What’s the Impact of Type 1 Diabetes on Body Image?

Body image is a lot more than what you see in the mirror. It’s about how you perceive your body, and also how you think other people perceive your body.

This image changes over the course of your life based on your experiences, and is built on your thoughts, values, feelings, as well as messages received from people around you and society. For instance, in the teenage years, your body undergoes a lot of changes, and it may take a bit of time to learn to accept this new body as it is.

Fashion, social media and advertising play a major role in the formation of body image. Being exposed to an unrealistic beauty ideal, with little diversity and an obsession for being thin, can be detrimental to body image. It can lead to the exclusion of people that don’t reflect this ideal, even though there are many natural body types in society.

In addition, comments made by family, friends, teachers, coaches, and sometimes healthcare teams, can also negatively affect self-perception, even when there are good intentions behind these comments.

With so many factors impacting body image, does having type 1 diabetes (T1D) also influence self-image?

Impact of T1D

Studies have shown that young people with a chronic illness such as T1D generally have a poorer body image than others. There are specific characteristics of T1D and its management that can impact body image, such as:

Having to constantly pay attention to what you eat;
Feeling like you’re living in a “diseased” body;
Getting weighed regularly at medical appointments and hearing comments about your weight;
Having to wear a device at all times (insulin pump or continuous glucose monitor);
Having treatment-related “marks” on your body (e.g., lipodystrophies, scars, bruises, glue residue).
Hearing stigmatizing comments from loved ones (e.g., getting complimenting for losing weight while you’ve been in hyperglycemia for too long).

Having a poor body image can have an impact on quality of life, self-esteem and even sexuality. Studies seem to show that negative body image leads to a greater risk for people with T1D to have:

A higher glycated hemoglobin;
A higher body mass index (BMI);
Anxiety, depression and greater distress;
Eating disorders.

While many people with T1D turn their illness into a strength and assert their difference, getting to that point can be a real challenge.

How to accept your body

There aren’t a lot of people who think that their bodies are flawless, but you can learn to see your body as it truly is. And while accepting your body may seem difficult, or even impossible, you can learn to appreciate it.

To improve your body image, you can:

Remember that your appearance (and weight) depends on many factors you have no control over (e.g., age, genetics);
Remember there isn’t a single beauty ideal, but rather a diversity of body shapes and people;
Be grateful for what your body allows you to accomplish instead of focusing on your looks (e.g., my legs allow me to walk with my friends, my arms allow me to cuddle my pet);
Practise different types of physical activity to find what you really like;
Listen to your body when deciding what to eat and how much, instead of letting something or someone else dictate what you should eat or avoid;
Consider how social media can affect your body image and unsubscribe from certain pages if needed. There are an increasing number of influencers who promote body diversity.

There are also solutions to deal with the specific problems associated with diabetes management, including:

Choosing an insulin pump without tubing, or resuming manual insulin injections if wearing a pump is bothering you;
Reviewing your insulin adjustment strategies to take insulin based on what you want to eat, instead of eating based on a pre-determined number of insulin units;
Asking your healthcare team not to weigh you or talk about your weight if it makes you feel uncomfortable;
Join groups of peers with diabetes to share your experiences and not feel “different” because of your diabetes;
Talk to a psychologist who specializes in body image and T1D.

If you take the time to appreciate the abilities and characteristics of your body, you can gradually learn to trust your body and treat it with the care it deserves. After all, how you look is only a small part of who you really are.

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