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Julie Duffy Dillon (00:00)

Welcome to episode 428 of the Find Your Food Voice podcast. Today, we’re talking all about how to enjoy eating again when you’ve been diagnosed with diabetes and PCOS with special guest, Erin Phillips. Let’s get to it.

Hey there, I’m Julie Duffy-Dillon, registered dietitian and your host. Welcome to this episode. This episode is devoted to those of you who have been diagnosed with diabetes or pre-diabetes and you feel like you were stuck in a corner with no way out, unsure on your next steps. What I know to be true is that when you have been newly diagnosed with any chronic condition that is associated with any kind of eating change,

can be really hard. It also can be really scary because of all the fear. You know, the things that I think about in particular with diabetes that I remember learning when I was a new clinician is all these bad things that can happen. And that fear can really promote these drastic changes. What I unfortunately, I also know to be true for research and also my experience as a clinician is when we make decisions based just on that fear, they don’t

usually stick. They don’t last very long. And one of the reasons is because it’s just too drastic. So for those of you who are struggling with a diabetes diagnosis and wondering how to move forward, again, this episode is created for you. We have a letter from a listener who wrote their letter to food all about

what to do. And in particular, this letter writer is in recovery from an eating disorder, also has PCOS, and just wants to like experience life and enjoying food, but doesn’t know how to do it. So I invited on a special guest. Her name is Erin Phillips. She’s a registered dietitian as well and specializes in helping people with diabetes to be able to just make it work for them without another rigid diet.

Her expertise is so valuable. So I invite you to just get yourself cozy and get ready to really appreciate some next new steps along the way.

Before we get to this episode’s letter, a few announcements just to remind you that if you are interested in this topic and you want to dig in deeper, I invite you to join me over on Substack where I spend a lot of time in the nuance of different types of experiences living with PCOS, including diabetes and PCOS. In particular, I have been specialized in helping people with PCOS to manage the symptoms, to increase energy levels.

all without another stupid, rigid diet that doesn’t work. And I love every month to take a topic related to PCOS and do a very deep dive into the research and also share with you the practice-based evidence that I have helping people for the last 25 plus years. So get to all of this over on Substack, like I said, at findyourfoodvoice.substack.com. And there you get a chance to also support me and my team as a paid subscriber.

Paid subscribers get access to those deep dives every month. And also, like just, hope you know this is how me and my team are able to make a living and we’d love the work we’re doing and we would like to continue to do the work. So becoming a paid subscriber if you’re able to is super appreciated. Along the way, if you have a complicated relationship with food and you need more support, I wrote a book for you.

It’s called Find Your Food Voice and you can get it wherever books are sold or at julieduffydillon.com slash book. All right, enough of all the announcements. Let’s get to this episode’s letter.

Julie Duffy Dillon (03:59)

Dear food, we’ve had a really rocky relationship. I’ve avoided you like the plague since I was nine, and I only indulged when I felt faint, but ended up eating everything in the pantry. Then after college, I was surprised to learn that you were not the problem. I’m sorry I ran away for so many years. I was, slash am fat, and the world told me you were the problem. So things have been good lately.

but now I have diabetes. Between the diabetes, PCOS, and being visibly fat, I feel overwhelmed. My previous eating disorder recovery work feels worthless. I don’t know how to engage with you and not hate you like before. I wanna continue healing us. How do I eat intuitively, be fat positive, and manage my diabetes without succumbing to diet culture? Let’s be friends again.

scared and confused.

All right, that’s this episode’s letter. Before we get to unpack this letter, I want to introduce you to Erin’s work. Erin uses she her pronouns and is a registered dietitian in diabetes care and education specialist who works with people all over the world from her little office in Seattle, Washington. Her mission is to support people with diabetes and the people who love them to live a long and happy life with diabetes without food restrictions, diets or shame.

She’s also an avid cat lover, wannabe dog parent, and obsessed with anything resembling arts and crafts. All right, I need to introduce her to Doug at some point, don’t I? But we are going to get a chance to hear from Erin Phillips in just a minute. We’re going to take a very quick sponsor break. But when I’m back, we are going to be chatting with Erin Phillips and unpacking this episode’s letter.

