Health at Every Size® Healthcare Provider Listing
Billie Karel, MPH, RD, LDN, CDCES
(she/her)
registered dietitian
Lutz, Alexander & Associates Nutrition Therapy
Raleigh,
North Carolina,
United States
Contact Me:
Make an Appointment:
Takes Insurance
Sliding Scale Available
Waitlist Available
Additional information about where I can practice: Licensed in NC, can see clients in person in Raleigh, or by telehealth anywhere in NC and in some other states, depending on local licensing regulations - please ask for current info about your state!
In-Network Insurance Companies:
- BCBS
- Aetna
Specialties & Areas of Focus:
- Eating Disorders
- Diabetes - all types
- Disordered Eating
- Family Feeding
- Type 1 Diabetes (T1DM)
- Type 2 Diabetes (T2DM)
- Prediabetes
- Polycystic Ovarian Syndrome (PCOS)
- Gestational Diabetes (GDM)
- Latent Autoimmune Diabetes in Adults (LADA)
- Mature Onset Diabetes of the Young (MODY)
- Binge Eating Disorder (BED)
- Anorexia Nervosa (AN)
- Bulimia Nervosa (BN)
- Polyendocrine Metabolic Ovarian Syndrome (PMOS)
Modalities & Theoretical Lenses:
- Intuitive Eating
- Mindful Eating
- Eating Competence
- Weight Inclusive Care
- Health at Every Size
Age Groups Served:
- Children (birth through 12 years)
- Teens (13-18 years old)
- Adults (18 years old and up)
- Older Adults (65+ years old)
- Children (birth through 12 years)
- Teens (13-18 years old)
- Adults (18 years old and up)
- Older Adults (65+ years old)
Additional Populations Served & Allied Groups:
- LGBTQIA+
- BIPOC
- People with chronic illness
- People with diabetes
- Neurodivergent people
Languages Services Offered In:
- English
- English
My Philosophy of Care
I am a registered dietitian (RD) and a certified diabetes care and education specialist (CDCES). I offer thoughtful, individualized support for each client to nourish themselves with care and intention, and to find as much peace, flexibility, and enjoyment as they can in their experiences with food. For those with diabetes and closely-related conditions, I also provide education and support for chronic illness management and medical self-advocacy. I encourage my clients to build greater self-compassion, curiosity, and respect for their bodies, and from that place, we experiment with approaches to food and to health management needs that work best for them. My approach is informed by the frameworks of intuitive eating and eating competence, in addition to Health at Every Size!
To me, HAES means that we each have the right to pursue health and well-being in the bodies we have, and to continue meeting our bodies with care and support as they change without being pressured or coerced into trying to change our weight. On the medical side, I believe HAES calls us as health care providers to unlearn the notion that weight is an intermediary for health, and to support each individual client in pursuit of health, wellbeing, and ease in their bodies as they are.
About Me & My Practice
I have been providing HAES-informed nutrition counseling since 2015, and have had the honor of supporting people all along the size spectrum in various aspects of nutrition, health, and body image. As a Certified Diabetes Care and Education Specialist, I specialize in providing HAES-informed nutrition counseling and support with medical self-advocacy for people with diabetes, prediabetes, and PCOS/PMOS and co-occurring disordered eating and eating disorders.
I came to work as a dietitian through a circuitous route! After working in the field of environmental health and justice for 10 years, I was ready for a change and interested in food access and security work. That interest brought me to pursue an MPH in Nutrition, where I found to my great surprise that I really enjoyed clinical work, so I took a big left turn into clinical dietetics after graduation and never looked back! HAES is, for me, the way that I bring that lens of equity, justice, and sustainability to my work with clients.
I’ve completed the following trainings that have helped me to better support fat and BIPOC clients: the BIPOC Eating Disorders Conference (2022 and 2026), presentations and writing by Ragen Chastain (several), Body Image Boot Camp from Brianna Campos (2022), and the Weight Neutral 4 Diabetes Care Symposia (2019 and 2021).
Accessibility Considerations
I work in a private practice setting, and so I am the main (usually only!) point of contact for my clients. We are an LGBTQ+ affirming practice, and have an electronic health record that can accommodate people with different legal and preferred names. This means that trans clients will never get a message from our EHR with their non-preferred name, even if that name is still on file with their insurance company.
Our physical office building in Raleigh (where I work from!) is accessible for those using wheelchairs and other mobility devices, and we also provide services by telehealth. Seating in our waiting area and counseling rooms is chosen to be inclusive of different body shapes and sizes. One of my colleagues is a fluent Spanish speaker and able to provide bilingual nutrition counseling; otherwise, we do not offer counseling in languages other than English or interpretation services.