating an entire meal — something as filling as pad Thai or Indian curry — and instantly want to eat the same thing all over again. This unending hunger would have brought me guilt and pain if it had struck in my teenage years or early 20s. I would have wrestled it into the back of my mind and denied it what it called out for. But by 30, I had ended that battle and agreed to give my body what it told me it wanted. And it had lately been telling me it wanted everything.
Almost without exception, this is how stories of getting over eating disorders and food-related body dysphoria end. “I gave my body what it told me it wanted.” Covert is clearly living in the culture’s body/mind division, which I theoretically believe is not the best for us, and which I find myself falling into all the time. More to the point, she had figured out that what she ate wasn’t a war, or a contest, or a secret test: it was just food.
Then there’s a quick medical stereotyping story. Despite extreme thirst, atypical hunger, and inexplicable weight loss,
… the doctor told me unequivocally that I didn’t have diabetes, despite a nurse’s suspicions. You’re too old, she said. You’re not sick enough. You’re not overweight.
“Too old” refers to Type 1 diabetes, which is generally diagnosed before a person is 20. As a quick oversimplified distinction, Type 1 is primarily about the body’s inability to produce its own insulin, and Type 2 is primarily about the body’s resistance to its own insulin. I know someone who was diagnosed with Type 1 diabetes in her early 30s, which is “too young” to expect a Type 2 diagnosis (which shows up in your 40s or beyond). She wasn’t thin, which perhaps made it take longer to confirm that she really had Type 1. These things happen; doctors should probably not be unequivocal, and yet it’s easy for doctors, like the rest of us, to confuse stereotypes with certainties.
Covert’s relationship with dieting started when she was 12, and her belly began to bulge.
I wanted to have power over what my body looked like. I found that power in strictly controlling what went inside it. It was often, if not always, misinformed. I decided the best way to eat fewer calories was to eat less food. I would deny myself whatever I thought I shouldn’t have with the discipline of a monk. I spent one memorable day holed up in my bedroom abstaining from everything — from the moment I woke up until dinnertime — so that I could eat the unknown calories in the Chinese takeout my family ordered every Friday evening guilt-free. But the delivery that night came hours late, at which point I was close to fainting. … What I lost in strength (and pounds — the only other time I’ve been below 100 was one particularly austere summer during high school) I felt I gained in control. I didn’t care about giving my body what it needed. I cared about making my body look the way I needed it to.
That’s the key to eating disorders as I understand them; they are about control. The calorie intake, the size of the stomach, the curve under the chin–those are the outward manifestations. But in the life of a young girl with so many pressures on her to look, act and feel certain ways, and so few areas where she can make her own choices, control is irresistible. If our culture venerated size, these same girls would be counting calories with a view toward increasing them as much as possible.
So Covert worked for over a decade on this control, and then worked at least equally hard to let go, eat what she wanted, with the most valuable kind of success there is.
I began to feel something akin to what I felt as a kid: that my body was a means to an end and not the end itself.
… a Type 1 diabetic has to become her own pancreas. I’ve marched into another full-on struggle against myself, assuming the job of an organ that can no longer function because my body is trying to destroy it. This requires dictatorial discipline. For every given amount of carbohydrates I eat — which can be found in foods ranging from sugar to bread to beans to even milk, and which then turns to sugar in the body — I inject myself with a corresponding dose of insulin. I compute in quantities of 15: For every 15 grams of carbohydrate, I need one dose of insulin.
Aside from her own story, which is still unresolved, Covert connects the dots: girls and diets, women and auto-immune disorders, body hatred and the desire for control.
The whole thing leaves me wondering: if girls and women weren’t judged by our looks to such an extreme extent, would we have the same auto-immune disorder numbers that men do? Is there some kind of subtle, unexplored link between our pre-pubescent focus on our bodies and our adult risks? Covert doesn’t take her musing this far, but I suspect she’s asking herself the same questions.