As a health professional, navigating complex and often conflicting messages about diets and health can be challenging. For years, the conventional wisdom has been that weight loss is the key to optimal health. Recently, there has been a shift in the understanding that diet and weight-loss-centered approaches may not be practical or sustainable for many people.
In this blog post, we will explore the principles of the non-diet approach and how dietitians and health professionals can incorporate it into their practice.
What is a Non-Diet Approach?
The non-diet approach is a way of thinking about health and wellness that emphasizes self-acceptance, weight inclusivity, and intuitive eating. It is based on the principle that health is not determined by weight or body size but by overall well-being, including physical, mental, and emotional health.
Instead of focusing on weight loss as the primary goal, the non-diet approach encourages individuals to develop a positive relationship with food and their bodies. This means listening to internal cues of hunger, fullness, and satisfaction rather than relying on external rules or restrictions.
It also means embracing a diverse range of body shapes, sizes, and food preferences and celebrating the unique qualities that make each person who they are.
Features of the Non-Diet Approach,
The non-diet approach features include those similar to Health at Every Size® (HAES®), Intuitive Eating, and the Satter Eating Competence Model (1). You can learn more about all of these topics as a DSC member.
- Rejecting Diet Culture: The non-diet approach rejects the cultural pressure that weight loss is the key to health. Eating is seen as normal without labeling certain foods as “good”, “bad”, “healthy”, “or unhealthy”. Non-diet nutrition is encouraged, with a focus on enjoying a variety of foods.
- Embracing Body Positivity: The non-diet approach encourages individuals to accept and appreciate their bodies, regardless of size or shape.
- Practicing Intuitive Eating: The non-diet approach emphasizes listening to internal cues of hunger, fullness, and enjoyment and developing a positive relationship with food.
- Focusing on Overall Health: The non-diet approach recognizes that health is multifaceted and includes physical, mental, and emotional well-being. People also have the right to choose not to pursue optimal health without having a lowered feeling of self-worth. You can learn more about this ideology in the DSC Weight Stigma course created in partnership with Kyla Blackie, RD.
Outcomes With a Non-Diet Approach
- Blood pressure and lipids
- Eating behaviors (including increasing fruit and vegetable intake, and reducing disordered eating behaviors)
- Self-esteem and positive body image
Wellness programs that promote a non-diet approach to health may also lower drop-out rates compared to diet and weight loss programs (3).
What’s the problem with dieting?
Dieting and weight loss diets can be harmful to both physical and mental health. Weight loss diets often involve restriction (of calories, certain foods, or food groups) and relying on external cues (ie. stopping eating once you’ve reached your calorie limit for the day, vs. stopping eating because you feel satiated) for making dietary choices. Additionally, diets usually don’t “work” to achieve the individual’s desired weight loss results in the long-term (4)
Dieting (including restrictive diets and weight loss diets) can lead to (5):
- Nutrient deficiencies: Diets often eliminate entire food groups. This can result in deficiencies of vitamins, minerals, and other essential nutrients.
- Disordered eating: Diets can contribute to the development of disordered eating patterns, such as binge eating, purging, and food and body preoccupation. Relying on external cues and the rules and limitations of diets can trigger feelings of guilt, shame, and anxiety around food.
- Negative impact on mental health: Diets can have a negative impact on mental health, leading to increased stress and anxiety. This can have a negative impact on quality of life and overall well-being.
- Weight cycling: Diets can lead to lowered physical and mental health in the long-term due to weight cycling, where individuals repeatedly lose and regain weight.
Celebrity Diets & “Wellness Routines”
As health professionals, we often see the effects of the latest celebrity diets on our clients’/patients’ health. These diets can be harmful and misleading and promote unhealthy restrictive behaviors.
Celebrities and influencers often promote diets through social media, interviews, or endorsements. These diets typically promise quick weight loss or improved health & wellness and usually involve restrictive eating patterns or expensive supplements.
Gwyneth Paltrow, the actress and owner of the wellness business Goop, recently came under fire after sharing her “wellness routine”.
In an interview on Dear Media’s podcast The Art of Being Well, her routine involves intermittent fasting and “supporting her detox”, choosing coffee that “won’t spike [her] blood sugar”, bone broth for lunch, and paleo dinner with “lots of vegetables”.
Whether or not it was her intention to have her choices replicated, viewers of the interview may retain the messaging of restriction for wellness.
What are the harms of celebrity diets?
- They can be nutritionally inadequate: Many celebrity diets are based on very restrictive eating patterns or eliminating entire food groups. This can lead to nutrient deficiencies.
- They can be misleading: Celebrity diets often promote quick weight loss or other health benefits that are not backed by evidence. This can mislead the public and cause followers of the diet to have lowered feelings of self-worth when the diet doesn’t work as well for them as their favorite celeb.
- They can promote disordered eating: Many celebrity diets involve extreme calorie restriction (such as Gwyneth’s wellness routine) or demonization of certain foods which can promote disordered eating behaviors.
- They can perpetuate weight stigma: Celebrity diets often promote a narrow standard of beauty and body size, which can perpetuate weight stigma and discrimination.
- They can be expensive: Many celebrity diets involve expensive supplements or meal plans, which can be financially burdensome for individuals. Often, promoters of these diets don’t take into consideration the impact of socioeconomic factors on dietary choices and overall health.
