'You're not broken. You don't need to be fixed.'

My wide-ranging interview with dietitian and diabetes educator Megrette Fletcher on what we can do to change how we see ourselves and why weight loss isn't required.

If you’ve ever felt like something is wrong with you—despite doing everything in your power to change yourself and especially if it’s because of your body size—this interview is for you.

Megrette Fletcher (She/Her)

, a dietitian, diabetes educator, co-founder of the Center for Mindful Eating, and author of No Weight Loss Required, joined me last fall for a wide-ranging and deeply inspiring conversation as part of my series Dared to Ditch, and I’m so excited to finally share it with you! We cover so much ground, including:

• How GLP-1 medications like Ozempic have been game-changers for people with diabetes.

• Why the future of these medications might not center on high doses or even weight loss.

• Why it’s okay to want weight loss (even though it’s not required to be an awesome person).

• How to cultivate self-compassion—especially if it’s something you’ve never experienced.

• How mindfulness can play a key role in healing from the trauma of weight stigma.

I’m also excited to introduce an audio version of this interview. The audio is slightly longer than the text version, which has been edited for length. If you prefer the audio format for these longer pieces, drop me a note in the comments and let me know!

This was such a warm, wonderful, and inspiring conversation, and the messages here couldn’t be clearer:

• We don’t need to be fixed, but we may need healing.

• Change is possible with guidance from experts and people with lived experience.

• With the right support, we can learn to hold space for ourselves.

• And perhaps most importantly, we often don’t see how far we’ve already come.

If Megrette’s message resonates with you as much as it did with me, please let me know in the comments. Share this interview with someone who might benefit from hearing it. And if you’d like to support this work, consider becoming a paid subscriber—until Jan. 31, I’m offering 65% off annual subscriptions!

Bio: Megrette Fletcher, MEd, RD, CDCES, is a registered dietitian, diabetes care and education specialist, public speaker, and author. Her focus on decreasing stigma fuels her passion for weight-inclusive diabetes care, treatment, and prevention. She co-authored Eat What You Love, Love What You Eat with Diabetes with Michelle May, MD. Learn more about weight-inclusive ways to prevent or manage diabetes at  NoWeightLossRequired.substack.com or visit her website at Megrette.com.

Megrette Fletcher’s interview for Dared to Ditch

Kristi: I'm interested in hearing more about your background and not just when and why you quit diets, but how you came to mindful eating and got involved with that.

Megrette: Sure. So I grew up in a fat home. So my mother and father both perceive themselves as being fat, and my brother and sister kind of got the brunt of that. And I, we didn't know this, but I had a thyroid dysfunction, so I was always thin.

And so I really was aware of how the thin privilege came up, and being the youngest of three, you know, your siblings are just brutal. I was not going to skate by as the youngest in the home, so they really called out a lot of thin privilege. And so it was kind of one of those things where I recognized thin privilege without having the words really early on.

But fast forward, you know, when you go to college, you know, we all pick majors, and I was going to be a physiological neuroscientist, so I was going to study behavior after brain injury. And I was tracking really well, except I didn't make the top two, so to get into the PhD program and in the college I went to, you had to be top two, and I was number seven of eight, so you know, my major professor said, so what's plan B?

Yeah, so I became a nutritionist. And then I decided I wanted to become a dietician. And I went back to school and became a dietician. And it was there that I really could see diet culture in its full glory. And I remember thinking, you know, people are really in the future. They’re always thinking about “once I lose the weight, once I’m at this size, once I can do this thing, then my life will begin.” And I remember thinking if they could just be in the present moment, that would be so good. So, I put it in the back pocket.

[I] had a difficult time in my life, was really struggling personally with lots of questions, and this wasn’t too far in the future, this was about five or six years, and started to meditate, and started to get some support to meditate, and I kept thinking if people were just in the present moment, that would be great. 

At the time, I had an absolutely personally horrible boss, and I had some free space at work and, you know, she just didn't want us to do anything except exactly what we were told to do.

So I was like, well, I’ll Google mindful eating. This guy, Fred Burggraf came up, and we connected, and I wrote my first book called “Discover Mindful Eating.” And it's really, you know, it's handouts about how to be in the present moment. And it really made me realize the value of mindful eating. And I was lucky enough Skelly Skills, purchased the book and has been providing professional credits for it. And that's who the target audience is. It's not for the consumer. But I think it really launched mindful eating in the vernacular.

And Jean Kristeller, who was a leading researcher and mindful eating myself, a dietitian, and then a Buddhist minister named Dharmacharini Amala, we came together and formed the Center for Mindful Eating. And we were able to reach out to other experts in the United States to really say, hey, like, you know, what is mindful eating and what is this all about.

And at the time, diet culture wasn't a term. At the time, [the book] “Intuitive Eating” had just come out, so since 2006, really in the infancy of understanding the impact of weight stigma, really not understanding what diet culture was.

