Please note that this is an Archived article and may contain content that is out of date. The use of she/her/hers pronouns in some articles is not intended to be exclusionary. Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights.
Did you know that women living with diabetes are 2.5 times more likely to be diagnosed with an eating disorder? Since there is a high prevalence of this co-occurring illness, and because of the difficulty of treating it, Center for Change (CFC) has a nationally known program to treat people living with this. Jenaca Beagley, MSN, APRN, NP-C, CDE, leads that specialized team. Though the letters after her name are impressive, what has always impressed me most about her is how she uses her lived experience of 35 years with type 1 diabetes to deliver personalized, empathetic care for patients.
What have you loved about working for CFC?
It’s my tenth anniversary working at CFC! Eating disorders (ED) can be so tricky to treat alongside a diagnosis of type 1 diabetes. Each person I work with has a different story and experience, which impacts how the ED shows up in their life. In the past ten years, we’ve focused on individualized treatment and how we can assist their recovery.
I want to know more about your connection to diabetes.
I’ve had type 1 diabetes for 35 years! I was eight when I was diagnosed. There is street cred when you introduce yourself to a patient with T1D and tell them how long you’ve had it. There’s an automatic connection; they immediately know that we’ve shared similar struggles (not ED, but the numbers, the food, working for a common goal). Same Boat Therapy is what I like to call it. We’re in this together. There’s a level of perfectionism that people with diabetes struggle with. The first thing I like to address when I meet with a new patient. “When you’re here in treatment, we don’t expect you to have perfect blood sugar levels. That’s not normal to have in regular life, and certainly not when we’re also focusing on ED recovery.” Perfectionism even goes with the idea that they want a “perfect” recovery with perfect blood sugars. We challenge that black-and-white thinking. If the ED is so loud, it’s really hard for someone who’s a provider to be singularly focused on having you eat or just take your insulin. This is ED brain. To find someone who understands that is hard. There is support out there; there are people who will understand. That’s why CFC exists.
What should people know most about people with diabetes and an eating disorder?
Understand that it’s complicated; it’s not as simple as “just eat” or “just take your insulin.” The way people communicate with someone with diabetes is HUGE! Having an ED in our culture is already tricky, but adding in diabetes is challenging. You always feel blamed and judged for diabetes. You shouldn’t feel guilty that you didn’t ask for it or that it was not your fault.
What is complicated about treating diabetes and an eating disorder?
For one, many diabetes management strategies parallel ED thinking. Someone might think they’re well-meaning by suggesting things to people with diabetes (who are already struggling with an ED but maybe don’t know), such as eating less carbs and exercising more….that can feed into the ED thinking. This is what makes it so complicated; they contradict each other. Understanding both and focusing not on good and bad foods but on the timing of those foods. Figuring out how you can both manage diabetes and also challenge the eating disorder. That’s why it’s so tricky! Patients have such a fear of insulin. In the ED brain, it twists the truth to spiral into your ED. EDs like to hear half-truths, such as “Insulin will make you gain weight.” We need to fact-check when they’re struggling with distortions.
What are some things that have changed in the past ten years of treatment?
Diabetes technology and how we incorporate that into treatment. With the advancements in continuous glucose monitors, we ensure everyone has one when they’re here. We’ve seen advancements with insulin pumps that have assisted in people being able to be more flexible when we’re focusing on the eating disorder side of treatment. We have different clients with different experiences; it’s helped us continue to fine-tune the program. Each patient has different challenges. We are flexible and adaptable.
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Center for Change’s Unique Treatment Approach:
At Center for Change, we provide full-service diabulimia treatment, with round-the-clock nursing and dietary care that stabilizes blood sugar levels long in flux due to the eating disorder. Our physicians and nurse practitioners evaluate patients consistently and provide medical interventions for their specific needs. Our Certified Diabetic Educator performs weekly assessments for each patient with diabetes, collaborating with members of the treatment team and outside medical specialists, such as the patient’s endocrinologist, to ensure the best individualized care and treatment our patients deserve.
The medical and dietary teams work closely together to ensure that individual meal plans are created to meet the patient’s dietary needs.