Some dieting programs and influencers may also promote their diet through an anti-diet lens. Claiming not to be a “diet” but a “lifestyle”.
Still, these diets often promote dieting behaviors including:
- Relying on external sources, rather than internal cues, to decide what and how much to eat, move, and how to feel about one’s body
- Assigning moral value to foods (labeling foods as “good” or “bad”)
- Quality of self and health are associated with weight, “hard work”, or dietary choices
- Promoting the program with images of individuals in smaller bodies or muscular bodies but not those in larger bodies
Weight-Inclusive Health Care
Weight-inclusive health care is a non-discriminatory approach that aims to support individuals in health, regardless of their weight or body size (6).
- Social determinants of health
It also acknowledges that weight stigma and discrimination can have negative impacts on an individual’s physical and mental health and well-being (6).
The goal of a weight-inclusive approach is to promote health, well-being and accessibility for all individuals, regardless of their weight or body size. It also encourages health professionals to examine their own biases and assumptions about weight and to adopt a more holistic approach to health (6).
Applying a weight-inclusive approach may include focusing on healthy behaviors that are sustainable, enjoyable, and desired by the client/patient rather than pursuing a certain body size as a marker of success.
What are the benefits of weight inclusivity?
A weight-inclusive approach can have benefits for both health professionals and clients/patients, including (6):
- Improved health outcomes: A weight-inclusive approach encourages patients to adopt healthy behaviors that are sustainable and enjoyable rather than pursuing a certain weight or body size as a marker of success. This can lead to improved health outcomes, such as the reduced risk of chronic diseases like heart disease and diabetes.
- Reduced weight stigma and discrimination: A weight-inclusive approach acknowledges that weight stigma and discrimination can have negative impacts on an individual’s physical and mental health and well-being. By adopting a weight-inclusive approach, health professionals can help reduce weight stigma and discrimination, which can improve patients’ overall health and well-being.
- Improved patient satisfaction and trust: A weight-inclusive approach can improve patient satisfaction and trust in healthcare providers. By adopting a non-judgmental, supportive approach that focuses on overall health and well-being rather than weight, health professionals can build stronger relationships with their patients and improve patient outcomes.
To learn more about weight stigma and a weight-inclusive approach, check out DSC’s Weight Stigma video course, created with support from Kyla Blackie, RD.
How Health Professionals Can Incorporate the Non-Diet Approach
As health professionals, we can incorporate the non-diet approach into our practice in a variety of ways.
Here are some tips to get started:
- Educate Yourself: Take the time to address your own weight biases and learn about non-diet and weight-inclusive approaches and how they differ from traditional weight-focused approaches to health and wellness.
- Language Matters: Use language that is inclusive and non-stigmatizing when talking about weight and health. Avoid using terms like “obese” or “overweight” and instead focus on health behaviors and overall well-being.
- Emphasize Self-Care: Encourage clients to engage in activities that promote self-care and overall well-being, such as mindfulness, movement, and social connection.
- Address Root Causes and Barriers: Look deeper into root causes of health conditions and barriers to adopting client/patient-desired health behaviors.
- Focus on Health Not Weight: Look at clinical indicators of health (blood pressure, lipids, blood sugars, etc.) and use your knowledge and skills to focus on health behaviors that can address these parameters.
- Support Intuitive Eating: Help interested clients to develop a positive relationship with food by encouraging them to listen to their internal cues of hunger, fullness, and satisfaction.
- Do No More Harm: Offer compassion, acceptance, and support for people at any size. Embrace a diverse range of body shapes and sizes and celebrate the unique qualities that make each person who they are.
The non-diet approach to health and wellness offers a refreshing perspective for health professionals who are looking to holistically support clients/patients in a meaningful way. By embracing the principles of intuitive eating, body positivity, non-weight-related health goals, and self-care, we can help our clients to develop a positive relationship with food and their bodies and achieve overall well-being.
Clifford, Dawn et al. “Impact of non-diet approaches on attitudes, behaviors, and health outcomes: a systematic review.” Journal of nutrition education and behavior vol. 47,2 (2015): 143-55.e1. doi:10.1016/j.jneb.2014.12.002
Fiona Willer. “The Non-diet Approach Guidebook for Dietitians” (2013). Lulu Publishing. Available from https://healthnotdiets.com/
Bacon, L et al. “Evaluating a ‘non-diet’ wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors.” International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity vol. 26,6 (2002): 854-65. doi:10.1038/sj.ijo.0802012
Mann, Traci et al. “Medicare’s search for effective obesity treatments: diets are not the answer.” The American psychologist vol. 62,3 (2007): 220-33. doi:10.1037/0003-066X.62.3.220
Bacon, Linda, and Lucy Aphramor. “Weight science: evaluating the evidence for a paradigm shift.” Nutrition journal vol. 10 9. 24 Jan. 2011, doi:10.1186/1475-2891-10-9
Tylka, Tracy L et al. “The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss.” Journal of obesity vol. 2014 (2014): 983495. doi:10.1155/2014/983495
Weihrauch-Blüher, Susann et al. “Body weight regulation, socioeconomic status and epigenetic alterations.” Metabolism: clinical and experimental vol. 85 (2018): 109-115. doi:10.1016/j.metabol.2018.03.006