Split in Two: When You Have Type 1 Diabetes and an Eating Disorder—and the System Only Sees Half of You

This piece addresses body image, disordered eating, and chronic illness. If you find this subject triggering, please take care of yourself and consider stepping away or reaching out to a friend or professional.

This isn’t just about illness. It’s about being torn between two kinds of care one that listens, and one that demands silence.

When you live with Type 1 diabetes, you’re told your body is complicated but capable.
You’re given choices, Monitors, Technology, A team. You’re taught how to listen to your body, adjust, and live.

However when you also live with an eating disorder, treatment looks very different. You’re told your body is dangerous. You’re given a meal plan and rules. You’re watched. Judged. Controlled. You’re taught that trust in your body is delusional, and compliance is the only cure.

I am one of those people who live in that split.
And let me tell you—it doesn’t just hurt.
It shatters you.

Two conditions. Two treatments. One body.

So lets break this down a little more into the difference in support i have received for my physical health vs the treatment i have received for my mental health.  

With diabetes, my care team checks in & asks questions like:

“How are you feeling?" 

"Are your insulin ratios still working for you?" 

"Let’s adjust if needed.”
“We know everyone’s body responds differently. You know your body the best.”

With my eating disorder, What I hear from my team is:

“You just have to follow the plan"

"You don’t need to understand it.

 "Just do it.”

"You need to try harder, have to be more motivated"  

“You’re not thinking clearly. We’ll decide what’s best for you.”

Do you see/feel that difference?
One says: We trust you.
The other says: You are the problem.

But what happens when they collide?
Try eating when every meal spikes your blood sugar but your treatment plan says “just push through.”

Try managing insulin when your body image screams that every correction is “too much.”

Try recovering when every single aspect of your medical life is already about food, numbers, control and now, recovery wants more of it.

Try navigating a system where one team helps you co-create a plan for your survival and the other that strips you of your autonomy in the name of saving you.

The result?

You disappear.
You become “difficult.”
“High risk.”
“Non-compliant.”

A liability in the eyes of systems too rigid to hold complexity.

But here’s the thing: I’m not resisting treatment. I’m resisting harm.

I’m resisting a plan that ignores the daily insulin, the carb counting, the emergency juice boxes.
A plan that demands blind trust in food, when I’ve spent years being taught to micromanage every gram of it. I’m resisting a system that asks me to let go of control when control is literally what keeps me alive. There is nothing healing about being told that your survival mechanisms make you unwell.

Diabetes made me a fighter. It taught me how to advocate, plan, adapt.
Eating Disorder treatment told me I had to forget all of that to be “recovered.” It’s like having a body that’s already complicated, only to be told: “That’s too complex for us to handle here.”

So they simplify you. Flatten you. Force you into a model made for someone else’s story.
And when it doesn’t work? They say you failed, that you do not want to get better. When really the treatment models that the Eating Disorder system uses was never designed for someone like you.

But I don’t want to choose between parts of myself. I want to be treated as a whole.

I want recovery that says:
• Yes, you’re diabetic.
• Yes, you have an eating disorder.
• Yes, this is messy and complex—but your body still deserves care that fits.

I want a therapist who doesn’t flinch when I talk about blood sugars. A dietitian who understands that some days food is medicine and some days food feels like poison. A system that sees my fear not as defiance, but as a signal: “There’s more to this story.”
I want what every patient deserves: a care plan that doesn’t ask me to choose between staying alive and being free. Because when you live with both diabetes and and a eating disorder, you walk a tightrope every day. One hand holding insulin. One hand battling your own mind. No safety net. No room for error. 

And all I’m asking is: Stop pretending a one-size-fits-all treatment approach/plan is enough for someone holding this much weight. 

To the systems, the clinicians, the gatekeepers of healing: If your treatment model can’t hold someone like me, then it’s not a treatment model it’s a cage.
And I didn’t fight this long just to be locked in another one. If you’re someone walking this road too: I see you. You are not “too much.” You are not broken. You are carrying more than most can imagine. You deserve care that treats all of you—not just the parts that fit the manual.