We really focused in on the present moment and weren't really focused in on weight stigma and the harm of that. But as the research started coming in, more and more research, this was probably around 2012-ish, 2015, somewhere in that vicinity, it was undeniable. You couldn't ignore the harm of weight stigma and the harm of dieting. So the Center for Mindful Eating at that time took a position to be weight inclusive. It's an awesome decision. 

Mindfulness can be a huge tool to heal from the pain of weight stigma, to heal from the trauma of weight stigma. So we want to identify diet culture. So that's one step that we need to do and it's so darn sneaky, it slips in lots of different places.

But once we identify, yeah, that's here, it's in the room, how do we heal from it? And that's where mindfulness-based practice is. Again, the evidence is so huge, mounting and mounting mounting evidence that mindfulness-based practices actually help us heal from trauma.

“And when we talk about stigma, we talk about weight stigma. It's intersectional. It's not singular. It isn't that we just live in a body and we have weight stigma. We may be marginalized. We may be feminine or queer or disabled, and there's lots of intersection there. But we have to recognize that stigma in any form is something that we untangle—we don't fix it. And so that's really where I kind of land. ”

—Megrette Fletcher

And my personal journey is, mindfulness to me is how it really allowed me to heal the trauma from growing up in a fat-phobic home. It really helped me learn how to talk to myself in a way that was far more compassionate than any voice in my head ever was. It really allowed me, because mindfulness is an aspect of self-compassion. So again, mindful eating is just bringing that self-compassion into food and eating.

Kristi: That's a great answer. One question I have for you, and that's sort of derailing from the topic, but I feel like we've taken some steps back as a culture, especially over the last few years, with the weight loss drugs and the marketing of obesity as a disease in and of itself. I wanted to just get your perspective on it, having this history with seeing the evolution of diet culture.

Megrette: So I just want to clarify the GLP-1 class of medication was developed for people with diabetes, and as a diabetes care and education specialist, I really want to say it's a good drug. It's a very very good drug. It has helped so many of my clients because it addresses the issue of insulin resistance. So for people that don't know what insulin resistance is, if you can think about insulin, which is a hormone that our body makes to unlock the cells to allow the energy from carbohydrates to enter, insulin is like a knife. So just imagine it like a knife. When we have insulin resistance, our knife is dull. It doesn't work well.

It can't kind of cut up the carbohydrates and allow the body to utilize them. So those extra carbohydrates, which are glucose, they float around in the bloodstream and they cause high blood sugars.

But when we have less insulin resistance, okay, insulin can work. It can cut up those carbohydrates. They can be broken down and enter the cell. It works. Insulin resistance appears to be inflammatory. So when we have insulin resistance, our body goes into an inflammatory response. And what they’re finding is these medications help with inflammation.

So, now your mind should be thinking, well, is it arthritis inflammation? We start recognizing, oh my goodness, we start thinking about metabolic syndrome. We start really starting to recognize that inflammation is actually one of the core central problems that our body faces. We know that having high stress increases inflammation.

“So, to me, when the marketers were coming around and saying, ‘How should we market these medications?’ I feel like they just totally, totally, totally missed the boat, because dieting doesn't work. People can't afford these medications. They've never been meant to be taken at high doses, so they're not designed to be taken at high doses.

They're a good medication that's being abused, you know, it's kind of like we don't understand that more of a vitamin doesn't make you healthy. We only need so much. Taking more is toxic. So people are like well, vitamin A is so good for you. Yeah, but it gets toxic. It's like not good. So it's this whole more is better mentality, well, if a little bit helps this, more would be better.”

—Megrette Fletcher

No, that isn't, it's not—that's greed. That isn't how things work in the world. So we have to call out these false views. I think the marketing of GLP-1s, you know my opinion, the research is coming out, everyone's gonna abandon them for weight loss because they don't work. They're too expensive. People leave the studies. You know

Ragen Chastain

does such good work in her newsletter, and you know shout out to [Eileen] Chavez over at Weightstigma.org, she does great work around just really highlighting how the current marketing of a very good medication is awful and how they're packaging something that could be very helpful for people with arthritis or these other conditions, like it could be super helpful, but they're going after weight. Why? Because weight stigma exists. Because the people in the marketing office said, “I can make someone afraid, and I can sell them hope.”

Instead of acknowledging bodies come in every size and instead of turning around and saying how can I nourish this body regardless of the size? How can I support this body? How can I make it okay to be in this body and society? But they've just amped up weight stigma. They've just amped up all of the negative vitriol that happens, and it's heartbreaking. It's absolutely, positively, heartbreaking.

