One of SweetSpot’s advisors, Michael Fulop, and I were giving a talk titled ‘Nag, Shame, and Blame: not working for you?‘ We had all the ingredients needed to keep it interesting, and not necessarily in a good way: it was at the end of a very long day at the Expo, it was the first time Michael and I had tag-teamed for a talk, my folks were quietly sitting in the audience, and generally I would rather eat barrels of overcooked spinach than talk to a large group. In the end, things turned out quite well, I’m glad we did it, and we’ve talked about doing a few more. Watch out!
We covered many topics, but someone asked about eating habits causing diabetes and expressed a sense of deep guilt and shame. Michael, being an experienced psychologist, quickly addressed this, not able to let such a toxic topic fester.
I’ll admit that the comment surprised me. I realized afterward that I rarely hear someone completely blame themselves for their diabetes. I’ve been in a rather insular world with people who have Type 1 or who have had the disease for a long time, so this sense of guilt and personal fault doesn’t often come up. I’m glad Michael jumped in, because I was sitting there feeling a bit stupefied.
I’m somewhat sheepishly going to bypass the issue of what lead up to this person’s guilt: eating habits. It is not an area I am familiar with and it is a minefield of raw emotion. The debate has become incredibly brutal. For example, a study titled “Changes in Perceived Weight Discrimination Among Americans…” was recently published in Obesity, a scientific journal owned by Nature, and here is a group of responses to that article that actually highlight the articles points about discrimination quite well (update: the forum I linked to is self-moderating, so some of the more acidic comments have been demoted).
Instead of focusing on the fault, how can we address that guilt and move forward?
Going back to this particular case, Michael hit it from two angles (we didn’t have a lot of time since this was during a Q & A at a public talk). One was to talk about the root cause of the guilt, which was the belief that eating habits (weight and lifestyle) caused the diabetes. Michael pointed out that the literature doesn’t talk about diabetes as having a single cause so much as a series of risk factors. This long and growing list does indeed include weight and lifestyle, but also age, family history, and race. Outsiders tend to underestimate the complexity of this disease. The second angle was about the need for support in moving through the guilt.
These points seem straight forward, and perhaps self evident. Yet the response from this person was part surprise and part relief; it seems their doctor just handed over some pills, said lose some weight and see you in six months. There was no framework in which to come to terms with and understand this complex disease.
The challenges of living with diabetes do not lie in the traditional medical realm (barring the search for a cure, of course!). If it was as simple as following exactly what the doctor orders, which could include testing 3-12 times a day and taking the occasional shot of insulin, diabetes would be a significantly lighter burden than it really is. The mental trials facing those who live with diabetes are too seldom addressed.
). We are so used to entering a username and password that anything different requires us to stop and think, which for just getting access to an account is not a good thing. 
