What is a Non-diet, Weight Neutral Approach to Diabetes Care?

A non-diet, weight-neutral approach to diabetes is taking the need, or desire, to lose weight out of diabetes care. Now, why would someone with diabetes want to do this? People with prediabetes and diabetes are often no strangers to dieting. Most of my clients have said they know more about dieting than a registered dietitian. As someone with thin-privilege, I would say this is often true!

Woman getting her blood pressure checked. Phot by Hush Naidoo

Research is showing that a person’s weight has less and less to do with what they eat. In fact, many thin people have never dieted. This paradox highlights that weight is determined by many factors. Emphasizing that one should control their weight via dieting can promote unbalanced eating, nutrient deficiencies, and disordered eating. Additionally, studies show that focusing on weight and restricting your eating is more likely to cause weight gain, not weight loss!(1) So, working with a non-diet, weight-neutral diabetes professional is refreshing because they understand these realities!

There are a lot of ways to improve your blood sugar without going on another diet, which only leads to yo-yo dieting. The benefits of a non-diet, weight-neutral approach to diabetes care aren’t measured on a scale. Instead, they can be seen in improved A1c, more balanced meals, consistent movement, and a decrease in the overall burden of diabetes. In a structured review of Mindfulness, mindful eating, and intuitive eating approaches, researchers concluded, “Mindfulness appears to work by increased awareness of internal, rather than external, cues to eat. Mindfulness and mindful eating have the potential to address problematic eating behaviours and the challenges many face with controlling their food intake.” (2)

Let’s unpack what these British researchers are talking about when they talk about internal and external eating cues. When we think about dieting, it is often the diet that tells a person what and how much to eat. For example, “At lunch, choose between” or “At dinner, you can have X number of points.” In both cases, the diet, not YOU, are defining the choice. This is an example of EXTERNAL cues. In short, someone or something is telling you what to eat, when, and how much to eat.

Internal cues refer to information only you know, such as food memories, “I loved eating that food!” It also refers to food cravings, “Eating X sounds delicious!” and hunger, “I am hungry, eating would feel good.” Working with a non-diet, weight-neutral diabetes professional helps you balance your internal cues (hunger, fullness, and food desires) and your external cues (time of day, blood sugar, nutrient needs). These professionals understand that internal and external cues aren’t ranked, meaning one is better than the other. However, both cues to eat are present and are often in conflict with each other. Weight neutral diabetes professionals work with you to resolve this conflict and to make peace with food, your body image, or your weight.

How does this help? Having diabetes means you are already juggling a lot of life’s alligators. Adding the additional stress of having to eat only X or weigh Y can get you out of balance because it focuses your attention on diet and not the other life events you are juggling, like work, family, finances, sleep, and health. Working with a non-diet, weight-neutral diabetes professional is acknowledging the desire to shift the focus from what you weigh to finding a balanced approach to health.

Curious about where you can find such a service? Let me introduce you to eleven weight neutral diabetes professionals who can help you focus on self-care vs. self-sacrifice to manage your blood sugars.

Meet RanDee Anshutz, RDN, LD, LMT. She is a Registered Dietitian Nutritionist, Licensed Massage Therapist and founder/owner of Synergy Health and Wellness. This nutrition practice focuses on the whole person, offering nutrition, massage, and diabetes care specializing in promoting Health at Every Size® (HAES) and supporting body trust.

Meet McKenzie Caldwell, MPH, RDN who is a Registered Dietitian RDN who, while obtaining her graduate degree, discovered Health at Every Size® — an approach to health that is weight inclusive and radically opposes diet culture. It recognizes that weight-loss diets simply don’t work and that all people in all bodies deserve respect and quality medical care. She paired this view of health with Intuitive Eating, a tool developed by registered dietitians to help clients balance their eating and truly enjoy all the foods they eat by tuning into their inner signals. McKenzie explains that focus on diabetes also includes gestational diabetes.

