The Mirror

© Thann Clark

I see a fat girl in the mirror.

Her hair has been long and short, white platinum blonde to dark brown.  Her warpaint (or makeup, if you want to call it that) changed over the years, but she is still fat. Sweatshirts and loose clothing in somber tones to prevent attention being drawn to the body she hates has been her uniform.

Even when I am told by others that I am beginning to look too thin, she is still taunting me from her reflective hell.

She won’t go away.


This is what having an eating disorder means to me.

Whatever you choose to call my particular disorder (diabulimia, skipping shots, or “Eating Disorder Not Otherwise Specified“), it’s something that will never leave me. When friends and family and acquaintances say: “You look great! Wow!”, my first thought is:

“Are you lying to me?”

It doesn’t matter that my second thought is about how good I might feel today or that I know that I do look great. The self-consciousness that came with being overweight as a teenager is forever frozen in my head. You are lying to me. I may be a healthy weight, but I still think you are telling me that I could look…better.

Am I lying to myself?

Diabulimia was my way of exerting some control over the chaos in my life. I may not have been able to choose my diabetes, but I was mightily sure that I could choose if I was going to take insulin.

Take that, diabetes. You don’t control me.

And I got thin. At such a price. I am still ashamed.

Yes, I no longer omit insulin. That’s not an option for me. I understand the toll withholding the life-giving drug does to my body. I have thrown out the baggy clothes. I force myself to wear clothes that show I am thinner. I am still uncomfortable in them, as if they are the Emperor’s new clothes and someone will see the fat girl parading around instead of me.

I have kept the weight off for the last two decades, always taking insulin. Eating (for the most part) what I want, when I want. Not denying myself a taste or two if it was worth it.

But there are days where the fat girl in the mirror mocks me. It’s those days that my blood sugars stay within range, but I’m living on coffee in the morning and snacking lightly through the day. I’m not denying myself nourishment; I believe that I’m not hungry. If I’m under stress, I forget to eat, but if I go low, I’ll grab a juice to bring me up. (A juice with added vitamins, so it’s not wasted calories. I detest wasted calories.)

The scale was not a tool that I allowed in my house for years, and once we got one, I try not to step on it too often (unlike in the past, where I would weigh myself every few hours…).

Like an addict, I know that I have to take one day at a time. Unlike those with an alcohol or drug addiction, I cannot avoid places where the addiction can rear its ugly head. My addiction is everywhere and with it comes insulin.

I am the fat girl in the mirror.

I will always be the fat girl in the mirror. She will be there. Always. Most mornings, she is talked back into the fog and I remind myself of the promise I made: Do everything to stay healthy so that diabetes doesn’t rob me of my life. Every day I make a choice. It’s the hard choice, not the easy choice. Don’t think it’s easy.

Wouldn’t you love a tidy end to this post? Something witty? Banal? Me telling you that I have conquered this eating disorder and think I’m a success.

My diabulimia, while dormant, will never end. I will never say I’m cured. Food will forever be something that I love and hate.

All I can do is help others understand that there is an alternative to skipping shots, even if I will forever see a fat girl in the mirror. I’ve gotten used to seeing her. She’s my reminder.

I’d rather see a fat girl than no one at all.


This week is National Eating Disorder Awareness Week. I’m sharing this post with you to show that many of us still struggle with body image issues, years after we are supposedly “cured”. There is help and treatment, but the best thing that friends and family can do is to learn more about the devastating mental and physical consequences of an eating disorder.  The disease may begin with a preoccupation with food and weight, but it grows to be so much more. There are many organizations that can help, including some specifically for diabulimia: The Diabulimia Helpline and We Are Diabetes

To learn more about my experience, read this

For Want Of A Nail…

Winter Horseshoes from WW1 – Wikipedia

For want of a nail the shoe was lost.

For want of a shoe the horse was lost.

For want of a horse the rider was lost.

For want of a rider the message was lost.

For want of a message the battle was lost.

For want of a battle the kingdom was lost.

And all for the want of a horseshoe nail.

