Handling Diabetes’ ‘Shoulds’

Megrette Fletcher
3 min readDec 8, 2020

“You ‘should’ cut out sugar, eat less sugar, don’t eat dessert, eat ‘X’ number of meals, eat ‘X’ number of snacks, eat before ‘X-time’, don’t eat between ‘X’ and ‘Y’ times of day. When it comes to diabetes, you may have heard a countless number of ‘shoulds’.

“You ‘shouldn’t’ be so hard on yourself” or “You ‘should’ relax and not worry so much.” Even trying to be positive can become a ‘should’ as Karen Ialapi RDN, suggests, “We need to let go of the “should” on both sides of the equation. Saying ‘we should be kind and accepting’ is a ‘should’ of sorts. The intent and message is a great and worthwhile endeavor. However, making it a requirement just adds to the ‘should’ list.”

Why is ‘Should’ Such a Confusing Word?

A lot of the confusion depends on who is talking. Whether you are being told by a trusted healthcare professional, partner, or friend you ‘should’ do something in a certain way, it may come across as genuine care and concern. However, it may just as easily awaken an inner teenager who is stubborn and defiant.

If you are saying, “I should…” you could be expressing your true desire to change. Yet, most often, the ‘shoulds’ that roll off our tongues are simply repeating a myth, diabetes’ folklore, or a random fact not connected to your specific health concern.

Shifting from ‘you’ to ‘I’ is a sign the ‘shoulds’ are becoming internalized.

Another reason why ‘shoulds’ are confusing is because they have a surprising amount of power when they are internalized. The process of internalizing a ‘should’ happens when the ‘should’ shifts from an option or possibility to a personal commandment. For example, “People with diabetes ‘should’ eat more low carbohydrate vegetables.” This ‘fact’ is offered as a ‘helpful’ direction to improve health. However, how this (and many suggestions like it) are perceived isn’t helpful if when, being human, you don’t eat or like vegetables. When you don’t eat and enjoy vegetables, you may feel like you have done something wrong or that you are a ‘bad’ person.”

Man pointing a finger at you. Photo by Adi Goldstein on Unsplash

Many people who have a history of dieting have internalized food-related ‘shoulds’ in a way that feels like blame, guilt, and shame around food, eating, exercise, and blood sugar levels. Meeting with a weight-neutral diabetes care professional can help if ‘should’ is painful, or if it is triggering you in any way.

If you are wondering, ‘Has this happened to me?’ you can try to be mindful of how often you command yourself to do something. The internalization of ‘shoulds’ happens slowly. You may have become so acclimated to telling yourself what to do, think, act, know, and eat, you can’t recall the moment when you didn’t think this way. This is another reason why ‘should’ is a tricky word to understand. We unknowingly ‘should’ be ourselves.

“Seeing food and eating objectively, without the ‘shoulds’ can help you reclaim your diet.” Megrette Fletcher M.Ed., RD, CDCES

Seeing food and eating objectively, without the ‘shoulds’ can help you reclaim your diet. This can be accomplished in a number of ways, including changing ‘should’ into a question, and/or switching ‘should’ with ‘could’.

Working with a weight neutral dietitian is also recommended. A weight-neutral dietitian has had training in mindful eating and intuitive eating and states on their website they follow the spirit of Health At Any Size. The WN4DC.com website offers a list of weight-neutral diabetes professionals as well.

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Megrette Fletcher

Is an RDN & CDCES, and co-author of Eat What You Love, Love What You Eat with Diabetes & Sweet Support Podcast