1 DIABETES. self -MANAGEMENT . NOVEMBER/DECEMBER 2010 $ TY PE 2 DIABETES. IN THE FAMILY. NEW TOOLS. 2010. Intuitive . EATING. For subscription information, please call (800) 234-0923. Or for a Free Trial Issue, visit us on the Web at Reprinted with permission from Diabetes self -Management, November/December 2010. Copyright 2010 Rapaport Publishing, Inc. Intuitive EATING. Enjoy Your Food, Respect Your Body by Linda Bacon, PhD, and Judith Matz, LCSW. J. enna, a new client, was ex- Ending the plaining what she wanted to get out of her counseling ses- blame game sions.
2 She said, I want to love Chances are you've been pre- food again. I want to pop a juicy scribed a food regimen to help strawberry into my mouth and not control your blood glucose levels. If think about my blood sugar. I want you're like most people, you find it to Enjoy a slice of gooey cake at my hard to stick with a rigid plan, and son's birthday party, guilt-free. I want if your meal plan excludes certain to go to a dinner party and feel free foods that you like, you mourn the to eat whatever my friend prepares.
3 Loss of those foods. Perhaps you've And what stopped her from tried to follow your meal plan, only enjoying eating? I have diabetes, to find yourself eating the ver y she said. foods you were told to avoid. Per- This was followed by a pause, as haps you were told you needed to if that sentence explained it all lose weight, and even though you that a diagnosis of diabetes means shed some pounds, a few months that food and eating can no longer later, they returned. You may won- be enjoyed. der why you can't just get your act Jenna's concerns aren't surpris- together and take better care of ing, given the advice most people yourself.
4 In fact, if you have Type 2. with diabetes receive about food diabetes, you may think that if choices and meal planning. When you'd done a better job monitoring you're asked to consider the carbo- your food intake and weight before hydrate content, fat content, your diagnosis, you wouldn't be in glycemic load, and potential impact this predicament now. on your weight of everything you So here's our first piece of eat, it can be extremely difficult to advice: Don't blame yourself! maintain a healthy relationship with Genes play a large role in the food, to truly Enjoy eating, and to development of diabetes.
5 We're all allow food to nourish you. It doesn't born with challenges in our genetic help when doctors, dietitians, code as well as in our life circum- friends, and family members all stances and this is one of the chal- seem to have something to add to lenges you were dealt. Your body the topic of how to eat with diabetes. was vulnerable to difficulty with If the prospect of choosing foods glucose regulation, and some com- strikes fear in you, or if you've tried bination of factors triggered that several diabetic diets and none of genetic propensity.
6 However, now them worked for you in the long that a diagnosis of diabetes has run, we've got some great news: made you aware of your body's There's no need to see food as your trouble regulating glucose, you're enemy, or to carefully restrict your in the driver's seat: You can learn eating. In fact, the opposite is true. how to manage your blood glucose The secret to managing your dia- and nourish yourself better. To get betes lies in learning to celebrate there, you may need to let go of food and its amazing ability to nour- certain beliefs that harm rather ish you.
7 Than help you. 44 Diabetes self -Management Intuitive eating means eating what feels right to you, when it feels right. Changing the ation that is believed to contribute to many of the complications associ- through healthy behaviors even in the absence of weight loss. diet mentality ated with diabetes. In the care and treatment of Type 2 In people with Type 1 diabetes, Health at Every Size diabetes, the value of achieving and prolonged high blood glucose typi- A new approach to diabetes man- maintaining weight loss has long cally leads to weight loss as the glu- agement that emphasizes wellness been an unchallenged tenet.
8 So cose exits the body in the urine and rather than weight is called Health you may be surprised to learn that the body begins to break down fat at Ever y Size (HAES). HAES. there is limited evidence to support tissue for energy. In people with encourages people to trust their this emphasis. In fact, evidence sug- Type 2 diabetes (or prediabetes) body to guide them in making gests that the pursuit of weight whose pancreases still make nourishing food choices and attain- loss which more often results in insulin, the body's response to high ing a natural weight.
9 The HAES. fluctuating weight than permanent blood glucose is to make and program includes three guiding weight loss can actually be harm- release more insulin, resulting in concepts: ful, both physically and emotion- hyperinsulinemia, or higher-than- Size and self -acceptance Respect ally. It also tends to distract a normal blood insulin levels. Hyper- and appreciation for the diversity of person from the behaviors and atti- insulinemia may promote weight body shapes and sizes, rather than tudes that really can improve one's gain in three ways: by causing pursuit of an idealized weight or health, such as eating well, being increased storage of glucose as fat; shape physically active, and cultivating a by interfering with the action of the Joy of movement participation positive sense of self .
10 Hormone leptin, which normally in physical activity for pleasure and It's true that the majority of peo- signals the brain that the body has health benefits, rather than primar- ple with Type 2 diabetes fall into had enough to eat; and by increas- ily for the purpose of weight loss the body-mass index (BMI) cate- ing the pleasure derived from food, The pleasure of eating well . gories of overweight or obese. even when the body does not need Intuitive eating based on physical But it's also true that insulin resis- more calories.