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Anorexia and pre-diabetes

Elenas

Active Member
I’ve just received a diagnosis of “anorexia nervosa” it’s something I have difficulty to accept as I feel I don’t fit into the diagnosis.

Everything is so confusing I’ve been diagnosed with pre diabetes ( insulin resistance) last year , and yes I did everything I could to control my insulin and BS so it won’t spike . Everyone adviced me to do a low carb diet ; so I eventually start to control my carbs intake like everone with diabetes is doing.
I’ve lost weight it’s true that I’ve lost a lot … and I wasn’t overweight , so I end up with this low weight. Which my endocrinologist first thought that will improved my numbers… it didn’t.

I have tried to gain back kg with healthy fat, I even ask for help here many time about how I can I safely gain weight .
I did my best , olive oil, avocado , nuts , eggs everydays ….
Well unfortunatelyt I keep losing, I think that what clearly can make me gain weight is high carbs such as rice, pasta, bread and juices…
But without insulin ( Im a type 2) and without metformin ( I don’t tolerate it) I just can’t take the risk to eat this ? Will it heavily spike my BS… can I?

Now they are asking my to gain weight ( my bmi is 16) but just how can I efficiently manage my pre diabetes and weight gain at the same time… I don’t know , they are asking me to eat meat and I’m a vegetarian since my 13 years old so it’s a no way for me.

Everything I read about diabetes type 2 is about dieting, exercising, losing weight… I feel like an alien with the opposite problem.
Now I’m about to start a therapy for my “anorexia “, but will it fit my pre diabetes problems? They are more like “intuitive eating” , “lot of small snack” … while I thought I needed intermittent fasting for reduced my insulin.
I’m so confused .
Is there anyone here that share such kind of problems with an ED, how do you mange your botth condition?
 
Can I just double check: your profile says you are prediabetic, but you mention insulin use

What sort of diabetes do you have, are you on medication for it, and what is your Hba1c?.

I don't want to give the wrong advice.
 
Hi,
I think you mention insulin/carbs in the context of your body's own insulin?
I assume you got a pre diabetes diagnosis and got into the low carb lifestyle and lost too much weight.
Is it possible you are too controlling of your carb intake possibly due to a fear of getting high blood sugars/insulin resistance? I don't know if you had a history of losing emotional issues with food, body image etc. as it is common for a diabetic (usually someone who has been told to eat in a strict way) to develop an eating disorder. I did but I am not saying that this is the right diagnosis for you.
I also know someone who has struggled to stop losing weight after having a diabetes diagnosis, doing a lot more exercise then struggling to eat enough fat and protein to gain back lost fat/muscle.
My advice to you would be the same if this is that kind of problem that you have i.e. you want to regain weight , that you should see what level of carbohydrates you can tolerate before your blood sugars get into diabetic range. Is there something you miss eating that you can add in again like toast or cereal, without it leading you back down the diabetes track again?
Eating the odd slice of bread etc. won't make you diabetic but if the thought of that is scary I think you may have a problem and will need some help to get back to a normal eating pattern and re gain weight. A healthy BMI is 18-25 with normal energy levels so I'd hope that with the right kind of diet and exercise you could get back to that whilst still keeping up our good habits re quality of foods!
 
Have you tested yourself against those old carb favourites to see if you spike.
I'd advise testing at 1 hour & then 2 with rice/pasta.
Have any of your labs included a c-peptide test ?
 
@Elenas maybe you are eating too little... just too small portions. If you are undereating then weight loss follows, as does malnutrition which is probably what the medics are afraid of. If you can show them that you eat more they may change their minds
 

Elenas - How is your relationship with food, and has that changed since your diagnosis?

I lived with anorexia nervosa for a number of years in my 20s and it's not a nice place to be. I think the basis your of your GPs diagnosis is important. Is it purely because you have lost weight to the extent you are pretty underweight, or did you talk about your longer terms relationship with food?

The word Anorexia can be defines as the lack or loss of appetite for food, so it can happen for all manner or reasons, not necessarily associated with the serious and worrying condition of anorexia nervosa.

These days I am a healthy weight, albeit at the lower end of the healthy BMI range. Should I happen to lose a bit of weight (it often happens if I'm travelling - in the heat, or massively active) I firstly focus on upping my protein, then adding a bit of a fat to that. Personally, if I eat too much fat I find my bowel gets a bit too frisky.
 
The best way to find out how many carbs you can eat without spiking too high is to test. If your blood sugars are fine, and the test 2 hrs after eating is fine then why not eat a little more carbs - maybe some fruit or a slice of bread to see how you do?

I was lucky as even with a diagnosis of T2 I got into remission by cutting to 100g of carbs then down to 85g to get rid of the early morning spike. I'm now back to between 100g - 120g a day without any problems.

Meanwhile try things like a low sugar fruit crumble to up the calories? - I make mine with cooked rhubarb, maybe with a few raspberries added in, sweetened with erythritol then topped with ground almonds (I rub in a little butter to the almonds). Bake for about 20 mins on 190C, then eat with double cream. I also made strawberry lollies when I had too many in - cooked the berries for a few seconds to soften them, sweetened then added to whipped double cream and frozen in small portions (about 2 strawberries a portion).
I also make a substitute for potato mash with a mix of butternut squash and kohlrabi - the kohlrabi needs a lot of cooking so I do that first, mash together then add butter and/or cream and black pepper.
 
