Issue 4. November, 2016

Letter from our Executive Director

Well, November's almost over && everyone in the Diabetes community knows what that means, we're almost thru with Diabetes Awareness Month. Some of you may be feeling what Mike Lawson dubbed a little overwhelming awareness && I'm coining some #blueburnout. We live with it, many of us advocate for it, and even more still work within the field; so when November rolls around it can feel like just one more area of our life in which diabetes has to take up one little part of our brain. But I do have to live with diabetes every minute of every day in my brain, whether or not there’s a blue circle campaign or #ProjectBlueNovember trending behind it. So I'm going to pull myself out of my blues the best way I know how, by focusing on the people that help me do so && noting all the amazing people in the diabetes world we got to work with over the summer.

In August we traveled to San Diego for the AADE conference and got to attend an in person DSMA Live show co hosted by @SweetCherise && @ScottKJohnson. We were thrilled to honor Susan Weiner, RD, AADE 2015 Educator of the Year, with a special dinner for all the work she’s doing in the diabetes community and her outreach into the diabulimia world. We were honored to be joined with icons from all over the diabetes world and DOC (Diabetes Online Community.) It was amazing to see how many well-respected people came out to help us honor Susan with a special night! Thank you again to our friends at ACUTE Center for Eating Disorders for sponsoring this special event.

In September we went to Chicago for two events; we had the opportunity to meet up with some of our favorite leaders from DiabetesSisters, an organization dedicated to supporting women with diabetes through forums, education programs and especially their local meet up, or PODS, groups. Seeing all those amazing leaders from the diabetes community in one place learning how to better help their fellow diabetic women was TRULY inspiring! September was also National Recovery Month, created to “increase awareness and understanding of mental and substance use disorders and celebrate the people who recover.” We were beyond thrilled to see all of our work advocating for access to treatment and insurance coverage so paying off as we presented our second presentation at the annual National Eating Disorder Association conference. Alongside, world renowned expert on insurance law, Lisa S, Kantor, Esq., we presented Know Your Rights: A Review of the Latest Insurance Law and Regulations You Can Leverage to a completely full room.

October we headed to Center for Hope’s symposium where we were thrilled to see eating disorders in men the subject of several topics, including the keynote address by esteemed Dr. Stuart Murray With Diabulimia Helpline seeing an increase in male clients ever year since our opening and male eating disorder patients making up to 25% of all those that suffer it was so nice to see some male- specific resources and tools to aid in the fight against eating disorders in diabetics.

In the same November spirit of celebrating Diabetes Heroes Diabulimia Helpline is proud to launch our new campaign I'd Rather Be A Hero, Than Die A Size Zero. We wanted a way to honor the amazing work and fight that goes into battling this disease && a celebration of the beautiful lives that come out the other side. We are so overjoyed to announce Alison Sullivan, RN as our very first #HeroNotSizeZero. Alison, now in recovery, leads part of a pilot program that does comprehensive disease management with at risk populations over 3 sites in 2 countries. “More than that I do cheerleading, I celebrate achievements and problem solve challenges, I attempt to knock down barriers that keep people from being well, all while advocating that their health provider is giving them the best possible care.” These are stories of truth, of struggles, of relapse, and recovery. These are stories of dreams, beliefs && hopes. These are the stories that are bigger than the eating disorder could ever hope to be. To learn more about the program, how you can nominate someone to be our next honoree and read about Alison's story, visit our new page here.

We know November also starts the beginning of what for some are “The Dreaded Holidays.”  We found two articles that can help you turn them into Dreamier Holidays instead For tips on achieving recovery without the perfectionism despite all the holiday stress check out Allison Marek, LCSW, CDWF’, Rising Strong essay below.  And to our Delight Recovery Hope has written a special article all about dealing with diabulimia, specifically, around the holidays. Both articles can be found below.  

Erin M. Akers
Executive Director, Diabulimia Helpline
@ErinMAkers

Rising Strong
by Allison Marek, LCSW, CDWF

For many people, perfectionism has become as much of a holiday tradition as carols and lights.  We often do not even realize that visions of Pottery Barn catalogues dance in our heads as we trim the tree or entertain.  In our hustle to have “the perfect holiday,” we lose our joy and our precious holiday time can become completely dictated by what other people think.  For people in eating disorder recovery, the food, abnormal schedules, and family interactions, on top of that hustle for the perfect holiday, may put people at greater risk for lapses.