Julie Duffy Dillon (05:50)

Hey Erin, welcome to the show.

Erin Phillips (05:53)

Hi Julie, thanks so much for having me.

Julie Duffy Dillon (05:55)

Yes, thank you. And when you dropped your new diabetes workbook, what? I don’t know. It’s probably been like 16 years ago now because it was so long ago. Oh no, it hasn’t been that long, listener. But I knew I wanted to talk to you on the show and I hope you got the letter. Did you get a chance to read it?

Erin Phillips (06:03)

Hehehehehe

Mm-hmm. Yes, I did.

Julie Duffy Dillon (06:15)

Awesome. So I’m excited to dive in because yeah, you’re someone that I have admired and learned a lot from about diabetes. And when you read through this letter, I like to think about the big picture first and foremost, like what do you think is happening? What’s going on with this person?

Erin Phillips (06:33)

Yeah, as I was reading this letter, I just had this image of someone, of the letter writer, like, finally grabbing onto, like, peace with food, and then having it, like, ripped away, and then also having their hands slapped. And, like, yeah, that just, that image just…

Julie Duffy Dillon (06:56)

Mmm.

Erin Phillips (07:01)

like hit me like a ton of bricks and just yeah, it also sounded like so many, ⁓ so many of my clients, so many of the people that I’ve worked with have had really, really similar experiences. And yeah, breaks my heart because it doesn’t have to be that way.

Julie Duffy Dillon (07:15)

Mm-hmm.

Yeah. ⁓

Mm-hmm. The way when I was reading it, the way that I was kind of experiencing it was this kind of like bounce back and forth. Like they described not really getting enough or like just not feeling like they ever had permission until they were so hungry, right? Like they were just, eventually they had to eat because that’s what human bodies do. ⁓ And the slap is that when the person got slapped in your kind of metaphorical experience, was it?

Erin Phillips (07:37)

Mmm. Mmm. Yeah.

huh.

Julie Duffy Dillon (07:52)

when they got diagnosed with diabetes or is that what you’re picturing? Tell me more about that.

Erin Phillips (07:54)

Mm-hmm. Yeah, yeah, like,

yeah, just, well, I’ve been doing a lot of learning about attachment, attachment theory and how attachment trauma shows up in our experiences and in our bodies. And ⁓ one of the, like one of the more serious attachment wounds is not only when the attachment figure is like,

turned away or ripped away, but also that the person is told they’re wrong for wanting or needing that attachment figure. And food is an attachment figure, and so is culture, so diet culture can be. so, yeah, being diagnosed with diabetes in our culture sends, unfortunately sends a message to people that they, that

Julie Duffy Dillon (08:34)

Mm-hmm.

Erin Phillips (08:52)

their relationship with food is wrong and that they need to completely change their relationship with food. And so that kind of is what that slap has felt like for me.

Julie Duffy Dillon (08:59)

Mm-hmm. Yeah.

Mm-hmm.

Well, and before we push record, I told you that I used to be a diabetes educator too. And one thing I remember when I was studying for the exam and all that, learning how much of getting diabetes was still mostly genetic. There was so much of it as just a family, it’s passed down. And so when I hear what you’re talking about, I’m like, why are people blamed so much for diabetes when we do have this information?

Erin Phillips (09:13)

Yeah.

Yeah.

I know.

Yeah, yeah. is that a rhetorical question or? Yeah.

Julie Duffy Dillon (09:38)

Maybe I guess I want to know your opinion. Yeah. Because it is like,

I mean, it’s it’s a big one. It’s a it’s a big problem. I think. Yeah.

Erin Phillips (09:45)

Mm-hmm. Yeah,

it’s a huge problem. Huge problem. Our culture just really sucks about it. think fat phobia and fear of illness are two things that really drive it. Fat phobia because…

Julie Duffy Dillon (09:57)

Mm-hmm.

Erin Phillips (10:12)

People, our culture just loves and really drives toward this body hierarchy. And so anything that brings our bodies up and other bodies down, we just get really sucked into that. so putting fatness and diabetes in this category together, people can other themselves.

