Lee Ann Thill was diagnosed with type 1 diabetes at the age of 5, back in 1978. “I had just started kindergarten, and had all the classic symptoms – peeing a lot, drinking a lot, weight loss. My mom took me to the pediatrician after she realized there was something wrong, and I was diagnosed. We went straight to the hospital, where I stayed for two weeks. “
Like many of us who were diagnosed decades ago, the narratives around food were confusing. From sweets restrictions to the exchange diet, there wasn’t a set “diabetes diet” that people followed. “I don’t remember following a diet, aside from avoiding sweets. My mom had an interest in ‘healthful’ eating and fitness, so the way we ate at home reflected the dieting trends of the times, which amounted to less refined grains, and lower fat foods. I was still allowed to have ‘sweets’ on special occasions, but we typically didn’t have foods like that in the house.”
Today, 40 years later, Lee Ann has moved to a vegan diet and lifestyle to manage both her diabetes and her desire to affect positive social change. “At age 14, I developed an eating disorder, and didn’t recover until age 32,” she said. “Becoming vegan has reinforced my healing process. For some people, it might appear that I’ve traded one category of forbidden foods for another, but as a vegan, I don’t think of, let’s say, a cheeseburger, as food. Plus, I eat vegan cheeseburgers, so it’s not like I’m missing out. An important idea that has emerged for me from my eating disorder recovery is that everyone – including animals – deserves to be respected for exactly who they are, nourished, and free from harm.”
The path to veganism was a slow process for Lee Ann, who followed what she called a “half hearted reducitarian [a commitment to eating less meat] lifestyle for several years, partly motivated by health concerns, and partly motivated by an emerging awareness that there was something questionable about meat. Inspired in 2013 by the documentary VEGUCATED, Lee Ann set her sights on transitioning to a vegan diet. “At first, I set a goal to eat at least one vegan meal a day. It was a fun challenge for me to experiment with new recipes and foods. Once I started to change the types of food I was buying, and had some “go-to” recipes, it became easier to increase the frequency of vegan meals. I really enjoyed that process, felt accomplished, and felt physically and emotionally better. By January 2014, I was eating all vegan at home, and maybe having one or two vegetarian meals or snacks away from home, so deciding to be vegan at that point, wasn’t a big change.”
Some people with diabetes are frustrated by the higher carbs found in vegan/vegetarian recipes, and are often deterred from experimenting with vegan foods due to the carb load. But Lee Ann has found that portion sizes and substitutions make a huge difference in managing those concerns.
“I add lower carb foods to “thin out” the carbs,” she said. “I make a chickpea-potato curry, but I load it with greens, zucchini, peppers, celery, carrots, and pressed/crumbled extra firm tofu. I eat it like a stew, no rice, topped with avocado and pumpkin seeds. Another strategy is to play with portion sizes if you have a higher carb main dish. I recently made lasagna with cashew-based ricotta, and had a “side dish” portion, with a big salad loaded with veggies that was lower carb.”
She also employs some “food math” in order to build her meals. “I rely on a veggie bowl formula. I keep a rotating selection of cooked veggies and prepared grains in the fridge. The formula is flexible to meet specific needs, and you can play with proportions to keep it lower carb. For example, I’ll add greens and beans, some grains and veggies, plus nuts, seeds, and some kind of seasoning to build a meal.”
“I had concerns about how my BG would respond when I first started transitioning to a vegan diet, which seems to be a common concern for PWD,” said Lee Ann. “I’ve found that my BGs have improved, with fewer spikes, and less frequent persistent highs. My A1c decreased slightly. I have also been able to discontinue several oral medications, including ones I was taking for cholesterol and blood pressure. Physically, I feel strong, and since going vegan, I’ve found a new, more sustained interest in athletics, especially running. I had a hard time following a fitness program in the past, but I’ve found that becoming vegan improved my sense of empowerment by showing me I can change my behavior.”
But veganism isn’t entirely about diet, for Lee Ann. There’s a bigger picture in play, and one that directly touches her experiences with diabetes. “Being vegan has made me more curious about power – who has it, who doesn’t, forces maintaining those dynamics – ways to alter power dynamics, and more critical of how my actions can better reflect my personal values, notably, fairness, empathy, knowledge, and creativity.
“I’m not active in the diabetes advocacy movement like I once was, but that experience was foundational for thinking about how power operates, both within the diabetes world (i.e. patient interests vs. pharma/tech interests, who gets invited to events), and in broader contexts (i.e. competition for health research funding, media representation). As a diabetes advocate, I became uncomfortable with what I perceived as power struggles, competition, and demand that diabetes be a priority. Of course, it’s a priority for me, but I sometimes perceived an implicit demand that people understand the “diabetes experience,” without fair reciprocity. I felt like a hypocrite, telling people they need to know about diabetes, and donate money to diabetes charities, but not learning about the infinite ways others are struggling and need support.”
“For a long time, I had been frustrated that there wasn’t a way to convey the physical and mental experience of living with diabetes – what it’s like to have a low or high BG, the emotional drain – but I hadn’t been willing to fully and thoughtfully consider the bodily experience of others. I hope people will trust me and give me the support I need, even if they can’t personally know the diabetes experience, and I need to reciprocate, not just towards humans, such as my support for racial justice or immigrant rights, but towards farmed animals. Can I know the experience of a chicken who is used for meat or eggs? No, but I can empathize with someone who feels threatened or objectified, and I can educate myself about their experience. I can trust that they want to be safe and unharmed, just like my dogs, just like me, and I can make choices that reflect that trust.”
Lee Ann Thill is an art therapist, licensed counselor, and artist, in Philadelphia. She’s a doctoral candidate whose dissertation research is exploring how veganism empowers women with a history of disturbed eating behaviors. To follow more of Lee Ann’s vegan journey with diabetes, you can find her on Twitter at @T1Vegan, and be on the lookout for her new website (to be launched soon).