[lemonadelife_blog]

When I was in college, I started smoking. It’s not something I’m proud to admit, and since it was something I knew I shouldn’t do, I never blogged about it. My reasons for smoking are complicated, yet pathetic. It made me feel better. It gave me something to do when I was bored. My friends did it. I knew it was something I shouldn’t do, which made me want to do it even more.

The funny thing is, I never really liked cigarettes. Smoking often made me sick to my stomach or dizzy. I couldn’t smoke very much because of it. I think the fastest I ever smoke a pack of cigarettes was about three days, but more often than not it would take me a week, or longer (unless I gave them out to people who asked – then they went faster). I didn’t like the way my hands smelled. I didn’t like how dry my throat became.

Yesterday, I had my quarterly endocrinologist appointment. Although my A1C came down – albeit oh so slightly – I found out my weight went up. Again. It’s devastating, but of course, not exactly out of my control. As I was taking the subway after my appointment, I was finishing up a book called The End of Overeating. The book, which like most books of its kind are filled with obvious statements and repetitive examples, had an interesting comparison between eating and smoking at the end of the book.

By itself nicotine is only moderating reinforcing, but that begins to change with the building of layer upon layer of sensory stimulation: The sight of the packaging, the crinkling sounds of the wrapper, the tactile sensation as you light a cigarette and hold it between your fingers, and the sensory characteristics of the first puff all bolster the reinforcement. Factor in the times of day and the location where you often smoke, and smoking becomes a conditioned behavior. Cues, couples with the emotional salience that the tobacco industry has embedded in cigarettes through decades of strategic advertising, intensify the drive for nicotine, which then becomes highly reinforcing. (Kessler, 240)

After several years of what I called social smoking (which is a misnomer – you either smoke, or you don’t), I quit. Cold turkey. I never developed a hard and fast physical addiction to smoking. It was the pattern of my life, the way cigarettes and built itself into how I lived, that made cigarettes a mainstay in my life for so long. I didn’t have to smoke, I wanted (whether I liked to admit it or not) to smoke.

I realized this is very much like my relationship with food. Growing up with diabetes prior to the insulin pump meant that my food was rather regimented. The idea that I would eat when I wanted to sort of flew out the window at an early age. Hunger? Pssh. It’s 3:30, dammit, and you will eat your crackers! It’s an easy way to get into a distorted pattern of eating and it’s something that I figured out a long time ago. (Edit: I realize that food is necessary, while smoking is optional; this analysis is based on the premise of *overeating* being optional, not food as sustenance)

It’s easy for me to blame my weight just on my diabetes. Blame it for my distorted thinking. Blame it for my inability to recognize the fact that I don’t have to eat lunch at lunchtime if I’m not hungry or otherwise occupied. That my eating schedule does not have to be fixed to a clock. I think it’s partially true. Like the habit of smoking, the habit of diabetes has reinforced odd notions about food. The rest of the problem? Lies in the same reasons that the rest of America is overweight. The portions at restaurants are out of control, so not only do we not recognize when we’re hungry, but we don’t even realize when we really aren’t hungry anymore. The fat and sugar content of food make it difficult to resist temptations, so it becomes easier to convince ourselves that we can or should or want to eat something. Over and over again, Americans have had their good intentions thwarted, and people with diabetes are no different.

The technology used to manage our diabetes doesn’t help either. We’re told we have the “freedom” to eat “whatever” we want “whenever” we want. We can be just like “them.” There’s no such thing as a “diabetic” diet. But for people who struggle with self-control and willpower, for people who grew up with a distorted pattern of eating because of meal plans, can take advantage of the insulin pump. I “can” have the mocha frappuccino, so dammit, I’m going to have one!

But that’s not true.

When I smoked, I made up a lot of excuses. I told myself that I didn’t smoke that much. I clearly wasn’t physically addicted to smoking since I would go so long without a cigarette, so it wasn’t a problem. I told myself that I didn’t even like it, so that meant I wasn’t really a smoker. But with every puff, I was a smoker.

The similarities between my reasons for smoking and my reasons for overeating are remarkably similar too: “It made me feel better. It gave me something to do when I was bored. My friends did it. I knew it was something I shouldn’t do, which made me want to do it even more.” I am an overeater. It doesn’t matter how it started. It doesn’t matter if the diabetes “made me do it.” It’s not making me do it anymore. I realized soon after graduating college that smoking really was hurting me, regardless of how slow or fast it was doing it. It’s the same with food. I know overeating is hurting me. I know that overeating is causing problems not just with my diabetes but with other parts of my health.

Every bite I put in my mouth that I don’t need, I am an overeater. But I know what to do to not be an overeater. Like smoking, quitting is hard. Painful even. There are a lot of cues and triggers and desires and reinforced behavior that make eating normally so very, very hard. But I quit smoking. Many, many people have quit smoking. Many people have stopped overeating too. If we recognize that smoking is unhealthy, why is it so difficult to recognize overeating is unhealthy too?

The last chapter of the book is called “Fighting Back” and it reminds me of all the people who think of living with diabetes as a battle. While I have never been keen on anthropomorphizing an illness (diabetes isn’t attacking you because it doesn’t have a consciousness), I do think one can fight against himself. Right now I am constantly fighting with myself in how I eat. It’s like the devil and angel on your shoulder, one telling you to do the right thing, the other telling you to indulge. I have to start working with myself to take care of myself, instead of constantly sabotaging my best efforts.

I can do this. But I need my help.


Filed under: Diabetes, Food, Health, Pump

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