Meet Billie Karel, MPH, RD, LDN, CDCES, who is a HAES®-aligned Registered Dietitian and Certified Diabetes Care and Education Specialist. She is offering Mindful Diabetes Self-Management:

Weight inclusive diabetes education & support group, promoting peace with food & body. To learn more visit Lutz, Alexander & Associates

Meet Trish Lieberman, MS, LDN, CEDRD, CDCES who is passionate in helping those with diabetes and disordered eating heal their relationship with food and body through intuitive eating and a weight-neutral approach.

Meet Lisa Lombardini, MS, RD, LDN who uses Intuitive Eating to help bring compassion and freedom back to your relationships with food. She uses a weight-neutral, Health at Every Size® approach. “By taking the focus away from weight, we can work together to help you meet your goals and focus on making sustainable changes for life.”

Meet Ashely Munro, RDN, LDN, CDCES who is a Certified Intuitive Eating Counselor, who weaves these concepts in both her practice and her life. Through teaching intuitive eating, she can help you manage your blood sugar and discover a different way of thinking; a ‘shift in mindset’ about eating and nutrition.

Meet Kim Murachver, MS, RD, LDN, CDE who is the founder and owner of Greene Nutrition. She is a registered dietitian/nutritionist, certified diabetes educator, and certified intuitive eating counselor. She explains that many people are quick to assign labels to foods as being “good” or “bad,” rather than looking at the big picture of eating patterns over time and our behaviors around food.

Meet Lauren Newman, RDN, who is interested in improving your relationship with diabetes management. She firmly believes that a healthy relationship with food and our bodies is better than any food could ever be. Her mission is to empower individuals with diabetes to make peace with food so they can live their best lives.

Meet Kylee Pedrosa, MS, RDN, LDN, CDCES, a Registered Dietitian and Diabetes Care and Education Specialist and parent of a child with type 1 diabetes. Kylee explains, “Most people know what to do to manage their diabetes — but not everyone knows how to do it. You may feel frustrated, guilty, and overwhelmed when the numbers on the scale and your A1C don’t change. The problem may not be with you, but with the one-size-fits all approach to diet, exercise, and blood sugar management.”

Meet Erin Phillips, RDN, CDESE, who is a Registered Dietitian, nutrition therapist, and diabetes specialist. She enjoys helping clients make peace with food and their bodies. “If you’ve been diagnosed with Type 2 Diabetes or Prediabetes, you might be feeling overwhelmed and unsure about what to eat in order to best care for your body. While most diabetes information is focused on weight loss and restrictive diets, my non-diet, weight-neutral approach will help you make sense of blood sugar and food while helping you make peace with your body.”

Meet Maddy White, RDN, who is an associate dietitian at Nutrition Instincts. She explains that “Good blood sugar management does not require you to give up carbs, stop eating your favorite foods, or go hungry. In fact, tuning into and honoring your body’s cues and needs can actually reduce stress and improve your blood sugar.”

Meet Nicole Myers, RDN, CDCES, a Registered Dietitian and Certified Diabetes Care and Education Specialist who is a part of a virtual private practice. Nicole has a special interest in women’s health and gestational diabetes. Nicole believes in a weight-neutral approach to diabetes care and enjoys guiding people through their journey with Intuitive Eating.

Grodstein, F. (1996). Three-Year Follow-up of Participants in a Commercial Weight Loss Program. Archives of Internal Medicine, 156(12), 1302. doi: 10.1001/archinte.1996.00440110068009

Warren, J., Smith, N., & Ashwell, M. (2017). A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: Effectiveness and associated potential mechanisms. Nutrition Research Reviews, 30(2), 272–283. doi: 10.1017/s0954422417000154

About the author: Megrette Fletcher is a Registered Dietitian/Nutritionist and a diabetes care and education specialist. She is also the co-author of Eat What You Love, Love What You Eat with Diabetes, and co-creator of Sweet Support Podcast.

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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