Diabetes Self-Management Blog

I’ve been reading The Diet Survivor’s Handbook, by Judith Matz, LCSW, and Ellen Frankel, LCSW. They tell heavy people not to diet, but to learn to trust their bodies to pick the right foods. “Eat when you’re hungry; eat what your body wants; stop when you’re full” is the mantra. But would this work for you? Should people with diabetes trust their bodies? Let’s think about this…

I’m a big believer in listening to your body. In my book The Art of Getting Well, I have a chapter called “Your Body — Love It or Leave It. ” My e-mail auto-signature reads “Love your body. Love your life.” I believe that we should let our bodies call the shots whenever possible. And I believe that food should be a source of pleasure, not worry. But I can see three problems with this when it comes to diabetes and food.

First, there’s so much bad food around. It’s so easy to get. We may have been trained to eat that food from the time we were children. So now we might think our bodies like it, when really they have never had a choice.

There’s also the issue of emotional eating. A lot of times we get stressed or depressed and reach for comfort food, usually something packed with sugar or fat. We might think that our bodies want it, when really we’re just soothing our feelings.

Matz and Frankel spend a fair amount of space helping people deal with emotional eating. They advise people to ask themselves, “Is this what my body really wants?” “Can I wait a bit on this, or am I really physically hungry?”

They realize people have gotten way out of touch with their bodies. It takes time to relearn how to be aware of the body’s hunger and to hear what it really wants. They also know that emotions will get in the way, but promise that it will get easier with time.

Where does diabetes fit in?
But if you have diabetes, do you have time to learn this way of eating, which they call “attuned eating?” Especially if you’re on insulin, don’t you need to measure your carbohydrate intake and be careful about everything you eat? Can you trust your body to do it for you?

I asked Linda Bacon, PhD, author of Health at Every Size, about this. Bacon teaches nutrition at City College of San Francisco. She said that people with diabetes can learn attuned eating without any special difficulty. Even for people using fast-acting insulins, matching carbohydrate to insulin isn’t an exact science anyway. Both carbohydrate absorption and insulin action vary with physical activity, temperature, and other things, she told me.

Bacon, Matz, and Frankel would agree that restricting your diet with numbers and rigid meal plans gets in the way of your body trying to do what’s right for itself. You may have to restrict somewhat, but try to do it as little as possible.

I would say that a person with diabetes might have to set more limits on emotional eating than other people do. It might be more important to get to the root of the stressors that drive unhealthy eating.

As Laurel Mellin, MA, RD, recommends in her book The Pathway, we might need to get good at asking: What am I angry about? What am I feeling sad, worried, or guilty about that is pushing me to eat this food? What would be a more realistic way of thinking about my situation that wouldn’t be so painful? That way, eating can go back to being something we do for our bodies, something we enjoy, not a drug to treat life’s stresses.

But what do you think? Can you trust your body to pick the right foods for itself? Can you hear your body’s hunger signals, and do you listen to them? Does following a diabetes meal plan interfere with your eating what your body really wants? Please let us know…I’ll have more to say about this next week.


  1. The other problem here for Type 2s is that so often our leptin/ghrelin response - how full we feel - is out of whack. This can also be linked to other endocrine problems such as hypothyroidism, and fat is a powerful endocrine organ in its own right, acting to preserve itself.

    I lost 25Kg on a low carb diet following diagnosis, and was completely amazed to discover a “full” feeling along the way. I’d literally never believed people who turned down treats because they were too full - until it happened to me for the first time in my life!

    Then of course there’s the excess insulin caused by insulin resistance, whose job is to pack away any extra carbs as fat. Eat the diet recommended by the major diabetes associations, and you grow fat around your middle, and interrupt your body’s signals to tell you that you’re full. The conditions are set up for obesity.

    Type 2s often don’t HAVE body signals to listen to. Another area where we sometimes envy you Type 1s, with a much simpler problem set…

    Posted by Nicky |
  2. Hey, Nicky, what do you mean you envy Type 1’s, with a simpler problem set? Explain please.
    On the other side, I envy Type 2’s who manage their diabetes with diet and excercise. No pills, no shots.
    As the old cliche goes, “The grass is always greener on the otherside of the fence” !!!!!!

    Posted by shinaye |
  3. Dear shinaye.

    Not all type 2 have happy days. I bet I inject a lot more insulin than you do.

    Nicky does discribe the diabetic nightmare you can get into with insulin resistance and using insulin to keep the BG in a reasonable range.

    I find it impossible to loose even one ounce. Before insulin I was able to go a day without food like my ancestors. Now I no longer can. Not sure but I think it is psychological. The body is so afraid of a low that it is happiest eating constantly. When I eat I consider food toxic, taking all the pleasure out of the experience which may also be bad.

    With a high degree of insulin resitance a very low carb diet is a must or you will have BG in the several hundreds all of the time. The problem is I am sure I would feel happier eating carbs.

