May, 2024 Newsletter

I have been wondering how body image and diabetes intersect. If you are also curious, please keep reading, and of course, share with a friend. If we haven’t met, my name is Megrette and I am a registered dietitian, diabetes educator. I wear a couple of hats as a writer. I have written 5 book and have two newsletters, which are free. The links are at the bottom of article.

What is body image?

Looking up the definition of body image in research articles and I found “Body Image (BI) is a multidimensional concept that involves people’s positive and negative perceptions, thoughts, behaviors, and attitudes about their body and appearance (Gardner, 1996; Garner & Garfinkel, 1982, Grogan, 2016).   This same article continues to explain, “BI is not only related to the way people perceive their body, but it also influences the way they interact with the world through that body (Piran & Teall, 2012).

Reading that made me pause. How does a person’s body image impact diabetes care? How does weight stigma impact body image? Golly, you can see, my curiosity has opened a can of worms. 

My unscientific take on why body image matters in diabetes care comes from the fact

  • It is hard to care for a body you hate, dislike, or feel has failed you. 
  • You can’t hate yourself well, happy, or healthy.
  • Fostering a better relationship with the body is diabetes management.

Reading a recent post from Recovery, Ginny Jones offers an excellent summary of how healthcare professionals can help people create a better relationship with food, eating and their bodies. Her suggestion is seeing what “is” vs what is “good” about the body. This suggestion is a principle of mindfulness and mindful eating, so of course I am going to share it. 

Another resource is Gretchen Wallace, MS, RD, CD. She writes a newsletter called The Full Life. This issue provides a body image check list. I loved the 20 ideas and the breakdown of how they might look in practice.

Counseling ideas from an MI perspective

What can you say when your client is angry, frustrated and grieving because of diabetes. 

  1. Give your clients (and yourself) permission to learn. If you use MI this could sound like,
    • “Changing your body image is tricky.” (Empathy/Reflection) Reading the two resources can help you understand body image work.
    • “What has helped you question diet culture?” (Open ended question that is Evoking) Here your curiosity becomes an invitation to hear the client’s larger struggles.
    • “Where could you go to learn more?” (Open ended question – Evoking) offers this article
    • “Can I share some resources? (Permission to offer information) Or 
    • “Have you found other people with lived experience?” (Evoking which is pulling inclusion, decreasing isolation, belonging)
  2. When working with clients (and yourself) remember body image isn’t a singular topic. There is a lot of thought, ideas and opinions about body image and how to support accepting our ever changing body. 
  3. Asking clients to be their own experience is a practice.  For this reason I will encourage you to be mindful of the word “just”.
    • I just need to meditate more. 
    • I just need to eat less. 
    • I just need to love myself. 
    • I just need to eat a balanced diet. 

Personally, I am triggered by JUST because it is a minimizing word. It invalidates the insight, and effort already taken. I think over the years I have an involuntary tick when it is said in a sentence, which is a funny thing to imagine. Even as I am writing these words, I am at my standing desk, my eyes are closed, my stomach is in a knot, and I am taking deep breaths to recenter myself. 

Often client’s belive that body image isn’t a big deal, that it is easy, and it “shouldn’t be” any harder for them, a person with diabetes. This is when you can be compassionately curious. Ask, “if you are comfortable sharing, I’m curious about how you think body image and diabetes intersect.”

Like you, I want to provide clients with permission and space to explore how body image and diabetes care intersect. Let’s keep talking because this is part of diabetes care.

What is happening in May  

For those of you who are new, here are the links to four of my books. Each offer continuing education options.

Weight Neutral Diabetes Counseling And Education Activities: Helping Clients Without Harping On Weight Available at Build strong counseling skills with this practical and effective resource. It offers 16 CPE. This truly unique book includes realistic examples and just-right activities you can start using with your diabetes clients tomorrow! Skelly Skills

Core Concepts Of Mindful Eating: The Professional Edition Finally—the foundations of mindful eating (ME) concepts, research and best practices in a comprehensive yet practical format. It offers 25 CPE. Begin or expand your understanding of mindful eating for your practice here. 

Discover Mindful Eating: A Step-By-Step Guide To Using 50 Mindful Eating Activities With Your Clients (Second Edition) Written by mindful eating expert Megrette Fletcher, MEd, RD, CDE, this updated classic bestseller is designed to give RDs and CDCEs the practical tools to confidently use mindful eating for a variety of counseling scenarios

Eat What You Love, Love What You Eat with Diabetes This is a client facing book on diabetes care that uses mindfulness as the foundation. It is in alignment with HAES principles and is adapted from Michelle May’s Mindful Eating Cycle.

Free Newsletters

These are offered twice a month as a free way to explore stigma in diabetes care. 

  • No Weight Loss Required Newsletter is a free weight-inclusive publication for your clients. It is published two to three times per month. 
  • Inclusive Diabetes Care offers self-paced CPE for healthcare professionals to unpack the many stigmas surrounding diabetes care.  

Weight Inclusive Nutrition Services

Would you like having a virtual RD in your office? I offer virtual counseling so you can refer clients for weight-inclusive nutrition education, counseling, or diabetes education. Please reach out to chat more about your specific situation. I am currently licensed in the following states: AK, AZ, CA, CO, CT, FL, GA, HI, ID, IN, MA, MI, NH, NJ, NY, OK, OR, PA, TX, UT, VA, VT, WA, WI, WV, WY.

Burychka D, Miragall M, Baños RM. Towards a Comprehensive Understanding of Body Image: Integrating Positive Body Image, Embodiment and Self-Compassion. Psychol Belg. 2021 Jul 27;61(1):248-261. doi: 10.5334/pb.1057. PMID: 34394951; PMCID: PMC8323527.

 Burychka D, Miragall M, Baños RM. Towards a Comprehensive Understanding of Body Image: Integrating Positive Body Image, Embodiment and Self-Compassion. Psychol Belg. 2021 Jul 27;61(1):248-261. doi: 10.5334/pb.1057. PMID: 34394951; PMCID: PMC8323527.

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