Diabetes, Celiac Disease, and the "Ideal Body Image" on the Development of Disordered Eating Behaviors

My cousin was diagnosed with diabetes and celiac disease when she was four years old.  She is now 11 going on 32, and she does not even remember the time when she did not have to watch what she eats carefully and track her blood sugar and insulin doses.  I worry about her often, but she has a… well, let us just say that she has a very dominant personality that I am convinced helps her cope with how difficult it is to have these two diseases at the same time.  She is very good at monitoring for herself the food that her parents give her and is quick to demand explanations of what exactly she is eating for meals and snacks given to her at school, and she makes blood glucose monitors look like the coolest things since sliced bread.

I was doing some research on celiac disease, and found an interesting article that looks at Disordered Eating Behaviors (DEBs) in people who specifically have both diabetes mellitus and celiac disease (Latzer et al., 2018).  According to the study, in groups with similar demographics, people with both type 1 diabetes mellitus and celiac were more predisposed to DEBs than those who only have one or the other.  The carb-counting and insulin treatment that accompanies diabetes treatments are associated with weight gain, which might promote negative body image and low self-esteem in individuals.  In addition to this, sticking to a gluten-free (GF) diet might provoke anxiety and avoidance of going out to eat because not all restaurants provide GF options.  Women in particular with both diagnoses in the study were at an increased risk to develop DEBs (Latzer et al., 2018).

With the combined struggles of having diabetes and celiac, and with the treatments and social interactions that come with having them, there is a chance that my cousin could develop a DEB.  Her dominant personality and confidence in herself and her abilities now give me hope that she will be okay, but reading studies like this, it makes me wonder how many people have mental and emotional hardships because their physiology is different than healthy and normal.  And it makes me sad to think that some of the anxiety and depression that people have is due to other people and societal “norms” and fads.  Body image should never be an issue, but magazines and social media, made and monitored and run by other people, say otherwise.  There is an extremely unhealthy image of the way women should look physically that covers the walls of every social media platform, and that has a huge impact on anyone who does not have that “idealized body.”

This social pressure can have debilitating effects on women of any age, race, social class, and religion, and it is disheartening to think that people are harmed by this.  It is even more disheartening to think that there are people with diseases, people like my cousin, who are even more susceptible to this harm.  I am glad that I stumbled across this journal article about DEB’s, because it only makes me that much more aware of my own contribution to negative societal pressures as well as my own self confidence and mental health.  Articles like this allow people to understand more how others are affected by physiology, and I now better recognize how important medical and scientific communication is, especially when it comes to issues rooted in society.

Latzer, I. T., Rachmiel, M., Levin, N. Z., Mazor-Aronovitch, K., Landau, Z., Ben-David, R. F., Pinhas-Hamiel, O. (2018). Increased prevalence of disordered eating in the dual diagnosis of type 1 diabetes mellitus and celiac disease. Pediatric Diabetes. doi:10.1111/pedi.12653