Julie Duffy Dillon (10:21)

Mm-hmm.

Erin Phillips (10:41)

And along with that, or yeah, other themselves, other others. Is that redundant? Yes, okay. And then the fear of illness or fear of disease, which is related to our fear of death, which is wild because that’s like one of the only things we all do, we all die. ⁓ Yeah, right? Yeah,

Julie Duffy Dillon (10:46)

Mm-hmm. Yeah, I’m following you. Yeah.

us.

Mm-hmm.

Yeah, die and pay taxes. That’s what my sixth grade teacher always used to say. Unless you’re a billionaire, I guess, but you know, whatever.

Erin Phillips (11:11)

Yes, if you have enough money to just not. ⁓

Julie Duffy Dillon (11:12)

She didn’t tell me that one. Yeah.

Erin Phillips (11:18)

Yeah, so then diabetes, this like illness and death gets pushed. ⁓ Yeah, like, well, if I can believe that there’s something I can do to prevent this by being, air quotes, good enough, then I can separate myself from illness, from death, from the fear of these things. And so.

Julie Duffy Dillon (11:22)

Mm-hmm.

Mm-hmm.

Erin Phillips (11:39)

I think that’s a big part of what perpetuates this blaming people for this genetic condition.

Julie Duffy Dillon (11:44)

Mm hmm.

Right. Yeah. Yeah. And I, I appreciate that getting the diabetes diagnosis or having that fear of that diagnosis. There’s so much ⁓ I think that people associate with it. And I would imagine leads to that fear like, I’m gonna go blind or I’m gonna have to get an amputation and and ⁓

Erin Phillips (12:02)

Yeah.

Julie Duffy Dillon (12:09)

I don’t know, think the way that I’ve experienced a lot of times, I’m kind of laughing because I’m like, hey, if you have health care and you’re able to see a doctor, you’re going to be already avoiding a lot of that. Everyone having access to a doctor is probably going to be more important than all of us spinning our wheels. I don’t know what you think about that, or if I’m on to something or not.

Erin Phillips (12:19)

Yup. Yup. Yup.

I could not agree more. I always tell my clients that if the number one thing that you can do to prevent these complications is have access to medical care, to healthcare. And like, what a time for us to be talking about that. And that’s much more complicated than, it’s always been complicated, much more complicated than it has ever been. And…

Julie Duffy Dillon (12:33)

Yeah.

Mm-hmm. Mm-hmm.

Right.

Mm-hmm. ⁓

Erin Phillips (12:59)

Yeah, if you do have access to healthcare, you’re at very, very low risk of all of those scary, really scary diabetes complications.

Julie Duffy Dillon (13:05)

Mm-hmm. Mm-hmm.

Yeah. Yeah. Yeah. Yeah. The access to health care. I’m in the state of North Carolina, ⁓ everyone in the state assembly is fighting over how they’re going to fund Medicaid, so much so that they’re just not going to, basically. So yeah, it’s ⁓ not a good time in North Carolina for many reasons, and that just happens to be one of them. I hope your state is better. ⁓

Erin Phillips (13:13)

Mm-hmm.

my gosh. Wow.

No. Yeah. A little.

Julie Duffy Dillon (13:35)

Good.

Erin Phillips (13:36)

A little, a lot, yeah.

Julie Duffy Dillon (13:39)

I’m sure it’s a lot. ⁓ something else I want to mention too is, I don’t specialize in diabetes per se anymore, but really help a lot of people with PCOS. And what I noticed for people with PCOS, getting the diagnosis of PCOS is something that is associated with them for a lot of people to be like when dieting really was at rock bottom. Like, and they were just told that they caused it. They did it.

Erin Phillips (13:48)

Yeah.

Yeah.

Julie Duffy Dillon (14:04)

But they have to cut out carbs and sugar. They don’t need to. And by the time I would work with folks, they had reached that rock bottom and started to recover, probably like this letter writer. But then when they are given a diabetes diagnosis or even the pre-diabetes diagnosis, a lot of times it makes all the dieting stuff come back. ⁓ And I wonder if that’s part of what this person is experiencing is like another diagnosis just to like punch them.

