Diet culture is more weighing clients. Dietitian Lucy Carey reveals the subtle ways diet culture may be lurking in your practice.

“Most of the people you’ll see in the clinic will be coming for weight loss,” the tutor told us. We swarmed around him, our new Student Dietitian badges shining with naivety. “We’ll go over exactly what to do but it’s a fairly easy consult because it’s just healthy food swaps.”

What a load of tosh.

Many years of experience later and I can confidently say that healthy food swaps are a) fairly useless, and b) actually a bit problematic… This is one of the ways that diet culture subtly shows up in your practice without you realizing it, masquerading under the guise of ‘healthy’.

As health professionals, we get into this work because we want to help people feel better in their bodies, right? But what I see on the daily is well-meaning health professionals who, without realizing it, are actually reinforcing the very patterns that keep their clients stuck. I say this as someone who has made these same mistakes myself.

This stuff is less in-your-face than counting calories or cutting carbs (although plenty of that still goes on). It’s more in the language we use, the assumptions we make, and sometimes even the ‘healthy habits’ we encourage. And it’s so normalized that it can be hard to pick up on.

But if you can pick up on it and correct it, you’ll notice a subtle shift. Your coaching will start to feel more aligned with your values, you’ll stop questioning whether you’re making an impact or not, and your clients will see results.

1. Labelling food ‘good’ or ‘bad’ (even in disguised ways)

You might not outright tell a client that their food choices are ‘bad’, but when you talk about ‘healthier options’ and ‘choosing nutrient-dense foods’, that is often what they hear. And more often than not they feel guilty and ashamed about it. In fact, the fear of being told off like this means that many people have learned to lie about their choices. Because all of the blame falls their shoulders. They think their weight is no one’s fault but their own. They don’t have enough will power. They are weak.

So they start trying to stay away from the unhealthy versions of their food, which of course increases cravings for these very same foods. This is dieting by another name. And it sucks them into the very same restrict-binge cycle that any diet sucks them into. Plummeting mental health, an increasingly all-or-nothing attitude to food, a higher risk of rebound binge eating, and long-term weight gain are all on the cards.

So what’s the fix? We all know that some food is better nutritionally than other food, that’s just fact. But the key here is how we talk about it. There is a place for unhealthy food and that place is for fun, for soul-nourishment. I talk about including healthy food, not excluding unhealthy foods. I don’t take the burger away, or switch the fries for kale chips, I just talk about adding more veggies to the plate.

2. Focusing on portion sizes

This is one of the most common pieces of nutrition advice out there. “Everything in moderation.” It seems harmless enough on the surface, but the problem is that asking clients to weigh, measure or restrict portions based on external rules reinforces the idea that their body can’t be trusted. They become more and more disconnected from their internal hunger and fullness cues.

For someone who has spent years dieting, it is all too common to feel ‘out of control’ around food, always convinced they are eating ‘too much’. The solution is not to be even more rigid in their portion control!

The fix? Get back in touch with those internal cues! Focus on regular eating using a hunger-fullness scale to help relearn body cues. It’ll be wonky at first, and they might go through a period of increased hunger while their body adapts. But it WILL settle down, and then comes the sweet, sweet freedom of knowing they can rely on their body to tell them when they’ve had enough.

3. Assuming weight loss is always positive

It’s so ingrained. When someone tells us they’ve lost weight, our first instinct is to say “Congratulations!” Am I right? But what we’re missing is asking them how they’ve lost the weight, and how they are feeling.

We probably all can point to an instance of someone losing weight through grief, stress, illness, etc., and being told how great they look. It doesn’t take a rocket scientist to realize that that’s not good.

However, weight loss through dieting is still celebrated even though the weight may have been lost through severe restriction that is impacting the rest of their life. Dieting often brings along with it food obsession, heightened anxiety around eating, and of course an increased likelihood of putting the weight back on. I once had a client who told me excitedly that she’d lost weight through cutting out carbohydrates. Instead of congratulating her on her ‘success’, I asked how she felt. She was exhausted, plagued by food thoughts 24/7, scared to meet up with her friends because of the food that might be there, and honestly about ready to punch someone in the face for a slice of bread.

No surprises there.

The fix? Weight loss is often beneficial, it’s true. But focusing on it is detrimental. I firmly believe we should focus on gaining health as opposed to losing weight. And health is the broadest sense of the word, too. More than just the physical. The emotional, the mental, the spiritual. Health is so much more than a number on a scale.

Recognizing how diet culture sneaks into our practice isn’t about shame or guilt – it’s about growth. Many of us were trained in a system that thinks it knows more than thousands of years of evolution. It prioritized too simplistic an understanding of health.

But small shifts in language, perspective, and approach can make a huge difference in how our clients relate to food and their bodies. Stepping away from rigid rules and weight-focused goals will help clients your clients find true health and wellbeing that isn’t dependent on how well they can stick to a plan. So, if this post made you pause and reflect, just know that I’m cheering you on. Keep questioning, keep learning, and keep striving to make a true difference to your clients’ lives.