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All articles that appear here have been submitted and reprinted with the permission of the authors. Copyrights are retained by the original authors and you must contact them for permission to reprint. If you have something you'd like to submit yourself please send it to [email protected]
CHARLENE'S STORY
by: Susan M. Julien
Although the following story is purely fictional, the factual information conveyed in it is accurate and substantiated.
The story of Charlene, a Type I diabetic struggling with an eating disorder.
When Charlene was diagnosed with juvenile diabetes at the age of eight, my
husband and I were heartbroken. At the time, we knew so little about
diabetes. Would our precious daughter be able to live a normal life? She was
our only child and we wanted her to be happy and successful - not burdened by
a chronic illness. Although we never discussed the diabetes with her, we knew
Charlene's life was bound to be more difficult because of this disease and
because of its deadly complications.
As a result, we smothered her with love and concern, yet Charlene seemed to
take the changes in her lifestyle in stride. Not once did she complain about
the insulin shots, the sugar highs and lows, or the meal plan she followed
faithfully. In fact, she rarely talked about it. I fussed over meals,
encouraged her to write down everything she ate, and demanded she monitor her
blood sugar frequently. And she did. We were so very proud of our little
girl. As the years passed, she developed into an attractive, athletic and
popular young woman. She appeared to be a normal, healthy child.
The summer before Charlene's sophomore year in high school, we noticed our
cheery, talkative daughter seemed moody. At that time, we were convinced it
was due to hormonal changes. It never occurred to us that it could be more.
After all, Charlene had never seemed bothered by her diabetes, school, friends
or anything. But both my husband and I had read that the physical and
emotional stress of diabetes exacerbates depression. I encouraged her to talk
about her feelings. I inquired about her weight loss. But Charlene assured
her father and I everything was fine. She admitted her weight had dropped
some from running every day, but that it was important she keep in shape for
cheerleading competitions. She also said she would speak to the doctor about
her frequent trips to the bathroom. We believed her.
A month later, I awoke late at night to the sound of someone vomiting. I
rushed to Charlene's bathroom, and found her clutching the edge of the toilet
seat, tears streaming from her bloodshot eyes. At that moment, I realized
just what was happening. And how blind we had been. Here, in front of our
eyes, our darling daughter had developed an eating disorder. She was bingeing
and purging her food. She was ignoring her sugar highs and lows. She was
even skipping insulin shots to control her weight. I think I knew it, but
didn't want to acknowledge it. I told myself, Charlene would never do that.
But she did. On that night I realized Charlene is bulimic as well as
diabetic. I vowed I would do everything I could to help her. I thought my
husband and I could make it better, even if we couldn't "fix" the diabetes.
Later, I learned the cold-hearted fact: it was my daughter's responsibility to
"fix" the eating disorder.
Charlene is recovering slowly and steadily. We sought out help through
Charlene's doctor, the Juvenile Diabetes Foundation, and the National
Association for Anorexia Nervosa and Associated Disorders (ANAD). Through
them, we learned more about the disease and what we could do to support
Charlene in her recovery. Most importantly, Charlene was referred to a
therapist specially trained in the treatment of eating disorders in diabetics.
The first step was to get Charlene back on a healthier track. In short, to
stabilize her blood sugars and help her maintain a nutritious meal plan. Once
a somewhat normal routine was established, Charlene began to have more energy,
feel less moody and sleep better. Only then was she ready to tackle the
bigger issues in therapy like body image and self-esteem.
For Charlene and most bulimics, anorexics and binge eaters, the illness is not
about food and weight, although it appears to be. It is about self-esteem and
body image. It is about independence and identity. It is about being your
own caretaker and loving yourself unconditionally. That is why therapy is so
essential. Without it, recovery is virtually impossible. And when the eating
disorder involves a child, the parents and siblings are encouraged to
participate in family therapy.
The physical consequences of an eating disorder are serious, but when someone
with an eating disorder also has diabetes, the effects are more immediate and
devastating. For diabetic bulimics and anorexics, it is crucial to treat the
symptoms of bingeing and purging, starvation and insulin manipulation
immediately. It is important to seek out a physician and a dietitian who are
both willing to work with this therapist. As we found with Charlene's
recovery process, a professional team approach to guide and support the
diabetic with an eating disorder holds a brighter promise of recovery. The
team needs to understand how eating disorders dovetail with diabetes. By the
nature of the illness and the treatment of it, diabetes can create a
preoccupation with food. Secondly, it can lead a child to view food as "the
enemy", as something dangerous. If a diabetic feels his or her life is out of
control because of the diabetes, an excessive control of food and weight may
be the outcome of wanting to feel in control. And as my husband and I
learned, teens with diabetes often feel their families are overly involved in
their lives. To rebel and strive for independence, food and weight obsession
becomes a teen's power, and an eating disorder becomes his or her identity.
In my daughter's case, this was true.
Months have passed since the night I discovered my daughter is bulimic. As
Charlene's parents, my husband and I have learned to support rather than
smother, encourage instead of demand, and love without conditions or
expectations. It has not been easy for Charlene or for us. In family
therapy, we have admitted to making mistakes, shed more than a few tears,
raised our voices in anger, but always, ended our sessions with hugs of love.
As parents, my husband and I did the best we could, but often, in our efforts
to raise a smart, successful daughter, we criticized too frequently and
praised too little. Today, we focus on the positive, listen more often, and
encourage Charlene to be her own person.
Even after participating in Charlene's treatment and therapy, supporting my
daughter in her daily struggle to recover, and reading numerous books, I
remain somewhat baffled by the complexity of eating disorders. But I have
learned enough to recognize the symptoms, share my story with others as a
means of support, and help prevent eating disorders.
In conclusion, I ask you to consider:
Because bulimia and anorexia are body image disorders, it is important to
recognize and help reduce the societal pressure on women to be pretty and
thin. This pressure fuels eating disorders among women, and as long as women
feel judged solely on appearance, eating disorders will continue to thrive in
our society.
Poor self-esteem drives bulimics and anorexics to find a means to feel
important, significant and powerful at any cost, even one's health. As
parents, we must make a conscious and consistent effort to raise children with
healthy self-esteem. Unconditional love, acceptance of a child's
individuality and praise rather than shame and blame will enable them to make
their own healthy choices. If a person is self-confident and feels worthy of
love, he or she will be able to develop healthy coping mechanisms, free of
alcohol abuse, disordered eating or other addictive behaviors.
To treat only the symptoms of self-induced starvation or the binge-and-purge
cycle is to ignore the underlying causes of disordered eating. A strong need
(yet intense fear) of separation and individuation from parents, siblings,
even spouses is at the root of most eating disorders. Therapy is a necessity
in recovery, and often, anti-depressants help alleviate the emotional pain
that accompanies the challenge of eliminating old behaviors and replacing them
with healthy ones. With the help of an understanding physician, an eating
disorder therapist and a knowledgeable dietitian, the process of accepting and
loving one's self unconditionally is not only possible, it is highly probable.
read more about Diabetes and Eating Disorders
Susan M. Julien
special thanks to two friends for their assistance:
©1998 Susan M. Julien.
Reprinted with permission.
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