Erin Phillips (14:07)

Yeah.

Mmm.

Ciao!

Totally.

Julie Duffy Dillon (14:33)

to keep them down. Yeah.

Erin Phillips (14:35)

Yeah, yeah,

yeah, I know they said my previous eating disorder recovery work feels worthless. yeah.

Julie Duffy Dillon (14:42)

which I wish I knew more about the even sort of recovery work. I’m like, I don’t know they were just trying

to stay concise in the letter, but I was like, what, you’re in recovery? Like that was like totally minimized, because that’s a really big deal.

Erin Phillips (14:47)

Mmm.

told, yeah, yeah, I had to

go back as I was thinking about it and like, you know, making notes for myself, I was like, something about eating disorder recovery in my notes. And I was like, wait, did they say that? And then I looked like I had to go back a couple times and they did.

Julie Duffy Dillon (15:06)

Mm-hmm. Yeah, yeah. So what

do you wish, like when people got diagnosed with diabetes, is there something that you wish everyone was told instead of like what they’re told now? If you had like two or three things that you wish like every healthcare provider would tell someone with a diabetes diagnosis, what do you think of?

Erin Phillips (15:15)

Yes.

Yes.

Ooh. Well, first and foremost, that it is not your fault. Like this is not your fault. You did not do anything to cause this. You did not choose this. And this is not, ooh, okay, this just came in my brain. This is also not something you can reverse. Like those things can be true at the same time. Like you did not cause this and it’s not.

Julie Duffy Dillon (15:30)

Mm-hmm.

Love it.

Mm-hmm.

Mm-hmm.

Erin Phillips (15:53)

It’s not a car that you can just put in reverse and drive the other direction. And so along with that, radical acceptance is so, so helpful in this context. And knowing that it’s not your fault helps so much with that radical acceptance.

Julie Duffy Dillon (15:56)

Yes, yes, yeah.

Mm-hmm.

Yeah, yeah. I

think that’s important. It’s so important. And I can appreciate how that may feel like a buzzkill in a way of like, I can’t cure it. Because I think we’re led to believe that as individuals, we can like harness all these powers to prevent death and disability. And when it comes to it, any chronic condition, right, like it’s going to eventually get worse, even if we’re perfect, whatever that is. ⁓

Erin Phillips (16:20)

Yeah. Yeah.

Yeah.

Yeah. Uh huh. Uh huh. Whatever that

1. Mm hmm.

Julie Duffy Dillon (16:41)

Yeah, it’s going to continue to get worse.

so let’s say for like this letter writer or someone who is like has an ene disorder history and has a history of like recovering from that, and they get a diagnosis of diabetes. Are there some things that you would say are your first steps that you’d recommend for them?

Erin Phillips (17:03)

Yes, I’m so glad you asked. First and foremost is my recommendation would be get good people in your corner. And that means loved ones, like having a lot of people when they’re diagnosed with diabetes, don’t tell anyone. Like the person that diagnosed them is the only one that knows and they don’t tell anyone else.

Julie Duffy Dillon (17:04)

Okay.

Okay.

Hmm.

Erin Phillips (17:31)

And like that’s so understandable given our cultural messaging around diabetes that we were just talking about. it makes, it makes, like imagine being diagnosed with cancer and not telling anyone. And now you’re having to go through all of this and you’re not telling anyone. So isolating. And I’m not comparing diabetes and cancer, but just saying, getting this diagnosis that is changing, changing.

Julie Duffy Dillon (17:54)

Mm-hmm.

Erin Phillips (18:01)

Like what’s going on with you, right? So telling at least one loved one and then get, if you can, get a healthcare professional, like a primary care provider that you don’t hate. if they, yes, yes, yes, exactly, exactly. And then if possible,

Julie Duffy Dillon (18:03)

Mm-hmm. Mm-hmm.

Who sees you probably, right? To actually like sees you, yeah.

Erin Phillips (18:30)

get a therapist and a dietitian. Yeah. Mm-hmm. Mm-hmm.

