09/27/2019

Diabetes Education: What’s Weight Got to Do with It?

By Megrette Fletcher. M.Ed., RD, CDE, Wentworth-Douglass Diabetes Services

Until diabetes becomes a personal issue, most people haven’t taken the time to understand what diabetes is. Like many people, you may have assumed that diabetes is caused by weight and therefore weight loss can cure diabetes. Many people also assume that seeing a diabetes educator or dietitian is a conversation about what you can’t eat to force you to lose weight.

“Seeing an educator isn’t about weight loss or going on some unsustainable eating plan. It is to help you learn about diabetes and develop a plan that works for you,” explains Marianne Evans-Ramsay, RDN. CDE, Registered Dietitian, Diabetes Educator, and co-host of the Sweet Support Podcast. “We know that people come in all sizes and that people can be healthier at any size. Working with an educator isn’t about going on a short-lived diet. It is about identifying the places you want to change.”

One of the biggest barriers to seeking diabetes care is something that few people even considered. It is how living in a larger body and/or having diabetes changes how other people perceive your health. Weight bias is assumptions about a person’s health or behaviors based on his or her size. When a person meets with a provider, they may experience this bias by not receiving the same medical care as someone in a different sized body. When a person experiences weight bias, the lived experience is called weight stigma.

Weight stigma isn’t uncommon. A 2016 review article published in the Journal of Nurse Practitioners concluded that the experience of weight stigma excludes people from participating in many common activities, including seeking medical care. Weight stigma affects people living with prediabetes and diabetes because of the blame and shame that surrounds being diagnosed with it. Few people are comfortable saying, “I have diabetes” because that disclosure may invite unwanted comments about eating, food choices, exercise decisions, and treatment options by family, friends and health care providers.

Ask yourself, is your weight or your current blood sugar control the reason you don’t schedule care or limit the amount of follow up care you receive? If it is, here are five things you can do to help you address weight-bias and weight stigma.

1. Learn more about weight stigma by listening to the Sweet Support Podcast.
2. The average clothes size of a woman in the United States is size 14.  Images on TV and in magazines are distorted and are typically thinner and more beautiful than the average person. Remind yourself that “That’s not real!” when you see only beautiful, smaller than average people in magazines. This lack of representation is a form of weight-bias.
3. Distinguish between language about health and weight bias. Healthy eating does not require you to lose weight. In fact, good diabetes care isn’t about how you look, it is about what you do! Meeting with a diabetes educator can help you develop a personalized plan that works for you!
4. Focusing on your weight or size is not helping you see the ways you contribute to society, your work, friends and family. The big and small ways you benefit the world has nothing to do with your appearance.
5. Speak up if you are dealing with weight-bias from a provider! Let them know their comments are hurtful and are not motivating.

Call Diabetes Services at (603) 740-2887 for more information about our services, community education programs and support groups.