It is time to stop blaming the diabetics for having Diabetes!
It has got to a point where diabetes cannot be mentioned in a sentence without someone also mentioning obesity.
This perpetuates the misconceptions that diabetes is explicitly caused by obesity and that it is preventable by living / eating better.
These perceptions are flawed, in so many ways that I decided I had to speak up about in the hope that we can start to draw attention to what is another, albeit more subtle, form of body shaming.
The first thing I want to do is explain that there are two types of diabetes, Type 1 and Type 2. The most commonly referred to type in conjunction with the “obesity epidemic” is type 2, but when I have seen things written about this (away from official sources) people are very vague and refer to the whole thing under the blanket term of diabetes.
The two types are very different. I am going to quote the Diabetes UK website for an accurate definition:
Type 1 Diabetes
Often referred to as juvenile diabetes, type 1 diabetes is a form of diabetes mellitus that is most common in children but can be diagnosed at any age.
Type 1 diabetes is an autoimmune disease that permanently destroys beta cells in the pancreas, meaning that the body can no longer produce insulin.
People with type 1 diabetes therefore require regular insulin delivery to manage their diabetes.
Type 2 Diabetes
Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body:
- Being ineffective at using the insulin it has produced; also known as insulin resistanceand/or
- Being unable to produce enough insulin
Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40.
As a bit of background explanation, my husband is type 1 diabetic. it was triggered when he was 5 yrs old after a bout of mumps. I don’t tell people about it as the primary description of him, but it comes up in conversation and it has struck me that now, more than ever in the past 13 years, I am finding myself having to justify his diabetic status.
I find myself having to explain his back ground , in order to somehow validate his condition it in the eyes of other people. I find I have to explain that he is active and healthy and not overweight, just to stop people giving you that look.
My husband is the one on the left of the picture, just an ordinary sized very active man at a wedding carrying a bunch of flowers who happens to be type 1 diabetic.
Coincidentally, the chap on the right of the picture is a very good friend of ours, an ordinary sized very active man at a wedding carrying a bunch of flowers who also happens to be type 2 diabetic.
Obesity is only one of the risk factors for type two diabetes along with:
You are over 40 (or over 25 if you are South Asian)
You have a close family member with diabetes (parent, brother or sister)
You are overweight, with a large waist size (over 80cm (31.5 inches) for women, 94cm (37 inches) for men, or 89cm (35 inches) for South Asian men)
Being South Asian, Black African, African Caribbean – even if you were born in the UK
You have ever had high blood pressure, a heart attack or a stroke
You’re a woman with polycystic ovary syndrome and overweight
If you’re a woman and you’ve had gestational diabetes or given birth to a baby over 10 pounds
If you have a severe mental illness for which you take medication (such as schizophrenia, bipolar illness or depression)
You’ve been told you have impaired glucose tolerance or impaired fasting glycaemia.
It is almost impossible to pin down the cause of one person’s diabetes to one factor alone, and up until recently the most common cause was considered to be the aging process. I cannot deny that the increase in type two diabetes among overweight and obese people is a strong indicator that this is more of a problem than it used to be, but it is rarely the sole cause.
Both of my grandparents on my Mum’s side were diabetic, diagnosed in their 60s. Neither of them were overweight, neither of them had a bad diet. If fact my Grandad followed guidelines so strictly that he even chewed his food the number of times that was at one time recommended by the government to aid digestion.
What I am trying to say is it is ridiculous and unfair to make assumptions based on one piece of information. Just as it is crazy to blame one factor for the contraction of a disease.
I do not deny that improving diet and reducing weight will reduce one risk factor significantly and therefore reduce overall risk dramatically (and it has numerous other health benefits…) But diabetes is in no way a preventable disease. Just as you can’t give yourself diabetes by eating too much sugar, you can’t rule it out by cutting sugar out the best you can do is reduce the risk. Read more about it here.
I also concede that of all the risk factors, it is the one that people have the most control over. It is easier to change your lifestyle than your genetic make up… therefore the advice to people concerning losing weigh to reduce the risk is in no way to be ignored!
The thing that worries me most about these perceptions of diabetes is the psychological effects it can have on a newly diagnosed person (or a not so newly diagnosed person).
Imagine being told that you have a condition that is going to be difficult to manage and can have serious complications, only to be made to feel that it was somehow your fault and that you could have prevented it if you only lived your life better.
Imagine having to justify a condition and constantly explain to people that you are not just suffering the aftereffects of in irresponsibly high sugar intake.
I have read recently that there are people who are uncomfortable and unwilling to tell people of their diagnosis for fear of being made to feel like it was their own fault.
This is unfair.
This is another pressure placed on people by society that is both unnecessary and damaging.
This is true whether the person with the diagnosis is overweight or not!
All I ask is you think before you assume.
If you hear the word Diabetes, do not automatically assume obese.