I just always want people to separate out because of my belief, and my—if I can guess what will happen in the future—I think we're just going to see that these drugs are useful in so many other places, but they're not going to be at that excessive dose. They're going to be probably at half the dose or quarter of the dose that we see them for diabetes, and we're going to find that this works really good. Metformin, which is a frontline diabetes medication, works great for PCOS. There's lots of medications that cross over because they look at the core issue.

Obesity isn't the core issue in our health society. It's just not. It's not the core issue. Access to food, access to medical care, feeling seen and heard, feeling like you belong, you know, feeling comfortable having that sense of ease, that's central to our health concerns. It's not, it's not our weight.

Kristi: So do you feel like we're going to swing back? I feel like some of the hype over the drugs have kind of hit their peak and now people are maybe starting to see like, oh, they weren't this great solution to weight loss. But at the same time, I feel like a lot of damage has been done, you know, because more stigma has been created.

Megrette: So there's no disagreement. 100% ditto. Yeah, I agree. And I do want to say that when they made obesity a diagnosis, it created an economic engine that hospitals have latched onto, that providers have latched onto and that economic engine. And I put it in air quotes, the “obesity engine,” it does include weight loss surgery, it does include medical exercise programs, it does include weight loss medication. All of those things when we look at that and we turn around and we say in absence of the word obesity, every single person on this planet needs access to medical care. Every single person on this planet needs safe access to move their bodies. Every single person on this planet regardless of who you are needs support, they need to feel seen and heard. It breaks my heart that it was just economic, you know, advantage that is what is creating those systems now.

Those systems were always needed, but it was because we could make a buck that we're creating them. It makes sense. It's a capitalistic society. I’m not going to, you know, I can't change that. But as we turn around and say, well, it's, you know, like maybe it's a bus now, are we then going to dismantle those systems?

And so again, are we going to dismantle showing higher weight bodies exercising? Are we going to dismantle having body diversity in ads? You know, are we going to dismantle that? Because we don't want to dismantle that part. That was the positive is that we are seeing body diversity. We are talking about, and I know this is crazy, but you know, for 25 years, I've been saying, could I get a blood pressure cuff that fits? Could I get a chair that my clients can sit in? You know, in the 2000s, I was the one who had to say, I need chairs that my clients can sit in, because they can't sit in the chairs that you provided. We don't want to dismantle that, that's a good thing. It keeps needing to go. It's the judgment.

That's what we need to dismantle, it’s the judgment. So yeah, I hope it's on the downslide, but I hope we can keep what is, what was so desperately needed as we slide down.

And I do think your weight loss surgeries, what we're finding is not a shock, but weight loss surgeries are really statistically not effective and that in order for weight loss surgeries to be effective, they are adding these GLP-1 medications. So again, I get it, weight loss surgery may be a solution for some individuals reading your newsletter or listening. And it's so important to understand that our journey towards health is unique to us. I don't stand in judgment of anyone. I appreciate and support body autonomy 100%. But I recognize that you, regardless of your size, are awesome. Period. So if you're awesome before you have these surgeries, you're still going to be awesome after.

“Awesomeness doesn't come with weight loss. It's already there.”

—Megrette Fletcher

Kristi: Is that part of your mission to help with sharing that message?

Megrette: My Substack newsletter is No Weight Loss Required. It's for people working to prevent or manage diabetes. I don’t believe weight loss is required for health. So that's a very firm belief. Many people who come say, “but I still want to lose weight,” and I get it. I would like not to have people talk about me, you know, or whisper or make comments or judge me. I would want that.

And that's what really the wish is … I want to feel like I belong, and the only pathway I've ever been told is through weight loss.

It takes a lot of voices to say, no, you belong. And you know, with that support, we'll find our way. We'll find what works for us individually. It's not good if we lose weight. It's not bad if we don't. It's nothing. It's just weight changes. It's a spectrum. I do not weigh the same that I weighed when I was born. I don't weigh the same I weighed when I was 10. I don't weigh the same that I weighed when I was 40. You know, like my weight has gone up and down because that's what weight does. And so again, when we kind of take that step back and we say, “If my self-worth is not tied to my size, what is it tied to?” And that is just stepping out of diet culture. 

Diet culture is so oppressive. It's such an oppressive thing. It's telling you, the adult, you can't make a decision. You can't make a food choice. You're not allowed to. You can't—you're not allowed to love yourself. That's an oppressive system. You know, that's an oppressive system that ultimately we're going to rebel against.

Yeah, so what does it look like when we take away that oppression? How do we dismantle oppressive systems?

It's always going to be here. Oppression is always going to be here. You don't fix oppression, you dismantle it.

“We don't fix people. People aren't broken. They're hurt. We don't fix them. We help them heal. So that's really my message to everyone. You're not broken. You don't need to be fixed. So this whole idea of ‘I'll lose weight and I'll be fixed,’ that's a false belief. People aren't fixed. They're healed.”