Julie Duffy Dillon (18:32)

Yes, yeah, get all those people lined up. You know, I love

like bringing this up because we all know, I mean, if we’ve read anything from Brene Brown or anyone who’s talking about shame, like shame loves isolation, right? So I think that’s a great reminder. Like make sure you like fill someone in on what’s going on and ⁓ you don’t have to hide from it. And ⁓

Erin Phillips (18:45)

Mm-hmm. Mm-hmm. Mm-hmm.

Mm-hmm. Yeah, yeah

Julie Duffy Dillon (18:59)

Yeah, there’s so much stigma, I think, because of the things we were talking about, that it makes sense why someone would want to do that. yeah, there’s so many people out there who are experiencing this too. I know, like, in my family, all the Duffies get diabetes by the time they hit 60. It’s kind of like something that happens to all of them. And three out of my four grandparents lived to be almost 100. So I know the other one was… I know, yeah.

Erin Phillips (19:03)

Mm-hmm.

Mm-hmm.

Mm-hmm.

Holy cow, that’s, I’m not just saying that because of the diabetes beast, but just in general, that’s a long ⁓ life.

⁓

Julie Duffy Dillon (19:29)

Well, and the one who was

like the first to pass away, he was 85. wasn’t like, yeah. So I like to share that because, you know, there’s something with like diabetes that like, you can live, like you don’t, it doesn’t necessarily mean it’s going to be an early death. And like we were saying, it’s something that having access to medical care.

Erin Phillips (19:34)

Wow. Yeah. Yeah.

Julie Duffy Dillon (19:51)

is so important. And that’s where I think too, like having access to a medical provider who sees you. So then you feel safe to go to the medical provider when you need help or just a checkup, you know? Yeah. So maybe some providers are listening and they can, you know, maybe be a little bit more, I don’t know, less shamy. Yeah. Yeah. Mm hmm. Yeah. Just like.

Erin Phillips (19:57)

Mm-hmm. Yeah. Yeah. Yeah. Yeah. Exactly. Exactly.

Yes.

Yeah, non-judgmental, open, like curious. Yeah. All these things, yeah.

Julie Duffy Dillon (20:19)

Instead

of assuming, just be like, well, so how’s your eating?

Erin Phillips (20:22)

Yes, yes. Oh my gosh.

I don’t know how many clients I’ve heard say things like when I was diagnosed, my doctor essentially asked me like, have you ever even seen a vegetable? And they’re like, that’s not what, how, what, like, yeah, makes you speechless.

Julie Duffy Dillon (20:38)

gosh.

Mm-hmm, yeah, the assumptions are pretty wild, but they happen all the time, for sure. Yes. ⁓ So with that being said, I wanna know more about what you have going on in your area. What kind of things are you working on?

Erin Phillips (20:48)

Wild. All the time. Mm-hmm. Mm-hmm. So yeah. Mm-hmm.

I published a digital workbook called Diabetes Liberated. It’s an anti-diet digital workbook to help you thrive with type 2 diabetes. And I was so excited to publish this. I’ve been, publish I mean self-pub, like it’s a PDF, but very accessible.

Julie Duffy Dillon (21:05)

Mm-hmm.

Love it. Yes.

Mm-hmm. Mm-hmm.

Erin Phillips (21:22)

And so I published that in the spring. I was really excited about that. I have, when we were talking about getting people in your corner, it made me think of some of the free resources that I have. One of them is about how, ⁓ essentially all the research about how I know that you didn’t cause your diabetes put in like,

Julie Duffy Dillon (21:34)

Mm-hmm.

⁓ wonderful.

Erin Phillips (21:50)

Like it can get a science nerdy as you want, or it can, you you can stay kind of a little more like, okay, just give me the facts. Um, and then I also have a podcast where we interview people with diabetes. So, um, I’ve heard from a lot of people that that’s really helpful, especially at the beginning of a new diagnosis of hearing other people just like, okay, people are okay. You can have diabetes and also be like,

Julie Duffy Dillon (21:58)

You

huh.

Erin Phillips (22:19)

You can be good. So yeah.

