The Dangerous Intersection of Fatphobia and Type 1 Diabetes

Living with Type 1 diabetes is challenging enough, but when you add the pervasive influence of Fatphobia into the mix, it creates a toxic environment that can be both physically and mentally damaging. Fatphobia can present as humiliating or derogatory words, actions, or suggestions. and it permeates many aspects of society, including healthcare. When it intersects with Type 1 diabetes management, the results can be devastating.

So lets talk about the Impact of Fatphobia on Diabetes Management. There are two issues here that i have experienced. Firstly there is the stigma of weight and secondly there is the misconception of Weight and Control.    

So i have talked about the issue around the stigma of weight not only with diabeties care but in healthcare in general many time before in my blogs. However from this issue I have a unique perspective of this after being obese for a long period of time, also being underweight and suffering with a Eating Disorder. So what are some of the things that comes with the stigma of weight?

People with Type 1 diabetes are already tasked with managing their blood glucose levels, insulin intake, and overall health. But when Fatphobia comes into play, it adds an additional layer of stress. Individuals may feel pressure to maintain a certain weight to avoid judgment from healthcare professionals, family, or even themselves. This can lead to unhealthy behaviours, such as under dosing insulin to prevent weight gain or adopting restrictive eating patterns that harm both mental and physical health.

The next issue i want to talk about is the Misconception of Weight and Control. Fatphobia often perpetuates the dangerous myth that weight is entirely within an individual’s control and that losing weight will automatically lead to better health outcomes. This ignores the complexities of Type 1 diabetes, where weight can fluctuate due to factors beyond one’s control, such as insulin resistance, hormonal changes, or even the body’s response to treatment. The obsession with weight loss can distract from what truly matters: maintaining stable blood sugar levels and overall well-being. we as diabeties deal with numbers all the time but quite often are scolded for the numbers on the scales when we go to clinic. I have never understood why HCPs need to know what i weight in terms of treating my diabeties which has nothing to do with those pesky numbers on those scales.  

Next thing i want to talk about is the healthcare bias and misdiagnosis that can come with the presence of Fatphobia within healthcare. So the Dismissal of Symptoms that the presence of Fatphobia can lead to, is where symptoms are overlooked or misattributed to weight rather than being properly diagnosed and treated. For someone with Type 1 diabetes, this can mean that signs of complications, such as diabetic ketoacidosis (DKA) or neuropathy, are ignored because a healthcare provider is more focused on weight than on the underlying condition. This can delay critical interventions and worsen health outcomes. There is also the misdiagnosis of many people as Type 2 diabetic rather than Type 1 due to the bias within healthcare based not only on weight but age. I have spoken to a number of people who have had this experience and it delays treatment and ultimately can affect someones health long term.

The bias doesn’t stop at diagnosis. Fatphobia can also create barriers to receiving proper treatment. For example, a healthcare provider might be hesitant to prescribe certain medications or treatments that could potentially lead to weight gain, even if they are necessary for managing Type 1 diabetes. This can leave patients without the best tools to manage their condition, all because of a misplaced focus on weight.

The Psychological Toll that is impacted by the Intersection of Fatphobia and Type 1 Diabetes can be a daily challenge. For me this started at a rather young age and also was impacted by my late T1D diagnoses. i didnt recieve my diagnoses until i was in my early adulthood.  Something i experienced is the Internalisation of Fatphobia. Living in a society that stigmatises larger bodies can lead to internalised Fatphobia, where individuals begin to believe the negative stereotypes about their own bodies. For someone with Type 1 diabetes, this can manifest as guilt, shame, or self-blame for their weight and condition. The constant pressure to conform to an unrealistic standard of thinness can erode self-esteem and contribute to mental health issues such as depression, anxiety, or eating disorders.

And while we are talking about Eating Disorders we cant go by without mentioning Eating Disorders and Type 1 Diabetes (T1DE). The intersection of Type 1 diabetes and disordered eating, sometimes referred to as T1DE, is a serious and often overlooked issue. Fatphobia can exacerbate this problem, as individuals may engage in dangerous behaviours like insulin manipulation (omitting or under dosing insulin) to lose weight. This not only puts their physical health at risk but also deepens the psychological distress they experience. The focus on weight over health creates a breeding ground for these destructive patterns.

So what can we do to Break the Cycle of Fatphobia in Diabetes Care i hear you ask?

Well these are just some ideas that i have found useful and of course are not an extensive list. First there is the provision of more Education and Awareness within all areas of healthcare. It’s crucial to educate healthcare providers about the dangers of fatphobia and the importance of focusing on overall health rather than weight. By shifting the conversation away from weight and towards holistic diabetes management, we can create a more supportive and effective healthcare environment for people with Type 1 diabetes.

Next i would say get comfortable with Advocating for Yourself. For those living with Type 1 diabetes, it’s important to advocate for care that prioritises your health and well-being, not just your weight. Don’t be afraid to challenge Fatphobic comments or seek a second opinion if you feel your concerns are being dismissed. Remember, you are the expert on your own body, and your health is more than a number.

Finally build Support Networks. Building a support network of friends, family, and healthcare providers who understand the complexities of Type 1 diabetes and reject Fatphobia is essential. Surrounding yourself with people who focus on health and well-being rather than weight can help you maintain a positive relationship with your body and your diabetes management.

I want to say that the intersection of Fatphobia and Type 1 diabetes creates a dangerous and harmful environment that can impede proper care and exacerbate both physical and mental health issues. It’s time to dismantle the harmful myths that equate thinness with health and to advocate for a healthcare system that treats the whole person, not just their weight. By recognising and addressing the impact of Fatphobia, we can ensure that everyone with Type 1 diabetes receives the compassionate, comprehensive care they deserve.