Amanda Decker, a nurse practitioner in rural Tennessee, becomes one of the first to receive MHP accreditation from the SMHP

Like a growing number of practitioners, Amanda Decker, MSN, FNP-C, MHP, became frustrated when she came to the realization a few years ago that many of her patients were getting sicker, despite her best efforts to help them get well. She had been working as a nurse practitioner in rural Tennessee for more than a decade, and she recalls signs of career burnout were beginning to show.

Amanda recently became one of the first practitioners to earn the prestigious Metabolic Health Practitioner accreditation through the Society of Metabolic Health Practitioners (SMHP), and the burnout that once threatened her career is a thing of the past.

The catalyst that changed the direction of Amanda’s career was her discovery that therapeutic carbohydrate reduction could be used to help patients sustainably lose weight and, in a wide range of cases, restore metabolic health to patients.

“I just remember feeling tired and frustrated, and I knew that something had to give,” Amanda said.

It was around that same time that Amanda started thinking about the connection between diet and health she had experienced in her own life.

“It occurred to me that I would both lose weight and feel better when I cut out the bread, potatoes, sugar, and the processed junk from my diet,” said Amanda. “I was very successful for the first time in my life when I was eating meat and plain vegetables.”

Amanda, who recently turned 40, lost more than 40 pounds and eliminated psoriasis from her life by cutting carbs and processed foods from her diet, and she started thinking more about how she could apply this knowledge to her patients.

“As I learned more about low carb and how it can lead to weight loss, and the pathology behind that, it was as if a lightbulb went off in my head, and everything started making sense.”

She began to learn more about therapeutic carbohydrate restriction (TCR), and started implementing it slowly at first.

“I started quietly trying it out on a few patients,” Amanda recalled. “Low carb was not widely accepted in rural Tennessee where my practice is located. I would suggest that my patients cut out the breads and starchy carbohydrates, and that they prioritize protein and focus on non-starchy vegetables, and see what happens.”

The results were astonishing.

“People started losing weight like crazy, and I had to start taking people off of diabetes medicines and high blood pressure medicines. It was truly amazing.”

It was around that time that Amanda discovered LowCarbUSA® and signed up for a professional training course in order to receive the LowCarbUSA® certification badge.

“I felt that if I was going to be putting myself out there, telling patients about low carb, and recommending it for them that I needed to have a certification behind me.”

The SMHP, working to improve metabolic health

Amanda was extremely enthusiastic when she learned of the formation of the SMHP, a non profit representing researchers and practitioners working to improve metabolic health around the world through education, training, and support of evidence-based nutritional approaches, including carbohydrate restriction, as a valid therapeutic option or intervention.

“The SMHP is definitely something we needed,” she said. “We’ve needed a unified voice saying that this is a legitimate therapeutic option, and it’s scientifically based. Now there’s an organization that backs us up.”

When the SMHP launched this past December, Amanda had already fulfilled most of her requirements for her MHP accreditation, and she was one of the very first to display the orange “Accredited” badge next to her name in the SMHP Providers Directory.

“I feel like having the badge next to my name lets other providers feel more confident in referring patients to me. They are assured that I have the knowledge and the skill set needed to guide patients safely through their journey, and not just doing something that is a fad off the internet.”

Amanda, who works at Dickson Medical Associates in Dickson, Tennessee, now only takes new patients for metabolic health and weight management.

“I guess it was about a year ago, that I stopped accepting new primary care patients so I could grow the metabolic health side of things,” she said. “I now get referrals from other primary care providers within my group, and I get referrals from the local orthopedist for patients who have to reach a certain BMI before they can get knee replacements.”

She also sees value in using lifestyle changes for treatment of neurological conditions, a wide range of metabolic health issues and as a way to reduce the side effects of chemotherapy.

“My practice is definitely incorporating more lifestyle medicine and using the metabolic approach to fix underlying problems,” said Amanda. “Patients are not going to show up and get a pill from me. They’re going to get more detailed counseling and education, with follow up and health coaching, to help them make this a lifestyle change.”

Amanda hopes that continued education, both for practitioners and patients can help remove the negative thoughts that are often associated with low carb approaches.

“There is still a large stigma against a low carb approach in general, because we’re so fat phobic, and the thought that if you eat fat, you’re just going to become fat.”

Amanda told a disconcerting story of a patient who recently left a message at the office answering machine at midnight to cancel an appointment scheduled for the next day.

