The response to Paula Deen's revelation that she has Type 2 diabetes highlights the false "either-or" dilemma that plagues our culture's approach to eating (and most other things): good or bad, right or wrong, all or nothing.
Paula Deen's popular brand was based on her audacious use of ingredients that are "evil" in this dichotomous view of healthy eating. Viewers watched in fascination and vicarious enjoyment as this sweet but naughty woman unabashedly broke "the rules." Now some of her critics are angry that she hasn't fallen to her knees, begged our forgiveness, and sworn off butter and sugar forever to pay penance and set an example for all the other sinners she led astray.
This all or nothing thinking has characterized yo-yo dieting for decades. At first, dieters are highly motivated to adhere to a strict diet of "good" food. Eventually, feelings of deprivation set in, leading to preoccupation and cravings for "bad" food, increasing sensitivity to temptations, giving in, guilt and consequently, overeating. I call this predictable pattern the eat repent repeat cycle.
While we weren't privy to Ms. Deen's early reaction to her diagnosis of diabetes, many people go through a period of grief, guilt, and fear that motivate them to adhere to a strict diet of the "right" foods. As with any overly restrictive diet, a drastic approach is unsustainable so the "eat repent repeat" cycle ensues, reinforcing the guilt and fear that fuel it. We've seen this play out repeatedly with other public figures and among our friends, family members, patients and clients. But living well with diabetes is a long-term process, not a short term pledge of perfection.
Ironically, it is the false dilemma -- on the diet off the diet -- that causes blood glucose levels to yo-yo, eventually giving rise to complications from uncontrolled diabetes. The problem is that, unless you know some fancy tricks, a yo-yo never stops in the middle.
Therefore, I prefer to think of eating and physical activity as a pendulum instead. It's easy to picture what happens when you draw a pendulum in one direction and let go: it swings to the opposite extreme. Rather than seeing choices as either good or bad, right or wrong, or all or nothing, small changes practiced consistently allow the pendulum to gradually find a smaller arc in between the extremes. An eating and exercise plan that takes into account one's health concerns, preferences, schedule, goals, cultural and other personal matters makes it possible to establish a healthy lifestyle that's flexible enough to withstand the realities of daily life in our abundant food environment.
Contrary to what some claim, the prevention and treatment of diabetes cannot necessarily be reduced down to a rigid and overly simplistic prescription for what to eat and how much to exercise. Further, diabetes self-management, like lifelong weight management, doesn't require perfect eating (whatever that is). Instead, it necessitates mindful eating. Mindful eating is a dynamic, flexible approach that embraces curiosity and non-judgment. It encompasses the entire decision making process, including:
- Paying attention to hunger and fullness cues
- Recognizing emotional and environmental triggers for eating
- Using nutrition information as a tool, not a weapon
- Choosing food that reflects balance, variety and moderation for optimal health and glucose control
- Appreciating the appearance, aromas and flavors of the food
- Noticing how different foods, ingredients and quantities affect satiety, energy and blood glucose levels
- Learning from mistakes rather than shaming, blaming or judging
- Engaging in joyful physical activity
- Understanding the appropriate use of medication and embracing blood glucose monitoring with an attitude of curiosity instead of fear
- Practicing consistent self-care that decreases vulnerability to stress and unhealthy behaviors
- Giving up the dichotomy of being in control or out of control, and choosing to be in charge instead
Paula Deen's homestyle recipes had come to symbolize another false dilemma: If it tastes really good, it must be really bad. Business decisions aside, I applaud her commitment to moderation rather than succumbing to the false dilemma of all or nothing thinking. As she explores the balance of eating for enjoyment and eating for health, I predict that this talented and spirited woman will set an example by proving that it is possible to eat what you love with diabetes.
By Michelle May, M.D., author of Eat What You Love, Love What You Eat and Eat What You Love, Love What You Eat with Diabetes
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Michelle May, M.D. is the author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle and Eat What You Love, Love What You Eat with Diabetes: A Mindful Eating Program for Thriving with Prediabetes or Diabetes (New Harbinger Publications, 2012).