What You Should Know About Eating Behaviors and Diabetes

Alyssa Vela, PhD; Health Psychology Fellow, McLaren Flint

Phoutdavone Phimphasone-Brady, PhD; Postdoctoral Fellow, University of Colorado School of Medicine

If you have diabetes, you probably know all too well that eating is often the most challenging aspect of diabetes management. You are not alone if you struggle to figure out what to eat, when to eat, and how to eat, even years after a diabetes diagnosis. When it comes to eating and diabetes, there are a few key aspects to pay attention to. Some of these eating habits may be familiar to you, and they might even start to cause problems in your life, such as your blood sugar, your relationships with friends and family, or even your relationship with your doctor.

Be on the lookout for red flags that your eating habits may be problematic:

1. Emotional Eating. You find yourself turning to food for comfort in response to any strong emotion, negative emotions in particular. You might notice yourself choosing to eat comfort food when you notice yourself feeling sad, angry, or frustrated. Emotional eating is often associated with a lot of difficult dietary changes, meaning it can be a real challenge for people with diabetes.
    
2. External Eating. You find that you cannot resist the sight or smell of tempting foods. With external eating, it is often that people feel overwhelmed by their senses around certain foods, and find them triggering, which may result in less healthy food choices and/or over eating.
    
3. Binge Eating.  You find yourself losing control and eating a large amount of food, sometimes to the point of feeling sick or uncomfortably full. A large amount of food may be several servings of a meal, a bunch of snack foods, or grazing on a variety of types of foods that are available until a large amount has been consumed. The key aspect of binge eating is that feeling that you’ve lost control, couldn’t stop yourself from eating, and felt emotions such as shame, sadness, or disgust.
    
4. Restrictive Eating. This type of problematic eating is most similar to being on a strict diet. Some people start by cutting out types of food, or even full food groups such as sugar, carbohydrates, or fruit. In some cases, people might also skip meals or fast for many hours of the day. You may have limited your intake so much that you are barely eating enough to power yourself through the day. This can cause you to feel tired or sluggish all day.
    
5. All-or-Nothing Thinking about Food. You are so focused on the foods that you can and cannot eat, you feel a lot of shame and guilt about eating certain foods. This often results in labeling foods as “good” or “bad,” and beating yourself up if you eat a food that falls on the “bad list.” All or nothing thinking doesn’t appreciate gray areas of life that sometimes challenges such as time or money impact how you eat. Thinking this way can also make eating with others, such as at a dinner party, really uncomfortable and distract you from the company of others.
    
6. Strict Dieting & Food Avoidance. Similar to restrictive eating, in some cases people feel guilty about eating specific types of foods (i.e. pizza), food groups (i.e. carbohydrates), or combinations of foods. This may result in anxiety in situations in which you are around these foods, or social situations in which everyone else is eating the foods that bring up guilt. It can also look like following any specific diet, Whole 30 for example, and beating yourself up if you are unable to follow the diabetes diet completely.
    
7. The “It’s already ruined,” mentality. You make a food choice that doesn’t fit your goals, and decide that you already ruined your day, week, or your entire diet plan, so you might as well eat whatever you want. This way of thinking often happens in response to restrictive eating or dieting. You may feel like you have failed and all is lost, so why not just give up until you can re-set? People often find themselves stuck in a cycle of restrictive eating and binge eating, or yo-yo dieting.
    

Everyone has to eat, so how we think about food and go about eating, plays a really important role in our happiness and well-being. There are many ways these patterns of eating can be improved to prevent any further eating-related problems and to help people meet their diabetes management goals. Such strategies include:

1. Monitoring your food. Tracking your food and monitoring what you eat is a great way to successfully manage your diabetes as well as manage your overall health and eating habits. There are several ways to monitor your food, such as calorie counting or paying attention to portion sizes. There are also great apps available to track your food intake throughout the day.
    
2. Establishing a regular pattern of eating. Keeping a journal of the foods you eat will also help with establishing a routine for eating. It is recommended to have 3 balanced meals and 1 to 3 snacks per day. If you plan these times out, you will be more mindful of not only what you eat but how often you are consuming calories.
    
3. Eating mindfully. Eating mindfully is reaching a state of full attention to your experiences, cravings and physical cue when eating. Some of the fundamentals of mindful eating are:

• Eating slowly and without distraction
• Listening to physical hunger cues
• Only eating until you are full

4. Staying physically active. A fitness routine is part of your diabetes management plan. Aside from the basic benefits of staying physically active, like weight control and toned muscles, staying more physically active with diabetes allows your body to be able to use its own insulin more effectively and you will have better blood sugar control.
    
5. Finding alternative activities to eating. Sometimes we just want to eat because the urge hits us hard. Instead of eating at those times of major cravings, consider other options, like journaling, watching TV or getting lost in your favorite book.
    
6. Seeking social and/or professional support. Sometimes managing our eating habits is too challenging for us to handle on our own. Make sure you seek out a support system of friends, family or professionals to keep your eating habits on track.
    

If your eating habits affect your life and ability to manage diabetes, talk to your doctor, a diabetes educator, and/or a mental health provider who specializes in helping patients with the challenges associated with diabetes management (a list can be found here). 

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