In this diet-crazed, anxiety-ridden world, many people are selling fad diets and quick fixes. You know dieting doesn’t work but you do want to change your food and eating choices. The question is how?

Seeking the help of a non-diet or weight-neutral diabetes educator or dietitian can help you change your lifestyle by focusing on nuturing and nourishing self-care. This article will provide you with a walkthrough of a typical appointment to help you understand the value of a weight neutral approach.

First – Let’s meet and simply get to know each other.

It is lovely to learn about you, the person, and not assume you are doing anything wrong. Even facing a new diagnosis doesn’t mean that you are guilty of eating poorly, or that you should be blamed. Many clients assume because they ‘haven’t lost weight’ that they are at fault. Judgment can derail any appointment and for many clients, this sense of ‘being wrong’ is often a sign that they are stuck in diet culture and have experienced weight stigma.

Second – You get to set the agenda, not us.

You might be thinking, but you are the expert, and while it is true that we have had a lot of education, it is completely false to think that we know YOUR body, needs or values. You know what else is false – that we know what resources you have available or are considering. So, instead of telling you what to change, a weight neutral professional typically asks questions to learn what you want to work on. Here is what an appointment might sound like.

Patient: “I was told that my A1C is up.”

Me: “You want to work on lowering your blood sugar?”

Patient: “Yes, I was thinking that it is what I am eating.”

Me: “Great, I would love to hear more about what you think is the issue.”

Pretty straight forward right? Yet, for many of my clients, the conversation turns towards self-blame. The following example will help you understand.

Patient: “I need to lose weight.”

The desire to change is complex. There are lots of reasons why you want to change however, when you feel frustrated, angry, resentful, or afraid this desire increases and it shifts from a choice to a demand. "I ‘need’ to lose weight." Lurking in this urgency and important 'need' is self-blame. Self-blame feels like motivation, but it isn't sustainable and it actually isn't helping. It is part of a larger problem called internalized weight stigma.

A weight neutral professional understanding how stimga work and will help you see how weight stigma, also known as weight bias, is discrimination or stereotyping based on a person’s weight. Weight stigma can increase body dissatisfaction, weight-cycling, a leading risk factor in the development of eating disorders. When weight stigma is internalized, these negative stereotypes such as the body is broken, at fault, or unworthy of care are created, repeated and believed, reinforcing an invisible cycle of self-blame.

A weight neutral dietitian can certainly help you learn about nutrition, or how to eat a balanced diet. However, where they really shine is helping you understand how food, diet, size, body image are both internal (our feelings, thoughts, and values) and how these can be magnified or undermined by our external world, or society. Here is an example of what they might say during a session.

Us: “You really want to change your diet.”

Patient: “I do! My blood sugars are out of control and I don’t feel well.”

Us: “Eating better would help you improve your blood sugar and feel better.”

Patient: “Yes, and I would lose weight.”

Us: ”Describe to me how eating better would be different than what you are doing now?”

Patient: “Well, I think I am ….” Voice trails off

Us: “You want to focus on eating a balanced diet, and the only time you have done this was to lose weight.”

Patient: “I guess you are right. I don’t think I have ever tried to change my diet unless I am trying to lose weight.”

Us: “So eating a balanced diet, simply to nourish yourself, is new.”

Patient: “Yes. I have never done this before.”

Us: “You can see that nourishing the body is not the same thing as trying to lose weight.”

Patient: “Oh my gosh! I get it! I’ve been focused on losing weight and the scale, that I am not thinking about what might nourish my body.”

Us: “Shifting to eating balanced meals, nourishing the body and learning more about diabetes, in general, seems like something that might work.”

Patient: “Yes. I don’t think I ever considered doing this.”

Us: “You are seeing more opportunities.”

Patient: “Yes, I really am and I am excited about meeting you! I really thought the appointment would be so different.”

Us: “It wasn’t the nightmare you feared.”

Patient: “No, you are really nice. I don’t feel stressed out or worried and I have learned a ton already. This appointment has been a mind-shift!”

Us: Silence – smiling.

Third –Diabetes is more complex than weight.

Nutrition is the foundation of health but it can’t do everything, including curing diabetes. This means managing blood sugar requires more than eating a balanced diet. We have all heard, “If you just lose weight…”. In our fast-paced world, many of the complexes of life are simplified to the point that they are wrong. This is the case with diabetes.

Fourth – Everybody Needs Nutrition – regardless of size.

Society has forgotten that everyone needs nutrition, it isn’t just people with diabetes or only when you are on a ‘diet’. All bodies need to be cared for, and for many people, the only time you ‘cared’ for your bodies, was when you were dieting. To make things even more confusing, what would happen if you felt that you weren’t ‘allowed’ to care for your body because of your weight? You see, for many people, the issue isn’t dieting, but trying to understand what self-care is, and what self-care looks like if weight wasn’t part of the equation.

Fifth – Support

Getting diagnosed with diabetes isn’t fun and to get through the rough times in life is better with support. Here are a few benefits of getting help.

  1. Support can help you create a plan and understanding your treatment options, which will likely include what you eat.
  2. Support comes in different shapes ranging from books, podcasts, online and in-person groups, yoga class, or hanging with supportive friends who ‘get’ the challenge you face.
  3. Support can come from your providers, therapists, nature or place of worship.
  4. Support can help shift your thinking to accept that there is no right or wrong type of support to help you. Ask yourself if you need a single dose of support or maybe something a bit more consistent.
  5. Support can help you see patterns. For example, maybe the issue isn’t about learning what to eat, maybe the real issue is getting the support in place to make the change. Meeting with, or signing up to attend a program is one way to overcome barriers, talk with your peers, and see what works for other people.

The five things a weight neutral nutritionist can help with begins by creating the space to learn. This opens the mind to see opportunities regarding diabetes, nutrition, medication, and movement without harping on weight. Self-acceptance of YOU, is what a weight neutral educator does best. If you feel like, yep that would help me, check out the WN4DC Facebook page.