Julie Duffy Dillon (22:21)

Yeah, yeah, hearing

stories is powerful, especially if you don’t have a lot of people you can probably tell about this experience. Yeah, I love it. Well, I’ll put everything in the show notes so you can see it in the show notes or down below. And listener, I don’t know if you know this, but like Erin is the person that all of us dietitians who are non-diet reach to when we are needing help with education on diabetes and diabetes medications. So check out our resources, they’re really good.

Erin Phillips (22:27)

Yeah. Mm-hmm. Yeah. Yeah.

That’s so nice.

Julie Duffy Dillon (22:49)

So yes, yes. ⁓ I mean, it’s totally true. Like, yeah, you’re the name that always comes up when we’re like, ⁓ what would Erin think? ⁓ So if people want to know more about you, is there like a website or social media that you use?

Erin Phillips (22:50)

Thank you Julie, that means so much.

I love it.

Yeah, am, let’s see, my website is erinphillipsnutrition.com. And then that’s E-R-I-N and then Phillips with two L’s. And then I am not on social media that much anymore. You can see on my previous Instagram is still up there, which is Erin Phillips Nutrition, where you can see all the resources that I have. And then I do have a Facebook group. It’s a free group for people with diabetes if people wanna join.

Julie Duffy Dillon (23:13)

Okay.

Mm-hmm. Mm-hmm.

Mm-hmm.

Mm-hmm.

Erin Phillips (23:37)

And you can find all of that stuff on my website. Yeah. Yeah. Yeah. Thank you, Julie.

Julie Duffy Dillon (23:40)

Awesome. Well, thank you so much. Thanks for stopping by and help me answer this letter.

Julie Duffy Dillon (23:46)

So there you have it. I hope you enjoyed my conversation with Erin Phillips. And I want to let you know that food has written back to this letter writer. But before we get to it, I want to encourage you to stay in touch. Let’s continue this conversation over on Substack. Findyourfoodvoice.substack.com. And if you want to join me there, you can subscribe. And again, for paid subscribers, I do a monthly deep dive devoted to a special nuanced topic related to PCOS.

I have deep dives on GLP-1s and PCOS. I also have what labs to get checked every year because you need more than an A1C. I also have two on perimenopause and menopause and PCOS, like what to expect and also ways to intervene. This year I also have a whole slate of new topics every month that I’ll be delivering to you. And I would love to connect with you again. It’s findyourfoodvoice.substack.com.

Lastly, I invite you to subscribe to the show. will be back in two weeks with my team, Rachel and Coleen and I have ⁓ an announcement to share with you. And so you don’t wanna miss this episode. All right, I have food’s letter back and I wanna say thank you for joining me today. I appreciate you have a bazillion podcasts to choose from. So thank you for choosing ours.

Dear scared and confused, we’ve had a rocky relationship and we are grateful you have focused on helping repair our connection. You deserve to eat enough and enjoy your food, no matter your size or healthcare diagnosis. We know your PCOS and diabetes diagnoses shook that belief, but remember you didn’t cause your health concerns and you can’t reverse them. You can learn tools to help you feel more energized and supported.

but consider telling a few friends or family members and surround yourself with a team that will root for you no matter what. You will need those reminders that food is not your enemy and you deserve to eat no matter what. Keep repairing and reminding yourself you are worthy of pleasure, satisfaction and kindness. Love food.

Thank you for listening to Find Your Food Voice. This is a podcast that was created, written, produced, and edited by me, Julie Duffy Dillon. Rachel Popik helps me behind the scenes to be able to get this episode to your ears. And so does Coleen Bremner. She’s someone that helps us juggle all the things to make sure that we can make it happen. So thank you, Coleen and Rachel, for all you do to make this podcast be able to come to everyone’s ears. Be sure to hit subscribe so you can make sure that you don’t miss an episode.

and also join us over on Substack. There you can support our team. We are a small and mighty team and we love what we’re doing. If you are able to financially support us by becoming a paid subscriber, it helps us to continue to do what we’re doing. All right, that’s enough for this episode. We look forward to being in your ears in two weeks. Until then, take care.