Think of all the places in your life in which your food choices are visible to others:
Your lunch at the office.
Your order at a restaurant.
Your cart at the grocery store.
Your plate at a holiday potluck.
How many times during your day can the people in your life—your roommates, your friends, your coworkers, your family, or even complete strangers—see the choices you are making about food?
This question was something that had never really occurred to me before diving headfirst into our Diabetes Simulation earlier in October. For two weeks, I did my best to live according to a patient profile of a 50 year old woman living with type 2 diabetes as well as a host of challenging comorbidities. In taking on this imagined identity, I experienced the learning curve that came with testing my blood sugar and managing multiple (placebo) medications while also making small but important changes to my lifestyle. This turned out to be more challenging than I anticipated. Suddenly, meal times were rife with judgment calls and second guesses. So often, I found myself staring into my pantry or scanning a restaurant menu, trying desperately to balance what sounded good vs. what had the right nutritional balances vs. what was going to keep me full and energized.
I’m fairly confident, though, that I would have been able to deal with this constant decisioning if I lived my life in a vacuum. If the world revolved around me and my health, I think I would be just fine.
But I get it. It doesn’t. Cut to real life, and my food-related decisions are being made not in a vacuum but under a hailstorm of environmental, social, and psychological factors. Healthy choices, in my experience, are so often at odds with the choices that are quickest, the choices my friends (and the other Fellows) are making, or the choices I have been conditioned to make.
Why? Because eating isn’t just about food. In my world, it’s about friends, family, values, habits, body image, history, access, money, time, media influence, and more. To understand how to lower my carbohydrate intake, for instance, is to understand my incredibly complex life web, of which carbohydrate intake is a small, small part.
Not only is that web complex, it’s also psychologically weighty. After my simulation experience, it’s no surprise to me that people with type 2 diabetes may struggle at some point or another with feelings of shame, guilt, or isolation. Though my experience was a mere two-week simulation, it felt as if every time someone watched me checking out at the grocery store or taking my lunch break, they were actually watching me tightrope walk across the precarious strands of my own complex web.It was a curious, vulnerable, pressure-filled place to be.
At no point in the simulation did I feel this more acutely than when Jake and I sat down with a Certified Diabetes Educator from MedStar Diabetes Institute. At about the mid-point of our simulation, she helped us understand where we were succeeding, where we were struggling, and where we had bitten off more than we could, or needed to, chew. She helped us begin to understand what would it mean for us as individuals, and for our communities at large, to begin pushing back against the quick, popular, and conditioned choices in favor of the healthy ones. Or perhaps to actually begin to transform the quick, popular, and conditioned into more healthful options. In what, for me, became a more emotional educational experience than I anticipated in the simulation, this educator helped me begin to see the power of these kinds of radical acts of healththat empower ourselves and each other with a sense of ownership, courage, and pride (rather than shame, guilt, and isolation) as we tread the strands of our complex webs.