Navigating the choices to live a healthy life can be confusing. Photo: 123rf.com
I started writing this column because I had questions about diabetes and, well, me. As a person who has spent much of my life (and almost all of my career) on the internet, I turned online for answers, but to be honest, there were more answers than I had questions.
Raw onion could supposedly lower my blood sugar, so could turmeric. I should do lots of cardio, but also strength training. Or if I did both, cardio should come after strength training, unless I wanted to lose fat, in which case, I should under no circumstances lift weights.
Megan Whelan is sharing her journey as she learns more about type 2 diabetes, health and herself Photo: Ashley Balderrama
In the before times, I thought self-care was about bubble baths and facials. I also included therapy, and more recently, lifting extremely heavy things over my head and throwing them on the ground.
Now, I think of self-care as the antithesis of internet health advice: It's taking that advice, in some cases reading the actual literature, and making it work for myself.
Understanding that what works for me will be completely different to what works for the next person has been a huge lesson. There is no substitute for individual advice.
And one of the things I've come to learn is that sometimes, there's not much I can do. Sometimes, I am looking for an individual solution to a systemic problem: the health care system, fatphobia, the food industry. Racism - not for me, but for the vast majority of people who have type 2. None of these are things I can solve, but they're all things that affect my diabetes as much as my diet.
Author, podcaster and activist Aubrey Gordon Photo: Supplied/ Beth Olsen
I learned this, in part, from a podcast called Maintenance Phase. If you haven't listened to Maintenance Phase, it aims to debunk the science behind diet fads, wellness scams and nonsense nutrition. Or as co-host Aubrey Gordon put it, gives listeners the source points for the stuff that has been haunting many of us for years.
"I think that's not an uncommon experience that lots and lots and lots of us have tried to change our body size, lots and lots and lots of us have jumped on to different diet and wellness trends. And lots and lots and lots of us have been underwhelmed, but we still sort of have this little goldfish memory, where every time there's a new diet, we're like, maybe this is the one."
"I think what we hear from listeners is that it's really helpful to have something that punctures that and not just something that punctures that but something that also includes perspectives from a fat person."
When I spoke to Boyd Swinburn, he told me that the reason GPs often tell people to lose weight when they're diagnosed with type 2 is that they're uniquely motivated to do so. And it's believed that fat loss of 5 percent comes with a "metabolic bonus," which is helpful in dealing with diabetes.
No doctor has ever told me that, or explained it to me in detail, something I lamented to Aubrey.
"We don't get precise messages, we don't get clear directives, we just get 'you're a fat person become thin immediately, and then I will deal with you. And then I will handle your health issues.'"
Talking to someone like Aubrey was a balm - someone who so wholeheartedly understood my experience. I told her about the root question I had of all of this: did I get diabetes because I am fat?
"One of the things that I think people really love to hammer on about fatness and about fat people becoming thin, is this: the bogeyman is type 2 diabetes. The bogeyman is heart disease. The bogeyman is hypertension, right? There's just this little trio of just like nasty little conditions that folks use primarily as a cudgel."
She says people rely on the idea of 'The Science,' as in "what does the science say?" "The truth of the matter is just really an overwhelming number of us are not reading the entire text of studies. We're not looking at methodology sections. We're not trolling through cross tabs. Like we're not doing the deep dive, what we're doing is parroting back things that have been said to us and that seem legitimate to us, and we're legitimating them by reaching for the science."
What the science says is that we don't know why people get fat, and we don't know how to get people to lose weight in a sustainable way. And Aubrey cites research that suggests between 65 and 80 percent of doctors have extremely strong biases against fat people.
"They say things like 'fat people are fat pretty much because of their own fault'. Or if a fat person is in ill health, that's their own doing."
"I think if we're interested in getting to the root of what's going on with type two diabetes, what's going on with hypertension, what's going on with heart disease, what's going on with fat folks' health and what's going on with health conditions - that also, by the way, exist in thin people - we have got to be willing to grapple with the idea that health care providers are extremely technically proficient, they have all kinds of knowledge that I don't have, that I'm guessing you don't have. But in the process of getting all that practical and technical knowledge, nothing was done to undo their biases."
And, Aubrey reminds me, diet culture is the soup we're all swimming in.
"It is designed to get people, it is designed to be like a treatment resistant virus. There are lots of people being paid lots of money to keep marketing bad information and hurtful and biased information."
The fearmongering around fatness, she says, means we all fall for it.
"We're being told that [being fat is] a reflection of your character and your worth and worthiness. Whether or not you are loveable as a person, and ... that is extremely human to want to do a thing to bring you more connection with more people, and more resources and support. And we should talk about whether or not this particular thing works ... and achieving those outcomes, and could you achieve those outcomes in other ways?"
A year into this, I know I didn't get diabetes because I am fat, despite what men on Twitter like to say. There are dozens of factors that combined to this outcome, including my genetics, my lifestyle, and my hormones. I also know that none of those things have anything to do with my character or worth - and gosh, that really is self care.