by Alexandra Williams
When you think of a working as a nutritionist you may be imagining creating meal plans,
prescribing weight loss and taking measurements. To be honest, when I started my nutrition
degree, I thought I’d be doing all those things too, until I came across Intuitive Eating, the
non-diet approach and weight-inclusive care.
Weight-inclusive care removes weight as a measure of health and instead focuses on health-
promoting behaviours and modifiable outcomes. This way of working doesn’t prescribe
weight loss and removes the personal responsibility of health from the individual.
Put simply, I work with clients to improve their relationship with food, movement and their
body image and work with them to sustainably improve their health, whatever their size.
This approach is often criticised as it is opposite to the way we were taught at university.
But weight-inclusive care is, in fact, evidence-based and more and more research is coming
out every week to support this way of working.
Why I don’t prescribe weight loss
Firstly, health is multi-faceted; there are over one hundred different factors which influence
our health. This can include biology, psychology, media, the food environment, the activity
environment, food consumption (including availability of food, portion size, convenience,
and accessibility) and individual activity. Putting the onus on only one sub-factor in this
complex web simplifies health way too much and puts blame on the individual.
Secondly, weight is an outcome, not a behaviour. When we make weight loss the focus for a
client and if they choose to consume more fruits and vegetables, eat more wholegrains, or
increase their movement and their weight stays the same or increases, they may feel
disheartened and don’t continue with these behaviours, despite the fact they’re all health
promoting, independent of weight change.
Thirdly, intentional weight loss often causes more harm. Research has consistently shown
that dieting is a risk factor for eating disorders, increased risk of anxiety and poor self-
esteem. Weight cycling (the process of losing and regaining weight) increases risk of
hypertension, insulin resistance and high blood cholesterol. And considering that the
majority of dieters regain the weight lost, weight cycling is an increasingly common risk
factor for poor health outcomes.
Finally, prescribing weight loss reinforces the message that certain bodies are ‘good’ and
others ‘bad’. Weight stigma is discrimination based on a person’s weight. Weight stigma is
an independent risk factor for negative health outcomes, regardless of body weight. This
may be because people who are stigmatised for their body size may have an increased
allostatic load, poorer healthcare experiences and avoid health-promoting activities because
of fear of further stigmatisation.
How to get started in the weight-inclusive space
- Listen to this podcast to start your unlearning: Unpacking Weight Science by Fiona Willer.
- Challenge your internal weight bias. Ask yourself this question and reflect on the answer: Do I treat clients differently because of their size?
- Join a weight-inclusive community. WIT (Weight-Inclusive Training) is a CPD membership platform which offers two weight-inclusive, non-diet training sessions per month by an expert Nutritionist, Dietitian, Exercise Physiologist or Psychologist as well as networking opportunities with your peers.
- Make your website and/or social media more inclusive. Cultivate your feed to include more diverse bodies and use inclusive language across your own platforms to make people feel comfortable reaching out for your guidance.
- Think about adding, not taking away. Start working with your clients to help them adopt more health promoting behaviours such as increasing fruit and veg intake, wholegrain intake and finding movement they enjoy without focusing on weight.