Perhaps the greatest cause of lapses in recovery during the holidays is another form of perfectionism: recovery perfectionism.  Recovery perfectionism includes worries about how family and friends will judge their progress, the pressure to be “fixed” or “cured,” and comparison to others.  Here are some examples of recovery perfectionism self-talk:

“I have to eat this/not eat this or Aunt Sally will think I’m just as sick as I was last year.”
“I can’t believe I’m still wanting to binge.  What is wrong with me?”
“After all of the therapy I had, I shouldn’t want to restrict.  Other people aren’t struggling like I am.”

Sound familiar? Brené Brown, PhD, LMSW, research professor at the University of Houston Graduate College of Social Work and author of the New York Times bestsellers Rising Strong and Daring Greatly says, “When perfectionism is driving us, shame is riding shotgun.”  Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.”  Brown’s research has shown that shame destroys the part of us that believes we can change, or in this case, achieve recovery despite holiday stress.

The following practices can help you stay resilient to shame and perfectionism, especially during the holidays...

Self-Compassion
If someone is in deep shame about where they are in their recovery, it is unlikely that that person will seek support from their family, friends, or treatment team, even though that is when they need support the most.  Self-compassion is the first tool to practice as you ready yourself to reach out for help.

Kristin Neff, PhD, professor at the University of Texas at Austin, has identified three components of self-compassion:

• Mindfulness: Pay careful attention to how you talk to yourself.  In preparation for holiday meals and gatherings, strengthen your mindfulness practice by engaging in the rich sensory experiences for which the holidays are known: the sound of bells, the smell of pine, the light of a menorah, the touch of snow.  Our mindfulness practice will help us become aware of our self-talk so we can make needed changes.
   
• Self-Kindness: How would you encourage your son, daughter, nephew, niece, or even a younger version of yourself to eat during your holiday celebration?  What would you say to your best friend if she was being hard on herself for feeling sad or angry?  Treat yourself like you would treat someone you love.
   
• Common Humanity: Though the holidays present unique challenges for people with eating disorders, it is important to remember that even people without eating disorders experience feelings of grief, stress and overwhelm during the holiday season.  Remind yourself that you are not alone.

To continue reading go to Rising Strong at Center For Discovery

Academic Research Spotlight

Although it has been debated for many years, there is now a general consensus that there is an increased incidence of eating disorders in people with type 1 diabetes. With the addition of insulin omission as a clinical symptom in both anorexia nervosa and bulimia nervosa in the DSM-V, incidence rates may increase even further. People with eating disorders and diabetes develop debilitating complications at a younger age, show a higher rate of disengagement with healthcare teams, are harder to treat and have a significantly higher mortality rate. Little is known, however, about why eating disorders are more common in this demographic or why people with eating disorders are much more difficult to treat. Using an online questionnaire, 98 people with type 1 diabetes and an eating disorder were surveyed in order to determine if they have comorbid psychiatric diagnoses and which terminology they use to describe their eating disorder. This article describes the findings of this survey and discusses the importance of having correct diagnostic terms for eating disorders in people with diabetes. 

Understanding Poor Outcomes in Women with Type 1 Diabetes and Eating Disorders

Allan, Jacqueline Anne. "Understanding Poor Outcomes in Women with Type 1 Diabetes and Eating Disorders." Journal of Diabetes Nursing. January, 2015.

Our friends at Eating Disorder Hope did a special article to highlight some of the difficulties facing diabetics during the holiday season. Read more at 'Encouragement with Managing Diabulimia During the Holiday Season'​

I also got to "meet" another legend in the diabetes world, when the legendary Bonnie Sher interview me for her show. Every Thursday @Bonnie hosts 'Bonnie Sher Show-Boomer Life,' a live 50‐minute Internet radio program dedicated to a generation of Americans who continue to be a major force for social change and poster children for independence and self‐expression. Host Bonnie Sher is the child of stage and screen industry veterans and a protégé of the late Sammy Davis, Jr. She is an actress, musician and entrepreneur with an indelible presence in the entertainment industry, including coveted spot on the “DList,” celebrities living with diabetes. I was honored to join at minute 24 as a co-host but you're doing yourself a real disservice if you miss out on the amazing interview between Bonnie and amazing Jazzer singer musician Julie Budd, at the beginning especially her ballad, "I'm in Love," it just gives you chills! It's the perfect start to set us into the Holiday spirit!