    Posted by CalgaryDiabetic |
  4. I wonder how much the “eat slower, try new flavors, savor the food” approach might help with the issues Nicky and Calgary raise. If it is very hard to feel full when you have Type 2, would it help to give yourself more time to get to fullness?

    I’m serious. Maybe if we treat eating as meditation, if we relax and breathe deeply between bites and learn to focus on the sensations in our bodies, we can start to detect satisfaction and fullness. What do you think? I agree with Nicky and CD about low carbs though.

    Calgary, are you still considering the ice cream and nuts treatment? That sounded interesting.


    Posted by David Spero RN |
  5. Dear David.

    Yes have not had time to go to costco yet. What I was planning to try is to take 1800 calories per day. Which would be hypocaloric for me and divide it 50/50 on a caloric basis between the smoked almonds and the ice cream. then divide this into 4 to 6 portions and enjoy. What do you think is it better to eat least per time and more frequently or less times and eat more?

    To make up for the bulk factor I can take some metamucil or salad. Is it better to eat the salad first and then the ice cream or vice versa. Most joy would be the yummy stuff last?

    Posted by CalgaryDiabetic |
  6. Just how many carbs should a type 2 diabetic consume per day?

    Posted by granny Pat |
  7. Hi All:

    I have Type 2 Diabetes AND Acute Intermittent Porphyria which requires me to eat more healthy carbohydrates to stop very painful, debilating attacks –with abdominal pain, nerve pain, paralysis and severe mental confusion AND to eat to manage my Type 2. Luckily, my endo doctor and family doc have helped me work on a diet that is high carb, low fat but does not raise my sugars. It consists mainly of veggie or lw fat proteins, healthy carbs–whole grains,and no soy foods. Soy is a real problem for me- if I eat it I have symptoms and get sick. So for me it is a balancing act– the thing is — I don’t eat alot of super processed foods as they often contain sulfites, soy and sulphur which are all triggers for an attack. Soo,,,for me everything I eat has to be good for me or I will get sick. The good thing? I have lost 45 pounds in 3 years–my A1c is great and it has changed how I look at food- I see it as for my health not against my health. Food is really to keep me healthy and that is what really counts– at least for me. There are no easy answers and everyone is different.

    Posted by Ellen |
  8. Hi 4 me carbs are ver difficult to avoid, if I don’t ear a meal with “some” carb content I often feel empty. I’m really having a very difficult time at supper. I eat after 7:30 pm most nights. I usually get home late, I stop at Curves 3 times a week and workout approx. 45 minutes. Usually my BS is in the high 90s or 100 after the workout. I have a 25 minute drove home then dinner. Eating healthy foods are good for me, but after I crave sweets. I find it very difficult to curve this craving. My MD has already increased my insulin to 52u in the pm and I have been feeling very anxious about eating. Just last night I had a 6′ Turkey and Ham sand. from Subway no condiments and lettuce, tomatoes and swiss, at 10:30 pm had BS of 58. I got up and felt so awful, I had milk and pbnj with whole wheat bread 1 slice. This morning my FBS was 158mg/dl. Very frustrating! Need encouragement! Thanks!

    Posted by mag |
  9. Ellen’s comment answers Pat’s question of “how many carbs should I eat?” Everyone is different. You have to find what works for you. Really paying close attention to your body is one way, but as in Ellen’s case, doctors or nutritionists can sometimes help. I like what Ellen said about food being “for my health, not against my health.” That’s the point — developing a positive relationship with food will help you feel better.

    Posted by David Spero RN |
  10. hi mag, i understand your frustration. i have to eat to put on a little weight so i can be just the right size yet at the same time i must watch my carbs. the only work out i do is on saturday nights when i do my personal or very own “dance the night away”. i get home pretty late on weekdays, ususally after 8pm. so i devised another way to get around my eating; i wake at 4:00am and take a heavy breakfast, real food @ 5:30am just before i leave the house. something like rice wiht veg sauce, or yam, or some other traditional ghanaian foods with easily digestible carbs. and a fruit…
    because i don’t want risk waht i eat outside, i carry two sandwiches along eat one @ 11am wiht a fruuit juice and the second @ 3:00pm wiht soda water and lemon. that sort of keeps me because i do a lot of sitting at work…
    them in the evening when i get home i take some oats or weetabix, or any whole grsain cereal wiht skimmed milk and crackers. mind you , they are all suger free.
    in Ghana we don’t readily have such options in Ghana but i have to go the extra mile to get them from the few supermarkets or pharmaciese that have them.
    i know a little effort will help you get over it and the best way to eat is to eat what you make.

    try some sugar free recipes too!

    all the best

    Posted by yesutor |
  11. I feel that there should be an injestion of some kind of food or an exercize or a liquid of some kind that can cure diabetes symptoms naturally……. in other words it can be managed naturally

    Posted by Cathleen Musser |

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