I love that description - 'frisky bowel' from too many fat bombs!
 
Elenas, I was pre diabetic and had problems keeping weight on when first diagnosed and commencing low carbing. I have also more recently had gastritis and a hiatis hernia diagnosed after losing a lot of weight, so much weight that my gp put me on the two week cancer pathway.

The way I maintain weight is by daily weighing.

When I lost the weight with my stomach problems I put it back on by having breakfast, early lunch, tea time snack and then dinner. So full fat greek yoghurt with nuts, thick peanut butter sandwich, with livlife bread at under 4 carbs a slice, lots of avocados, macadamia nuts, I kept the calories up and eat whether I was hungry or not. I did similar when I was first diagnosed pre diabetic only I kept to 3 meals a day to keep my insulin levels down,all low carb but a lot of it.
 
lucylocket61 said:
Can I just double check: your profile says you are prediabetic, but you mention insulin use

What sort of diabetes do you have, are you on medication for it, and what is your Hba1c?.

I don't want to give the wrong advice.
Click to expand...

I don’t inject insulin, i actually mention insulin level as I have insulin resistance and I have checked my insulin level at hospital (it was too high).
I’m in a pre diabetic condition , hba1c is nowadays at 5.6 .
I spike heavily after eating any kind of carbs so I’m on a strick diet control.
 

Yes exactly, my own insulin level, my pancreas produce it too much, and it’s not well absorbed by my cell ( insulin resistance)

Well I actually use my home glucose monitor, and every single fork of carbs spike me.
If I eat 20g of carbs I reach 250 mg/dl 2h after, so yes I admit I’m kind of dead scared to eat carbs.
My body tolerate some veggies with low glycemic index , but that’s it.
After carbs I feel thirsty and at night I have disconfort in my leg .

I don’t feel I’m anorexic in the sence that I’m okay with the fact to gain weight and will happily gain some , just I don’t suceed because i don’t know what to eat to make me gain weight without spike my BS.
 

I push myself the best I can
I will try harder
 

Well I think they base it on my BMI , + the fact that I don’t want to eat meat, and fear so much for the carbs.
The also push on metformin so I can eat more carbs but it made me sick to take metformin so I refuse. Then they eventually consider that I don’t want to make change and try to gain weight base on this .

So now they are talking about tube feeding …
To be honnest I don’t feel they listen to me.
 
Elenas said:
I don’t feel I’m anorexic in the sence that I’m okay with the fact to gain weight and will happily gain some , just I don’t suceed because i don’t know what to eat to make me gain weight without spike my BS.
Click to expand...
Have you actually counted the calories you eat in a day to make sure you aren't accidentally on a low cal diet?
 

Thank you so much , well from what I’m testing my body is getting hyper with more than 50g of carbs a meal …
I can reach up to 280 /300 mg/dl if I eat more than 50g . So I’m pretty limitated because of that.
What I’m eating everyday is salad with olive oild goat cheese, nuts,tofu, soya protein steak, eggs, full fat yogurt, cucumber, spinach, brocoli, cauliflower, mizo soup…
This make me good BS result.
 

So you think I should snack more?
I m currently not taking breakfast or snack because I’ve seen it’s bad for insulin, that it spike it and so increases the insulin resistance.
Will it be okay for me to add snack?
 
Antje77 said:
Have you actually counted the calories you eat in a day to make sure you aren't accidentally on a low cal diet?
Click to expand...

Yes… and it’s indeed too low calories about 800. But I sincerely wonder where to find the calories as I eat mostly salad with eggs/ cheese/ tofu…
It’s a normal size plate I’ m making so I don’t see what I can eat more to have more calories
I would dream to have juice , icetea, pasta….
 
You can have lots of green veg with butter or olive oil on. I am unsure about you saying about 50g of carbs a meal - bread has only 18g of carbs a slice. Lots of cheese is good and higher in calories.

When you say you can reach 250mg/dl after 20g of carbs, what was your pre-meal figure? It may be that you are running high in the background, so the meal isnt spiking you much. Have they tested you for type 1?
 

Unfortunately, the harsh truth is that with a BMI of 16, then consuming 800 calories a day, you are not on a healthy path. You need to find a way to consume more. I'm not necessarily saying you need to eat more carbs. As someone who lives a low carb lifestyle, that would rather go against me, but more nutritious foods.

You mention not caring for meat; does this mean you are vegetarian, you just don't care for it too much or you are uncomfortable due to the calorie dense nature of some meats? Do you eat fish? Fish can be excellent, and oily fish is nutrient dense.

If eating more nutritious food pushes your blood sugars up too much then it could be you need some pharmaceutical support to cope. If your numbers go very high, has your doctor ruled that you could be a slow onset Type 1?

Whatever is going on, it is important you find a way to stabilise your weight. Ending up with malnutrition - or worse, will not enhance your life, no matter what your blood sugars are.
 
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