—Megrette Fletcher

We need support. We need kind voices. We need people that have the capacity to challenge these messages because a lot of people that are healing don't have the energy to challenge them.

So the people that have healed have to.

Kristi:  What would be your advice to someone who's just starting on this journey? I didn't tell you this, but I've had two children with anorexia, and what led me to quit diets was my youngest relapsing and me realizing I was asking her to do things I was uncomfortable with and I needed to work on my own issues around food in order to best help her.

So my why for quitting diets and spreading this message is very strong. But I think a lot of people don't come into it with that level of crisis, right? And maybe they're just fed up but not sure where to start. What do you say to people as they're just starting on this journey to maybe love themselves and them not even being aware that that's what they're going to be doing?

Megrette: Beautiful. The answer is we just need to listen to others with lived experience. Lived experience isn't quantitative, it's qualitative.

When somebody with lived experience says, yeah, this is what happened to me, or this is how I felt, or this is what I thought, that really helps you turn around and say, did I think the same thing? Was that my experience? Did someone say that to me too? We start to challenge the narratives in our head.

We're trying to understand something that we can't understand. We're trying to change what is normal in our brain.

And the only way we can imagine the change is to have somebody else say, this was my experience. This is what happened to me. This is what I saw. This is what I experienced. This is what I did. This is what helped me.

That conversation makes your brain bigger. Now, when we listen to people without lived experience, people like me. So I don't have a child who had an eating disorder. When we listen to people like me, I'm not going to give you lived experience. I'm going to give you my perspective, which is biased. I'm going to give you my clinical training. I'm going to give you information that could be very, very helpful. But it's not going to make your brain bigger. It's going to help you figure out the steps, you know, what do I do next or how do I put this all together?

In the change process, once we discover dieting isn’t our right path, we have to explore, and listening to lived experience really helps us explore.

So first step, listen, hear, talk to, interact with people that have had this, they have the same why as you. The second step is turning around and getting the support you need to say, all right, I understand those people's why, what's my why?

We don't all have the capacity to be with ourselves. In a clinical setting, I call it holding space, but it's really turning around saying, “I need more support.” Change doesn't happen without support. Period. Whether that support comes from your newsletter, whether that support comes from a group, or it comes from a professional, we just need support, okay? Because when we are in relationship with other people, when we're interacting with other people, we are in a growth mindset. Support again is another way to make your brain bigger.

You turn around saying, oh geez, know, Kristi said this and I didn't think about it that way. Oh, you know, Megrette said this and well, I never thought about it that way.

So again, as we start trying to move out of diet culture, it doesn't seem like we're doing anything when we listen to lived experience. It doesn't seem like we're really making any progress when we get support, and that's a false belief. You're making huge progress. You've now created the conditions for you to turn around and say, “I have a better understanding of what I'm dealing with. I have support to really challenge myself and grow personally. That support really helps me when the darker, heavier feelings come in, when the doubt comes, because it does come.”

Just as much as insight comes, uncertainty and doubt, and regret and fear and guilt, and all that stuff come. And that support really guides us to then start saying, “Well, what would I do? Well, what would I tell someone? Well, what's work for me?”

“It doesn't seem it, but we're all having many, many wins along the journey. Sometimes when we get further along that journey, we start seeing those wins, and we start saying, know what I could do, I could start a newsletter, I could talk to a friend, I could do these things. These are things I could do because they're in reach now. And the more things are within reach because we created the conditions for them to be within reach. All of a sudden you find yourself, you're reaching for things that will help you because it's there.”

—Megrette Fletcher

It's normal to reach for things that help us. It's a beautiful response. But you can't reach for something that's not there. You're not wrong that it's not there. You're not bad that it's not there. You didn't fail because it's just not there. It's not present.

So if self-compassion is not present, you can't reach for that. How do you get self-compassion to be present? If you've never talked to yourself with compassion, you're like, I don't even know what that would sound like. So that's why somebody with lived experience can help you explore that.

That's where that support, that community, that interaction, those groups, that relationship. So we've moved from information, learning about, to the relationship.

That is really the stuff that helps us start turning around saying like, “Oh, I've got support to actually try this.” I've got feedback when it doesn't work, you know? So that's my suggestion.

I hope you were as uplifted by this interview as I was. I would love to hear your big takeaways. What did you relate to the most? Any big takeaways! Pam packed a lot of insight about our complicated relationships with food and exercise into one conversation. I’d love to hear what you think—did you relate? Any big takeaways? Drop them into the comments! If you loved this piece, consider sharing it with others. Share the link on your favorite socials or hit the restack button! 🔄

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Share Your Story of Ditching Diets

If you’ve found freedom from dieting (or you know someone else who has), I’d love to share your story so that it may inspire someone else! DM or email me at kristik @ substack.com.