Your Emotional Relationship with Food and Its Impact on A1C


There is no doubt that food plays a crucial part in overall type 2 diabetes (T2D) management. Unlike the more straightforward aspects of diabetes, like taking medications on time and making room for daily movement in your schedule, the what, how and why of eating can be emotionally triggering and difficult to grasp for many people—but know you’re not alone!

We might not even know why we eat the way we do or what drives our food decisions. People with T2D come from all socio-economic, familial and cultural backgrounds—what we eat and the way in which we eat is often reflective of that. 

Our emotional relationship to food is not only affected by diabetes but also directly and indirectly affects our diabetes, especially our blood sugar levels and HbA1C (A1C).

Understanding your A1C

The A1C is a blood test taken every three months to measure your average blood sugar level over the previous few months. The test measures the amount of glycated hemoglobin—bound sugar and protein in red blood cells—there is in the bloodstream.

The higher your average blood sugar, the more glycated hemoglobin—thus a higher A1C. 

The following are typical A1C ranges:

  • No diabetes, 4.6-5.6%
  • Prediabetes, 5.7-6.4%
  • Diabetes, 6.5+%

The target range for adults with diagnosed diabetes is less than 7%, and for children with diagnosed diabetes is less than 7.5%.

People with diabetes are more likely to struggle in their relationship to food

Developing an emotionally healthy relationship with food can be difficult, especially if you live with T2D. However, it is crucial for better mental and physical health, including better blood sugars and A1Cs.

While disordered eating and eating disorders exist on a spectrum, up to 20% of people with all types of diabetes are affected by at least one. Disordered eating patterns include emotional eating, binge eating disorder and restrictive eating patterns. This can look like limiting the number of carbohydrates or calories eaten in a single meal or day, or completely removing entire food groups altogether. 

Many people with diabetes exhibit disordered eating patterns because diabetes is a condition that is highly focused on food, nutrition, carbohydrates and portion sizes. Others may recommend nutrition plans like low carb or keto to people with diabetes, but that eating pattern may be restrictive for some and not sustainable. 

When we tend to eat higher carbohydrate foods and meals, our blood sugar levels go up and when we eat fewer carbohydrates and smaller portion sizes, our blood sugar levels are not as affected. This can lead many people to develop an unhealthy relationship with food overtime because of labels of “good” and “bad” sugar levels or food. 

Forbidden + tempting foods

Studies have shown that the most common types of food eaten during binge eating episodes are high carbohydrate foods like breads, pastas, and sweets, and people who prefer sweet foods have an increased binge eating frequency. 

Sweets are often framed as forbidden foods for people with T2D, making them more tempting. People who enjoy sweet foods are more likely to develop an unhealthy relationship with food, restricting sweets during the day and later binging them at night.

These patterns of restrictive and binge eating can lead to increased blood sugars and higher A1Cs overtime

Higher A1Cs can lead to T2D complications, including retinopathy, neuropathy, heart disease, lower-limb amputations and premature death.

There are no “bad” foods 

It’s important to remember that there are no bad foods, just bad relationships with food. If you’re struggling with your relationship with food stemming from a T2D diagnosis, it is crucial to talk with your doctor and share your concerns. 

Your doctor may refer you to see a certified diabetes care and education specialist (CDCES), or a registered dietitian (RD) who can help you develop a sustainable and balanced eating plan, or they may even refer you to a therapist who can work with you to improve your relationship with food. 

Balancing a sustainable, healthy eating plan with physical activity and the right medications can go a long way to improving your physical and mental health. 

Building a healthier relationship with food 

Developing a healthier relationship with food can take time, and may require help from your health care team. Every time you eat, instead of picturing calories and carbohydrates, envision how the food you’re eating will fuel what activities and hobbies you love to do. 

Picture food giving you strength, and ditch the guilt around treating yourself—we all deserve a break! Focus on how the foods you eat make you feel and keep in mind that health comes in all shapes and sizes. Developing a healthy relationship with food is crucial for your overall well-being and diabetes management.

Working on your relationship with food will take time, so be patient with yourself and your body as you work through it. You can always check out our food page for recipe ideas or lean on our mental health resources to help with the emotions that may arise. 

Know you’re not alone. Our BT2 community is here to support you!

Editor’s Note: This content was made possible with support from Lilly, an active partner of Beyond Type 2 at the time of publication.

WRITTEN BY Christine Fallabel, POSTED 05/17/23, UPDATED 05/17/23

Christine Fallabel has been living with type 1 diabetes since 2000. She's a health and science writer and has been featured in Diabetes Daily Grind, Insulin Nation, Diabetics Doing Things, and is a regular contributor to Diabetes Strong, T1D Exchange and Healthline. She earned her Master of Public Health from Temple University and received her Bachelor of Arts from The University of Delaware. In her spare time, she enjoys hiking with her husband in the mountains of Colorado, tinkering with her DIY Loop insulin pump, drinking strong coffee and reading in front of a cozy fire.