Is Type 2 Your Fault?
When you’re first diagnosed with type 2, you have to deal with major changes in your life. Many people have to deal with feelings of guilt as well: "I brought this on myself." A double burden.
But is that true? Popular press articles take this point of view. They point out the undisputed link between obesity and type 2 diabetes. They often illustrate their stories with photos of obese people about to gorge on humongous hamburgers.
There’s no question that being overweight or obese increases your risk of type 2 diabetes. But not everyone who is overweight gets type 2. And some normal-weight people get type 2.
What causes people to be overweight? Different "experts" will blame different things: too many calories, too much fat, too much carbohydrate, too much junk food, too little exercise, etc.
We don’t need studies to show some of these effects. We all know people who eat nothing but junk food and still stay skinny. We all know people who eat healthy foods and still get fat.
Factors of type 2 diabetes
Genes are clearly important. Adopted children tend to have the same BMI as their birth parents. Genes can affect appetite, as illustrated by the extreme case of children born without leptin. Such children have voracious appetites and fight to get food. Most overweight people are not leptin deficient, but many have leptin resistance.
Genes can also affect how efficient you are at converting calories into fat, and how difficult it is for you to lose it.
The environment is also important. During famines, there are very few fat people. But some starved people are skinnier than others.
And personal choices are important, although in exteme cases, like the leptin-deficient children, the drive to eat may overwhelm any personal choices. Starvation is a powerful motivator, and some people feel as if they’re starving all the time.
So genes, environment, and personal choices all affect whether or not a person is overweight, and genes affect whether or not a person will develop diabetes, with or without being obese.
So does that suggest your diabetes is your fault? How do we define fault?
What if someone told you when you were 12 years old that your genes showed you were at 99% risk of becoming obese and diabetic unless you did X and Y? If you ignored the warning, then I’d say getting the diabetes was partly your fault, although it wouldn’t be your fault that you got those predisposing genes.
But what if no one warned you of your high risk? What if experts couldn’t agree on the best diet to avoid diabetes? Most of us eat what our friends are eating, and it’s very difficult to be different. So if you ate what everyone else was eating but you got fat and then you got diabetes, you shouldn’t blame yourself.
However, the fact that getting diabetes isn’t your fault doesn’t mean you can’t do anything about it now that you have the diagnosis. Dump the guilt and focus on the positive. Think of the diagnosis as an early warning sign. Think of yourself as lucky to get this early warning that nudges you into eating healthy foods and getting exercise.
Do what you can to control this disease, but remember that you’re human and don’t beat yourself up when you occasionally fail. Having type 2 is not your fault. Ignoring it after you know about it is.
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Gretchen wrote for HealthCentral as a patient expert for Diabetes.