Dreading booking in with a dietitian, doctor or diabetes educator following a diabetes diagnosis? I don’t blame you – and I’m a dietitian. The go-to recommendation from most health professionals is “just lose weight” – which you’ve heard before, right? 

Not only is this advice unhelpful and riddled with weight stigma, it’s also incorrect. 

Considering the fleeting nature, potential harm, and limited success of intentional weight loss interventions at Balance and Bite, we focus on weight-neutral diabetes care. 

What is weight-neutral diabetes care? Instead of focusing on your weight (we don’t ask your weight or weigh you), we focus on factors inside your control (e.g. stress management, fibre intake, movement) that can help lower and maintain your HbA1C, blood glucose levels and other physical biomarkers. 

Because at the end of the day, you don’t have to lose weight to manage your diabetes. I’ll share why in this article. 

What is weight-neutral diabetes care? 

Weight-neutral diabetes care is a way of managing diabetes that focuses on health and behaviours rather than weight loss. The goal is to improve biomarkers like HbA1c. It shifts the focus away from weight loss (which we can’t control). 

It encourages self-care behaviours (which we can control), such as improving our relationship with food, eating more fibre, drinking more water, joyful movement, stress management, improving cooking confidence, reducing emotional eating, promoting body trust, and improving sleep. 

A weight-inclusive approach to managing diabetes shifts away from the traditional “don’t eat this” model and instead focuses on “what can you add in” to improve your health. 

“At the end of the day, a non-diet and weight-neutral approach to diabetes care is about empowering the individual in front of you. At Balance and Bite, we want our clients to leave a session feeling like, “I’ve got this” – not, “This is too hard, I’m going to fail before I even begin” 😓

Erin Murnane – Dietitian & Owner Balance and Bite

How does weight-neutral diabetes care work in practice? 

If you want to use a weight-neutral approach to manage your diabetes, here’s what we might focus on in our 1:1 sessions. Rather than discussing your weight, we’ll look at one of the 42 factors affecting blood glucose levels such as: 

Eating regularly 

Eating regularly is one of the most important things you can do to manage your blood sugar levels. The goal is to have something to eat at least every 3-4 hours to help regulate your hunger and fullness hormones and also reduce the risk of binge eating.

Carbohydrates 

Once you’re eating regularly, we’ll turn our attention to carbs. And no, I won’t be telling you to eat a low-carb diet (60g carbs per day). 

Why?

Because, telling people to eat a ridiculously low intake of carbohydrates can make them want more and feel out of control when eating them, potentially leading to poorer glycemic control. 

Instead, we’ll focus on the type of carbs you’re eating (low GI vs. High GI), the amount and frequency of carbs, what you’re eating them with (protein, fat and fibre) and how all carbohydrates (yes, even lollies and chocolate) can fit within a healthy food intake. 

Fibre 

Using our intuitive eating and “what can you add in” approach to health, we look at fibre and its role in reducing HbA1c and fasting blood sugar. Increasing your intake of fibre-rich foods (whole grains, fruit, vegetables, nuts, and seeds) can help slow digestion (aka allows glucose to enter the bloodstream gradually), giving insulin more time to play its part. 

(Enjoyable) Movement 

Knowing movement’s physical and mental benefits, we help clients find enjoyable ways to move their bodies, whether walking, yoga, rollerblading, or high-intensity activities. 

Stress management 

While changes to your food and movement can improve diabetes, don’t underestimate the role chronic stress plays in your blood glucose levels. We focus on reducing stress (where possible), including food stress. 

Medication 

Sure, lifestyle changes, such as diet, exercise, and stress reduction, can help manage type two diabetes; you may also require medication to improve insulin sensitivity and reduce the risk of long-term complications. In a non-diet approach, we help people overcome any shame or stigma they may face regarding taking medications for type 2 diabetes.

Get curious 

Rather than telling clients what to eat, we provide education and recommend that they become curious and think about how foods make them feel. Do you notice you have more energy when you eat low-GI carbs? Do you feel better having smaller meals more frequently throughout the day? Do you have less energy when you eat high-GI carbohydrates? Do your carb cravings increase when you try to avoid them? 

Benefits of a weight-neutral approach to Type 2 Diabetes 

• Limiting disease progression
• Managing symptoms
• Supporting mental health
• Reducing weight stigma
• Empower clients 

Common weight and diabetes questions 

Let’s clear up the confusion. Why are so many health professionals still recommending (and focusing on) weight loss to manage diabetes? 

Q 1. Can weight loss help with diabetes? 

Although there’s a blanket belief that weight loss helps improve diabetes, this is not always the case. If your weight loss method includes crash dieting and fasting, your body may produce more glucose than it needs, which may lead to higher blood sugar levels. While weight loss research shows initial improvements, e.g., improved HbA1C, biomarkers eventually return to starting levels, even if weight loss is maintained. 

To improve your diabetes, focus on eating more fruits and veggies, less refined sugar, moving your body more, reducing stress, drinking more water, and taking medication (and other things you can control). These changes may or may not lead to weight loss, but they will likely lead to better blood glucose control.

Q2. How to lose weight with diabetes? 

While it’s normal if you want to know how to lose weight with diabetes, it’s important to know it can be harder to lose weight if you’re diabetic. Another reason why health professionals say “just lose weight” is so problematic. Rather than focus on weight loss to improve your diabetes, we encourage you to focus on behaviours you can control, like eating more fibre, moving your body, taking medication, or drinking more water. 

Want to manage your diabetes without focusing on your weight? 

Book an appointment with our experienced non-diet and HAES diabetes dietitian. Or send us an email with your weight-neutral diabetes questions.