“She had just gotten her cholesterol tested by her GP and he told her she couldn’t come in because she ‘wasn’t allowed to do any of those protein fat diets.’ It broke my heart because she had worked up the courage to make her own appointment to come work on her weight, which is a huge thing. And because she went somewhere and had her cholesterol tested, she felt like she couldn’t come because her doctor told her it was unsafe. And that’s just not true.”

Amanda is optimistic the SMHP can help bring about change as more researchers and practitioners come together to shine a light on the research and data showing that low-carb, high-fat diets are safe and effective for fat loss, and reversing metabolic illness.

Amanda estimates that fewer than 10 percent of people are successful at sustainably losing weight using traditional ‘calorie restriction’ approaches, but that the success rate is probably closer to 50 percent when patients are able to find ways to satisfy their hunger using a protein prioritized, lower carb approach.

And she believes the success rate can go even higher as the SMHP makes it easier for practitioners to find therapists, counselors, health coaches and registered dietitians who are open to low carb approaches.

“For those that aren’t successful long term on a low-carb diet, there are often other issues like food addiction that they’re dealing with. The SMHP will make it easier to access a whole team of people to see that number move past 50 percent.”

In just the past couple of months, Amanda says she has already had two new patients who located her through the SMHP Provider Directory, and she is seeing value in the directory as a way for her to locate providers when she needs to refer her patients to a specialist.

Clinical Guidelines

Amanda points to the Clinical Guidelines, developed by a committee organized by LowCarbUSA®, and now managed by the SMHP as an extremely valuable resource for any practitioner using low-carb approaches with their patients.

“I have that document printed and it’s in my practice on my bookshelf,” she said. “I’ve shared it with my precepting physician, because in Tennessee as a nurse practitioner, I’m required to have a physician that I work under. And so it tells him I’m not out there making up things as I go. There’s legitimate science to this.”

These Clinical Guidelines provide clinicians with a general protocol for implementing therapeutic carbohydrate restriction as a dietary intervention in hospitals or clinics. These guidelines are meant to be applied as a dietary intervention for specific conditions for which carbohydrate reduction has been shown to offer therapeutic benefits.

Amanda suggests any practitioner interested in incorporating therapeutic carbohydrate reduction into their practice use the Clinical Guidelines as a starting point.

“I think that document, along with the free CME that’s offered through Diet Doctor, is a great place for any clinician to start to learn more about therapeutic carbohydrate restriction and how to implement it in their practice.”

Transforming lives through therapeutic carbohydrate reduction

“Therapeutic carbohydrate reduction has transformed me personally,” Amanda said, “and I’ve also been able to slowly implement it with members of my family as well. My mom had just crossed over the border of being diabetic, and we’ve been able to reverse that for her and get her off of two medicines. My dad was showing some early signs of some heart issues, and he has lost roughly 30 pounds with low carb. And my sister has seen improvements in her IBS and her migraines by going low carb.”

“It starts with one person, and then it just branches out and goes out in the community from there. And I think with the SMHP, all these branches are going to be able to come together and we’re going to be able to create this huge forest of people that can show it off to the world. That’s my hope.”


  1. James Hall APRN on April 7, 2021 at 7:56 am

    That feeling of burn out do to not seeing positive changes in our patient’s lives is devastating. Seeing blood pressures and A1C’s going up instead of normalizing is very frustrating and it leaves you wondering if we, as providers, have failed them somehow. After embracing a low carbohydrate lifestyle and seeing the positive changes in my own life, it allowed me to see a different treatment option. I actually feel like I am making a difference again by improving and even reversing metabolic diseases using the SMHP guidelines. Thank you for sharing your story!

  2. Victoria Zweidler-Rich on April 10, 2021 at 2:27 am

    This is just fantastic! I feel like I’m having „Imposter-Syndrom“ or a „Wanna-Be“ Health Coach daydream, but the simple fact is – I am also one of those success stories. I have been on a Healthy Keto or LCHF diet for over 5 yrs and it has saved my life! I‘ve lost over 80 lbs and holding, all of my inflammation disappeared after just weeks of eliminating the „bad foods“ and incorporating more of the good foods. OMAD and extended fasting came automatically. My energy levels and cognitive strength are high & constant. I just feel great! Wish I knew about this 20 yrs, 3 surgeries, dozens of medications ago. Now I am med-free, pain-free and just free to enjoy life! Oh yeah and I haven‘t been sick a day the last 5 yrs. Thanks for planting a small seed of hope for the rest of the world. I am actually considering the Training provided in this article for myself. It would be a dream come true, maybe even my calling – to help others help themselves!! Become healthy people … it‘s all in your hands, it‘s your life to live. God bless 💞

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