Body Image and Type 1 Diabetes


Ten years ago if you had asked me to show off my insulin pump, you would have had me running for the hills. If you had asked me if I was truly comfortable in my own skin, I would have laughed in your face. Diet culture and the beauty industry told me my size was not desirable. They told me women like me might have a harder time finding love and they told me that I needed to work harder and eat healthier in order to be “strong and sexy!”

Media representation told me women don’t have tubes attached to themselves and they told me that diabetes is not a part of everyday life. Now, obviously, they didn’t say these things directly to me. But they didn’t need to—it was entrenched in the messages I saw in magazines, on TV and in the news. It was embedded in the language we used when talking to our friends and about the people we idolized.

Growing up and going through puberty and all those lovely changes is hard enough, but throw in a disability or disease that may or may not be visible, and your whole list of things to worry about grows to the length of your arm.

Circumstances matter

The thing about body image is that there are so many factors that can lead us to either positive body image or negative body image: how you were raised, who you were friends with, what city you lived in, what resources you had growing up. All of these things are part of the big, messy equation that creates the topic of body image and should be accounted for when we think about how we view our bodies.

For me, becoming a person with type 1 diabetes was a huge event that led to an incredibly negative body image. Not only did I hate my body for “quitting” on me, but I also had the stigma of having the disease that was purportedly caused by eating too much sugar. I grew up bigger and stronger than my friends and at a ripe age of 13, was told by a dance teacher that I simply was too big to dance in certain numbers due to the fact that the outfits were going to be too revealing (I kid you not).

Throughout my teen years (ages 13-19), I really struggled with my body image. I would hide my diabetes so no one knew I had it—I hid my pump in my bra, and I would go days without checking my blood sugar if it meant I had to pull it out in front of people. I vividly recall the time of my life where I went 38 days without checking my blood sugar.

Alongside all that is mentioned above, I also knew that there was a really easy way to lose weight through manipulation of insulin and proper diabetes care. And I’m telling you, I wasn’t even big! What I didn’t realize was that my unhealthy habits were silently leading me down a dangerous path to diabulimia.

It wasn’t until I was 20 years old that I realized there was no shame in being different (read: unique and a total warrior!). I had spent so many years worried about what people were thinking of my devices and disease that I had forgotten to check in on how I was viewing them myself.

Changing lanes

I remember my lightbulb moment so clearly. I was on the beach in the Dominican Republic and my partner and I went for a walk. I was only thinking about how I looked, was focusing so hard on holding my stomach in, and trying to ignore stares toward my Omnipod and Dexcom. We walked past a woman and my partner said, “Did you see her tattoo?!”  I said, “I didn’t… What was it?” And it actually hit me like a brick wall… I was so wrapped up in my own insecurities that I wasn’t able to worry about anyone else! I think this happens a lot of the time—we’re either consumed with our phones, or too engaged in conversation to even acknowledge others around us. I am also a firm believer that we are our toughest critics and what we’re insecure about is usually nothing obvious to a stranger’s eye.

I want to share my top three thoughts that helped me overcome my struggle with showing my disease, my body and how I overcame my negative self image:

It’s not you, it’s them: This idea was the hardest for me to learn and was definitely one of the missing pieces when it came to body image and living with a visible disease. What I’ve only recently come to realize is that we cannot control the actions or thoughts of others. People are naturally curious. To us, tubes, wires and devices alike are our norm. But to many, this is the first time they are seeing our bodies or hearing of someone like us having diabetes.  They stare because they are curious and this is something new to them. People always say, “Kids ask so many questions!” It’s like that, but for all ages: people will stare at things they are unfamiliar with and will ask questions (rude or not) if they don’t know!

In these moments, it can be hard to overcome the fear of judgement, but I have learned to take the time to educate or to simply just smile back. It not only breaks their stare, but it shows them you are aware that they are intrigued. Say hi to them as they walk past! Ask them if they want to learn more! Or let them watch you take your medicine. Let them ask questions. This was hard for me at first, but I have honestly found that 99 percent of people will take you up on your offer and appreciate your openness to share!

Me, myself and I: At the end of the day, YOU are the toughest critic of your own self. Body image is funny in a sense because we see ourselves in the most vulnerable positions. By your teenage years, you’ve spent so much time looking at your body that you have started finding things to completely pick apart—acne, freckles, moles, lumps, bumps, you name it! But remember your friends? They see you for a few hours at a time. And I can promise you with my whole heart that when friends or strangers see you, the last thing that they are thinking about are all your nooks and crannies.

Hard truth: The hard truth is obviously more difficult to swallow but also a really humbling notion. It’s accepting that we are, in fact, different. We might look different than the norm. This is the thing that I tell people and months later, they message me saying that they hated me when I said it, but now they realize it is reality and it was what let them completely forget about the negative body image. It is the idea that this is our reality and we have two choices: we can either fight it or go with it! It isn’t accepting that it’s fun, or lucky, or no big deal—it’s the notion that we are understanding that this is what we have been dealt with and we can either make peace with our bodies or fight it til the end. I’m not super stoked and accepting of it 24/7, absolutely not.

But I think about all the times I hid my disease instead of having fun in high school, and how much danger I put myself in because I wanted to be like the other kids and neglected my health. I think about how much stress I put on my loved ones while they watched me hate myself and my body because of something I could not control. Forgiveness was something I had to learn. I finally forgave my body and started working with it rather than against it. It was maybe the hardest thing to understand but once I did, I couldn’t believe how differently I saw my body, my condition and my world.

An amazing difference

Once I started working with my body, I actually and completely lost all my insecurities towards showing my disease and my robot parts. I didn’t care what people thought of my physical appearance (particularly my size/weight).  I didn’t care about the stares, or the insensitive questions, or the comments because I knew that those who were inquiring were just curious, uncomfortable, or unsure about it. I opened up to the conversations and showed myself and the world that we really aren’t that different or incapable.

We fight every single day to keep our body alive—and that is actually an amazing statement! If people knew how hard we work to be the amazing humans we are, they would be shocked. But they don’t normally understand, and that’s okay, because we have built these communities for those who do understand the struggle.

To obtain positive body image, it takes time, and a lot of trust in yourself. It’s showing up for yourself when you want to run and hide (aka sometimes me in the weights section at the gym). I didn’t become this confident, care-free bionic woman overnight but each day I felt my heart become a little less heavy.

Please love yourself. I promise you, life is so much more enjoyable without the fear or worry of what some strangers are thinking! Let them stare—show them how amazing you are! Dance, sing, laugh and let them watch you, tubes, chairs, wires and all. Take control of your happiness and self image! It will take time, but you can get there! I started my business because when I was struggling, I so badly wished I had a coach to help guide my thoughts and frustrations. Please feel free to message me if you would like further guidance in this topic—I am here for you and I only want to see everyone happy and healthy and confident in their bodies!


Erika Arff

WRITTEN BY Erika Arff, POSTED 01/23/19, UPDATED 11/04/22

Erika Arff is a Canadian health coach who just launched The Confidence Klinik. She has type 1 diabetes (T1D) and wants to support others who live with it, knowing how lonely of a disease it can be. You can find her on Instagram @theconfidenceklinik and @erikaarff and her inbox is always open: