This article was written by psychologist Dr Jen Nash, who lives with type 1 diabetes.
Your relationship with food
Did you know that you have a ‘relationship’ with food, in the same way that you have a relationship with friends, family and loved ones?
The diagnosis of diabetes brings this relationship into sharp focus – suddenly lots of ‘strangers’ (in the form of healthcare professionals) are intensely interested in your diet...
They may often ask many detailed questions about the ‘what’, ‘how much’ and ‘when’ of your relationship with food.
It's natural to feel a bit scrutinised by this attention, and perhaps even guarded. The intentions of even the most well-meaning healthcare professional can feel a bit intrusive.
This article will help you think about how to adjust your mindset following your diagnosis so you can feel more equipped to face the food challenges ahead of eating with diabetes.
Hunger is not the only reason we eat
Food is such a pleasure, and life with diabetes doesn’t mean the end of this. The difficulty is that in our food-abundant environments there are over 30+ reasons why we eat, and hunger is just one of them.
We often beat ourselves up for not being able to stick to our healthy eating plans, but traditional advice tends to assume that we are only eating when we’re hungry and stopping when we’re full.
All of us - with or without diabetes, and of all shapes and sizes - know that this is often not the case.
Being sociable doesn’t always have to involve eating
Eating with others is a great way of spending quality time and connecting with those we love and care about.
While sharing meals with family and friends is one of life’s pleasures, many people feel that they have very little control over the food they eat when they’re with others.
It’s as if spending time with friends and family always has to involve food and has become the default position: “But we always go for coffee and cake!”
Our friends are eating, so we eat too. Sharing food can be fun and are great ways of nurturing and fostering connections. But is food the only way to bond with friends and family?
Of course, there’s nothing wrong with this, but if you’re trying to maintain a healthy weight, or struggling to manage your diabetes, you may want to increase your feelings of control around eating socially. If this is the case, then it’s a good idea to think about whether there are other ways, apart from eating, that you can use to bond.
Are you stuck in a behaviour rut?
As humans, we’re predictable creatures and we all have social ‘defaults’ or ‘scripts’ that we tend to play out time after time. Unconsciously, we tend to repeat expected behaviours in given situations.
We need to learn from this, identify what our personal ‘social script’ or scenarios about eating with others and, just like the director of a movie, decide if the script or scenario needs changing or indeed entirely rewritten!
Think back over the social occasions you’ve been involved in during the last 6-12 months, events like:
- Christmas/religious celebrations
- birthdays
- weddings
- events with buffets
- children’s parties/events
- going to a restaurant – formal to fast-food
- going for a coffee.
When it comes to your eating behaviours, how predictable are these social events to you? Are you happy with the way things are? What could you change?
Marsha’s story
In this hypothetical story, Marsha has been living with type 2 diabetes for three years, and shares her experiences:
“I started by thinking about how I usually ‘do’ having a coffee and realised that I always get a cake with it – even if I’ve just eaten a meal or whether or not I am actually in the mood for something sweet.
“I would get a cake because I had a script that said, ‘I always have cake with a coffee’. While this was a reasonable script when going for a coffee was just an occasional treat – now that I have a coffee most days as I am out of the house, it’s a recipe for disaster!
“I realised that I could experiment by challenging my thinking and asking myself whether I really did want a piece of cake. Coffee shops sell other snacks I could have instead, or I could try having my coffee in the café with the option that I could always go back and get a piece of cake if it was still calling me!”
The irony is that Marsha may end up eating something with more calories than the cake, but that’s not the point of this experiment.
The point is that she’s learning how to figure out her ‘script’ and find ways to challenge it and not settle for a default script that doesn’t suit her. Of course, some of us may not go for a coffee as often as Marsha, but we can always practice these skills at other times – especially around the people we find it hard to say ‘no’ to when they offer us food.
Think about your behaviour and the script that goes with it in social situations. Here are some examples that may be familiar to you:
- “We always have chips at the weekend”
- “I have to eat a bit of everything at a party”
- “I always buy something to eat with a coffee”
- “I always accept free samples of food when offered them”
Can you change your ‘script’?
Did you make a decision to repeatedly behave in this way with the script that goes with it? Is it helpful? Do you want to experiment with changing it? If so, here are some ideas of other things you might like to do with friends and family – try one or two of the following and see how you get on:
- play a board or card game
- look at photos
- go for a walk and talk
- play a sport together
- do a puzzle or crossword
- volunteer for a local charity
- watch TV or a film
- go for a drive
- learn something new together
- visit a historical place
- do some gardening
- go to a local attraction
- try go-karting
- go on a bus or train ride together
- be by water (river, lake or garden pond).
And finally, simply drink the coffee – without the cake.
Set yourself achievable goals
Remember that living with diabetes doesn’t mean you need to feel restricted - you just need to find the balance between ‘healthy’ foods and ‘treat’ foods.
I often encourage application of the ‘80:20 rule’ or ‘90:10 rule’ to food decisions (making healthy food choices 80-90% of the time is much more likely to be successful in the long-term than striving for 100% at all times).
Talk to your healthcare professional about the best way to manage this healthy balance. There are a number of practical things you can do to help give yourself the best possible start:
- Remove foods that you know are your ‘go-to’ temptations.
- Set small, achievable goals.
- Keep a food diary if you find tracking helpful.
- Experiment with one new, healthy food or recipe each week – you never know what delicious healthy new foods you may discover.
- Remember that preparation is a key part of succeeding at anything in life. Experiment with aiming to think ahead in your day or week in order to prepare. This way, you’re less likely to grab a takeaway purely because there’s nothing quick to hand.
Slipping off the healthy eating wagon
Just like relationships with spouses, partners and family members have their ‘ups and downs’, it’s completely usual for your relationship with food to have similar ebbs and flows.
Food is everywhere and has so many meanings, that it's common to find the journey of navigating it tricky at times.
If you’re someone who tends to beat yourself up for getting off track, I encourage you to treat your relationship with food in the same way you might play a game, as explained below.
When you play a sudoku puzzle or a game on your phone, you might ‘fail’ a level or don't perform as well as you may like, but you probably also keep your ‘performance’ in perspective. Games allows us to have an ‘oh well’ attitude, which means that we don’t let our less-than-perfect performance one day stop us from playing the next.
How can you experiment with developing a similar kind of attitude towards your food choices – if you make a less-than-perfect choice, how can you keep it in perspective, and is there anything you can learn and try differently for next time?
Be accountable
We’re also more likely to achieve a goal when we have some accountability. If you can, ‘go public’ with your intention with a supportive health professional, friend or family member.
Evidence shows you’re more likely to succeed as you know you’re going to have to ‘report back’ to them. This can be a useful strategy in the habit formation stage, until new behaviours become second nature.
A final note
Food is a relationship that you’ll have for life, so by taking some time to reflect and develop the skills to manage it as well as you can, you will ensure it’s as harmonious as it can be.
You can also feel confident that you are doing all that you can to ensure your health is as good as it can be on the diabetes journey.
Keep in mind that nobody is perfect and that everyone's health, diabetes and diet is likely to be managed differently, so focus on yourself and what it takes for you to be in the best health you can be.