It is not that simple
If you here the word diabetic do not automatically assume it was their own fault
It wasn’t.
Project Warrior Goddess 
Great post, Sam. I can absolutely see your point, and it is unfair to make a blanket judgment that because someone develops Type 2 diabetes that it is because they are obese.
That said, when we see a large percentage of young (and obese) children in this generation developing Type 2, it’s hard not to draw conclusions.
My sister gained a boatload of weight during her pregnancy with my niece. In fact, she developed gestational diabetes. My niece was born at nearly 11 lbs, and has been overweight her entire life (she is now 16 and clinically obese). And she has just be diagnosed with Type 2 diabetes. And PCOS.
When I developed high blood pressure, I didn’t LOOK obese, but my BMI score put me in the obese category, and the truth was that I was a soft blob and couldn’t run for 2 minutes straight if my life depended on it. My BP is now under control – even though I’m still overweight – because I bust my ass to move everyday and try to achieve better CV health.
I’m babbling.
I know it’s not fair to blame obesity for Type 2 diabetes, but it’s also not fair to rule it out as a cause – especially in light of all the evidence around us…
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You are right, it is certainly a risk factor, and a high one, but not the only one.
I wasn’t attempting to rule it out as a cause, just point out that it is not the only one by a long shot and in the majority of cases it is a combination of factors that will cause it.
To be honest it is one of the only risk factors that people have control of so I can understand why it has such strong associations. Working to reduce it as a factor is never a bad thing.
I am not one to remove personal responsibility, I will always hold up my hand and say I am overweight because I ate everything and there is noone else to blame.
I agree too that the amount of young people developing type 2 diabetes is increasing at a scary rate, and that this is due at least in part to the obesity problem.
I just wanted people to know that it is possible to be diabetic without being overweight. and to attempt to address the tendency (some) people have to forget the difference between type 1 and type 2
It is the assumptions that wind me up, same as always. Some people make the link without bothering to find out the facts.
There is a difference too between a medical practitioner telling you that you can reduce the risk and /or make yourself healthier by eating better and being more active, and the media and society in general thinking that it must be their own fault.
(PS…I am technically still obese and at high risk of type two diabetes…albeit not as badly as I was…)
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I agree with everything you’ve said here. And it is frustrating that people make these assumptions without the knowledge. There is a massive difference between Type 1 and Type 2, and – as you’ve pointed out – even in Type 2 obesity is not the sole determinant that you’ll develop it.
I think, perhaps, that the sheer number of people (especially young people) developing Type 2 these days, and who are, coincidentally, obese, is certainly not helping the case that there are many other factors. There are, no doubt, but when the vast majority of Type 2 that we see, day to day, are those who are grossly overweight, it’s bound to cloud perception.
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you are absolutely right about that, and I can in many ways completely understand the assumptions!
I think I know a disproportionate amount of active not obese diabetics to be honest (at least 8) and probably more than most people know at all. So I get frustrated with the assumptions. I think, in this as in everything, I just wish people would think a little bit. and that information was more easily available.
I have done a slight edit to the post as it read a little bit like I was saying that there were no links, which of course there are.
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You know that many non-overweight Type 2’s? Wow! Now that is an eye opener for me.
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no, I admit that 3 of those are type 1s
(I did the thing I am complaining about!)
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Still 5 type 2s who aren’t overweight is still a staggering # to me because all the type 2s I know are also overweight. Not saying that’s the only reason they developed the disease.
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I know, it is unusual isn’t it…
It may be why my perceptions are different to other peoples.
I can understand why you have that perception, if the only type two diabetics you know are overweight.
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Absolutely spot on! One of the big problems with so much emphasis on obesity as a factor in diabetes is that it people who aren’t overweight don’t always recognise the warning signs of pre-diabetes and many go undiagnosed for way too long.
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That is an excellent point 🙂
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This is so true. There is a tendency nowadays to blame weight for everything, when for many diseases (including diabetes) there are a number of factors which combine to contribute. And you’re so right about most things you read about diabetes not distinguishing between type 1 and type 2, which are completely different!
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PS I am now blaming it on the boogie, at my desk 😀
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excellent!!
A lot of things are down to the boogie 😀
and desk boogieing is an excellent practice!
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PS…so am I now… 😀
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exactly, it is a factor, but I wanted to attempt to distinguish between the two types and highlight that it is not the only factor.
A very good friend of mine is type 1 diabetic slim bordering on skinny, he says people, including his personal trainer question whether he is really diabetic because he is not overweight!
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As I understand it, before type 1 diabetes is diagnosed/treated, isn’t dramatic weight loss a symptom? I don’t know much about diabetes in general, only the basics, but that seems to ring a bell.
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yes it can be I believe.
I didn’t know much until I married a diabetic, then I felt I should know more 😉
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