– Old Proverb

It wasn’t a conscious effort or a determined decision to skip a dinner shot the first time. I just got caught up in whatever insignificant thing that I was doing that evening (A teenager’s life is so important, so it was probably something like talking on the phone in my room while eating and painting my nails fire engine red.) and then I just went to bed. The next morning, I woke up and realized that I had missed my evening insulin mix (both long- and short-acting), but that I wasn’t…well, to be honest…dead. I took my morning dose, choose another black outfit from the closet (“Christel,” my father sighed with exasperation, “Are you going to a funeral?”) and waited for my friend to pick me up.

I knew what DKA was. I knew what ketones do to a body. I knew what a lack of insulin will do to your mind. My control was crappy already and life wasn’t entirely sane in my family, so I had a lot of independence when it came to my diabetes. My parents asked what my blood sugar was, and I would pull a random number out of my head (or another part of my body) to blurt out. They weren’t stupid. (The lack of prescription refills on my test strips were a dead giveaway.) And I took insulin. Just not every time I ate.

I was fat.  Why was I fat? I can name several reasons, but it started with a 3,500 calorie Diabetic Exchange Diet to put the weight on after my diagnosis. (68 pounds looked scary in photos. I actually threw out pictures taken at Joslin when I first arrived there, because I looked so sick.) I kept eating well after I packed pounds back on my little frame and a year and a half later, I started high school at 104 pounds. I graduated high school at 135 pounds, and at 4’11” inches, that put me in the “She’s got a nice personality and a pretty face, but…” dating category.

Eating was a way of socializing with my family and friends, and I was always of the mind: “I can eat anything I want and let me prove it to you.” I would skip a shot when I felt like it or was too tired to deal with it or out with friends and didn’t want to stop having fun. This attitude didn’t go away at university, but I added drinking alcohol into the mix. (Legal, people. I went to university in Canada, where it was legal for me.) I was scared of being low when I was drunk, so I wouldn’t take a full dose before we went out to bar hop, but we’d carb load before hand. And sometimes at 4am when we’d come back to the dorms. I knew where every bar’s bathroom was in Montréal.

I met someone who loved the whole package and it was with him that I had a summer of great blood sugars and healthy eating and biking the Lachine Canal every night. My size 14 clothes hung on me and when September rolled around, I was a size 4. And then the relationship ended and I drank coffee and cried a lot. Old habits rose up like zombies and skipping shots and eating what I wanted became de rigueur. 95 pounds. 94. 93. I just didn’t care. Nothing “bad” was happening to me and people told me how great I looked. Guys who wouldn’t give me the time of day before were now giving me their number.

I thought I could have lived like that for a long time. (Silly me.) Spilling ketones, downing liters of soda daily, taking insulin once a day with an arbitrary amount chosen (“Hmm… I’m feeling about 340 today… 10 of this and 12 of that and off we go…). I may have lived, but I was barely surviving.

My endo saved me. She wasn’t one to pull punches and knowing me for most of my diabetic life, knew that I could talk my way out of a lot of things, but I was cornered by a series of questions that ended with: “How long have you been skipping shots?” The jig was up. I was officially diagnosed with diabulimia.

Outpatient intensive individual and group therapy or inpatient treatment were my options. I chose the former. I didn’t see myself as someone with an eating disorder. I saw myself as someone who was fat and never wanted to be fat again. I saw myself as someone who didn’t want to be diabetic and was still hoped that it would just go away. I still saw the fat girl in the mirror. Body issues? I haz them.

There are a lot of us out there, struggling. I know that I’m not alone, but it was years before I met someone else in person (Lee Ann Thill) who also dealt with diabulmia. I wrote about it in a column on , was on dLife TV for an article on diabulimia and was even interviewed for a CNN piece. (They focused on a woman who developed irreversible complications and was still skipping shots rather than me, who was now healthy and not skipping shots. I wasn’t sensational enough.)

Therapy changed me for the better. It took a long time and even after twenty years, I still struggle with how I look to myself. But I haven’t skipped a shot since therapy ended.

And all for the want of a small dress size…

I could have lost so much more.

I’m not talking about my weight.