Communicating About Weight in Dietetics Practice: Recommendations for Reduction of Weight Bias and Stigma

Howes, Erica; Harden, Samantha M.; Cox, Heather K.; Hedrick, Valisa E.

doi:10.1016/j.jand.2021.01.016

Cited by 9 publications

(4 citation statements)

References 46 publications

(74 reference statements)

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“…Though only mentioned by one participant, preceptor use of weight-stigmatizing language impacted an intern's diet. The literature noted individuals who experienced weight-stigma from RDs demonstrated increased anxiety, body image dissatisfaction, negative psychological stress responses, and disordered eating-especially increased binge eating behaviors [43,44].…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Dietetic Interns’ Dietary Habits during Supervised Practice

et al. 2023

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Supervised practice is a prerequisite to becoming a registered dietitian. Research suggests that environmental and social factors may affect dietary choices. This focus group research aimed to gather opinions from dietetic interns to understand what factors related to supervised practice, if any, affected their dietary habits. Qualitative data were collected via seven recorded virtual focus groups in which trained moderators facilitated a discussion using a series of controlled questions. Participants, dietetic interns (n = 42) who were currently completing or had completed their supervised practice within the previous six months, attended one of seven virtual focus groups. Each focus group had five to eight participants. Transcripts were separately coded by two trained researchers using a grounded theory approach to identify themes and subthemes. Researchers discussed any disagreements in coding and established a consensus. Elements related to the dietetic internship were observed to influence participants’ dietary choices. Main themes included time, finances, food access and availability, physical and mental effects, non-supervised practice factors, and social factors. Dietetic programs and preceptors should explore ways to raise interns’ awareness and minimize the potential negative impacts of these factors on interns’ dietary habits to improve their overall internship experience.

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Section: Discussionmentioning

confidence: 99%

Factors Influencing Dietetic Interns’ Dietary Habits during Supervised Practice

et al. 2023

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“…Dietary studies seeking to recruit participants with overweight and obesity should consider these potential feelings of embarrassment or fear of judgment, which may inhibit recruitment and retention of individuals with higher weights. Examples of strategies that may mitigate potential feelings of weight stigma during research procedures include using people-first language [ 49 ] when discussing weight in study recruitment materials, asking about participant preferences when taking weight measurements, and avoiding the perpetuation of stereotypes about obesity in images and communications (e.g., using images of people eating “unhealthy” foods in study recruitment materials) [ 66 , 67 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Weight Bias and Stigma on the 24 h Dietary Recall Process in Adults with Overweight and Obesity: A Pilot Study

Howes,

Parker,

Misyak

et al. 2024

Nutrients

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People with overweight and obesity tend to both underreport dietary energy intake and experience weight stigma. This exploratory pilot study aimed to determine the relationship between weight bias and weight stigma and energy intake reporting accuracy. Thirty-nine weight-stable adults with BMI ≥ 25 completed three 24 h dietary recalls; indirect calorimetry to measure resting metabolic rate; a survey measuring weight stigma, psychosocial constructs, and physical activity; and a semi-structured qualitative interview. Multiple linear regression was used to determine if weight bias internalization, weight bias toward others, and experiences of weight stigma were predictive of the accuracy of energy reporting. A thematic analysis was conducted for the qualitative interviews. Weight stigma was reported by 64.1% of the sample. Weight stigma constructs did not predict the accuracy of energy intake reporting. People with obesity underreported by a mean of 477 kcals (p = 0.02). People classified as overweight overreported by a mean of 144 kcals, but this was not significant (p = 0.18). Participants reported a desire to report accurate data despite concerns about reporting socially undesirable foods. Future research should quantify the impact of weight stigma on energy reporting in 24 h recalls using a larger, more diverse sample size and objective measures like doubly labeled water for validation.

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“…The Academy of Nutrition and Dietetics position statement encourages RDs to be self-aware of weight bias and provides recommendations to reduce weight bias. 34 Since HAES alignment is associated with lower weight blame, there may be a role in educating RDs about HAES, or specific components of the HAES philosophy, to reduce weight bias. However, more research is needed before the adoption of such measures.…”

Section: Correlates Of Haes Alignment In Registered Dietitiansmentioning

confidence: 99%

Alignment With Health at Every Size May Be Associated With Lower Weight Blaming Among Registered Dietitians in the United States

Wijayatunga,

Bailey,

Klobodu

et al. 2024

Topics in Clinical Nutrition

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Health at Every Size (HAES) concept promotes health irrespective of weight. This study aimed to determine the correlates of HAES alignment in registered dietitians (RDs). Of the 246 RDs, 34.1%, 34.6%, 13%, and 18.3% were aligned, somewhat aligned, not aligned with HAES, and unaware of HAES, respectively. Weight blame was lower in RDs aligned with HAES than among others (P = .001). Alignment with HAES was not associated with body mass index, prior weight bias training, practicing weight management, or implicit weight bias (P > .05). Understanding the correlates of HAES in RDs is important for the care of individuals with higher weight.

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Communicating About Weight in Dietetics Practice: Recommendations for Reduction of Weight Bias and Stigma

Cited by 9 publications

References 46 publications

Factors Influencing Dietetic Interns’ Dietary Habits during Supervised Practice

Factors Influencing Dietetic Interns’ Dietary Habits during Supervised Practice

The Impact of Weight Bias and Stigma on the 24 h Dietary Recall Process in Adults with Overweight and Obesity: A Pilot Study

Alignment With Health at Every Size May Be Associated With Lower Weight Blaming Among Registered Dietitians in the United States

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