Specialized Treatment for Diabetes & Eating Disorders

When individuals diagnosed with Type I diabetes begin taking insulin, they often gain weight. This weight gain is a sign that the body is functioning properly. However, as Type 1 diabetes is commonly diagnosed in childhood or early adolescence, young image-conscious individuals often struggle to accept weight gain as a byproduct of their illness and begin manipulating insulin or engage in other disordered eating behaviors such as dietary restriction or purging to control weight gain. Studies show that women diagnosed with Type 1 diabetes are two and a half times more likely to develop an eating disorder than their peers.

The highly specialized Diabetes Program at the Center for Hope of the Sierras is among a small handful of residential programs in the country with the ability to address both the medical and psychological components of co-occurring diabetes and eating disorders. The Diabetes Program opened in April of 2009 and has since helped women of all ages on the road to recovery from their eating disorder while effectively managing their diabetes.

The Diabetes & Eating Disorders Program is run by a comprehensive team of experts in the field, including:

Dr. Kathryn Eckert, a board certified pediatric endocrinologist
Dr. Steve Graybar, licensed clinical psychologist
Dr. Lorraine Platka-Bird, registered dietician with a Ph.D. in nutritional biochemistry
Licensed Marriage & Family Therapists
Licensed Clinical Social Workers
24 Hour Nursing
24 Hour Patient Assistants

A Gradual Recovery Process

At the Center for Hope of the Sierras, we understand that treatment for co-occurring diabetes and eating disorders requires finding a balance between appropriate insulin intake and slow, gradual weight restoration while closely monitoring the individuals progress. It also requires educating patients about their bodies and their diseases so that they learn to regulate the amount of sugar and calories theyre consuming. This way, patients find a balanced, healthy weight they can be happy with, without feeling compelled to abuse insulin.

There is a certain degree of urgency that accompanies chronic high blood sugar, explains Kathryn Eckert, M.D., a board certified pediatric endocrinologist. Because it is often accompanied by hospitalizations, we have a limited window of time to get blood sugars under control.

At the same time, normalizing blood sugar levels too quickly can be equally harmful. For medical and emotional reasons, we dont want patients gaining 10 pounds in just a few days, as can happen when patients follow the optimum medical recommendations right away, says Dr. Eckert. Ideally, the recovery process is slow and calculated with a great deal of medical monitoring and management.

The Need for Concurrent Treatment

Like all eating disorders, diabulimia and co-occurring diabetes and eating disorders are mental illnesses, which means treatment professionals must do more than tell female individuals with diabetes to stop restricting their insulin or take better care of themselves. Treatment is much more complex than simply gaining weight and learning to properly use insulin. Its about finding a balance between what the body needs (insulin) and what the patient can handle emotionally.

The best outcomes are achieved when patients receive integrated treatment for their diabetes and their eating disorder simultaneously. Its fruitless to engage people in eating disorder treatment without addressing the medical issue of diabetes, says Steve Graybar, Ph.D., licensed psychologist. Treatment for both conditions must occur simultaneously, which means bringing blood sugar levels back into the normal range slowly while at the same time adjusting to weight changes and addressing emotional issues in individual, group, and family therapy.

At the Center for Hope of the Sierras, patients receive intensive support and medical management for their diabetes in addition to the proven treatment program for their eating disorder. The Diabetes Program accounts for the biology of eating disorders and diabetes, but also the psychological, social, and cultural implications that are interwoven into the biological process. With treatment anchored in the bio-psycho-social model, patients receive

Comprehensive Medical Management, including nutritional education and rehabilitation, blood sugar monitoring/testing, insulin administration, a monitored exercise program, and more.

Individual, Group, and Family Therapy, which address the food, weight, body image, and interpersonal issues underlying an eating disorder as well as the emotional factors that are interfering with responsible self-care for the treatment of diabetes.

A Home-Like Environment with 24-Hour Nursing and Social Support, where women can connect in a meaningful way with peer, staff, and themselves.

A Mulit-Disciplinary Team of Experts in a CARF Accredited Residential Program, including a board-certified pediatric endocrinologist, a registered dietician with a doctorate degree in nutritional biochemistry, licensed psychologists and marriage and family therapists, a psychiatrist, and 24-hour nursing and residential staff.

With treatment and medical stabilization, patients learn that constant feelings of irritability, dehydration, and fatigue are not normal and that they can feel better when managing their diabetes in a healthy way. Patients learn better ways to cope with the feelings brought on by weight gain, get educated about nutrition, diabetes management, and healthy living, and develop a support network that understands the implications of a dual diagnosis.

Diabetes and eating disorders are both complex diseases when taken separately; when the conditions exist in the same person, the results can be devastating, with consequences ranging from nerve damage to kidney failure to death.