I Believed I was Helping People by encouraging them to “Shrink their Bodies”

I even taught a weekly prediabetes class (in English and Spanish!), and I remember standing in front of the room, confidently telling people that if they wanted to reduce their risk, they just needed to lose 5–10% of their body weight. And if they wanted to lower their risk even more? Well, they should lose even more weight. Like it was that simple.

I genuinely believed I was helping people. I even completed an adult weight management certification, where I was taught that weight loss was the key to better health outcomes. I followed the guidelines, repeated the same weight-centric messaging, and reinforced the idea that shrinking the body was the answer.

Health At Every Size Transformed my Approach

But then, in 2017, I started learning more about Health at Every Size. First, I took Evelyn Tribole’s Intuitive Eating Pro Skills course. Then, I started following the work of folks like Christy Harrison and Sabrina Strings, who each detail data that highlight the harm of weight stigma in healthcare and the ways in which weight-focused interventions often lead to worse health outcomes. Eventually, I conducted hundreds of interviews on weight-inclusive care through my own podcast, speaking with experts from all over the world. And what I learned changed everything.

Turns out, there’s research suggesting that people can improve blood sugar, lower A1c, and feel better overall without focusing on weight loss. Behavior-focused interventions—like eating balanced meals, moving in ways that feel good, managing stress, and taking medications when needed—work better for the long haul. When people feel supported and not shamed, they stick with these changes, and their health actually improves.

We’ve been sold this idea that losing weight is the magic fix for diabetes. But the reality? Long-term weight loss is incredibly rare, and for most people, weight cycling (losing and regaining weight over and over) can actually make health worse. Plus, telling someone to shrink their body doesn’t address the barriers to health like food access, stress, and medical stigma. 

Sustaining Healthy Behaviors May Be More Important than Weight Loss

We also forget that health isn’t just about personal choices. Where we live, how much money we make, our access to healthcare…these things matter way more than a number on the scale. If someone is struggling to afford nutritious food or has been dismissed by doctors because of their weight, focusing on weight loss isn’t going to fix those issues. A weight-inclusive approach takes these bigger factors into account and helps people make changes that actually fit their real lives.

The Diabetes Prevention Program (DPP) study showed that yes, participants who lost weight reduced their diabetes risk, but the study didn’t separate the effects of weight loss from behavior changes. When researchers followed up 10 years later, most participants had regained the weight. However, those who continued with health-promoting behaviors—like balanced eating and movement—still maintained a reduced risk of developing diabetes, even without sustained weight loss. This suggests that the behaviors themselves may be more important than the weight loss, and for some, the weight loss may simply be an initial result of adopting those behaviors.

Even when I was diagnosed with prediabetes myself in 2024, my BMI was (and still is) considered “overweight.” However, when I made meaningful changes to my health, such as prioritizing nutrition, movement, and stress reduction, my BMI didn’t budge, yet my A1C dropped from 5.8% to 5.2%. If I had only focused on losing that recommended 5–10% of my body weight, I probably wouldn’t have made changes that were sustainable or improved my A1C as much as I did.

Shifting Away from Weight Centric Advice

At my 1:1 virtual nutrition counseling company, Diabetes Digital, we’ve shifted away from weight-centric advice, and the results speak for themselves. Our clients lower their A1C, feel better in their bodies, and build habits they can actually maintain. Of course, we believe in bodily autonomy. People have the right to make the choices that feel best for them. But instead of treating weight loss as a prerequisite for health, we focus on sustainable habits that support long-term well-being. That shift has been transformative for our clients, allowing them to break free from the dieting cycle and focus on what truly improves their health.