Coping with the Need to Change
Among our diabetic patients, there has been a consensus that eating-control is difficult to achieve, even when wrong food choices involve serious illness. The consensus is also that some foods trigger compulsive eating, uncontrollable by ordinary acts of consciousness. We think that compulsive eating is as much part of diabetes as is elevated blood sugar.
The Psychosocial Dimension
The basic problem with proposing diet revision as therapy is that eating behaviors are not rationally determined. The social basis of eating patterns often conflicts with individual needs and opposes the attempts made by an individual to modify diet as a means of restoring and maintaining health. The idea of " a diabetic diet" as a fixed set of instructions and a restricted food list is stubborn and fits with a passive-dependent attitude of the patient who says "fix me".
We think that compulsive eating is as much part of diabetes as is elevated blood sugar. The control of diabetes is, therefore, more complicated that it seems at first glance. It is not simply a matter of choosing the right foods but it is a matter of learning a whole new way of coping with hunger, desires, cravings, social pressures, and a host of self-regulatory challenges that most people never deal with.
A new attitude of approach to diet revision is required especially when you have a chronic illness. The new attitude is based on self-responsible, self-monitored and self-directed change. The Alpha Nutrition Program assumes that the patient is in charge and makes his or her own decisions. The professional role is to support this effort and assist in trouble-shooting when symptoms recur or the irrational aspect of eating behavior is dominant.
There are several key concepts that help us understand the process of "healing" a chronic disorder. First we consider the resistance to change, then the lifestyle pattern of the patient, then the tendency of patients to have irrational behaviors around food - to experience food cravings, compulsive eating and relapses even after they have discovered the important benefits of diet revision.
The book, Managing Diabetes 2 and the Alpha Nutrition Program
talk about the behavioral issues of diet change and food control.