The prevalence and practice impact of weight bias amongst Australian dietitians

Abstract

SummaryObjectivesThis study explored weight bias amongst Australian Accredited Practising Dietitians (APDs) and the effect of client weight status on dietetic practice.MethodsParticipants were 201 APDs, recruited using purposive sampling. A self‐administered questionnaire, the fat phobia scale (FPS), was completed to assess explicit weight bias. Participants were then randomized to receive either a female within the healthy weight range or female with obesity, accompanied by an identical case study for a condition unrelated to weight. Participants assessed the client based on data provided, provided recommendations and rated their perception of the client.ResultsMean FPS scores indicated mild fat phobia. However, dietetic practice was significantly affected by the client's weight status. Dietitians presented with the female with obesity assessed the client to have significantly lower health and were more likely to provide unsolicited weight management recommendations. In addition, dietitians rated the client as less receptive, less motivated and as having a lower ability to understand and sustain recommendations.ConclusionsThe contribution of this study is the exploration of how weight status may impact dietetic practice including assessment, recommendations and perceptions of the client. Dietitians may practice in a manner that represents or could be perceived as negative implicit weight bias, despite the explicit FPS assessing only mild fat phobia. Further research to understand the extent of the problem and how it impacts client outcomes and to test possible solutions is required.

A Study of Anti-Fat Bias among Danish General Practitioners and Whether This Bias and General Practitioners’ Lifestyle Can Affect Treatment of Tension Headache in Patients with Obesity

“…In line with other studies [10-12, 14], the Danish GPs we studied expected patients with obesity to be less compliant. We augment these earlier findings by showing that the difference in attitudes relating to compliance primarily occurs when the patient is male.…”

“…The study also adds a European perspective to the literature, since decisions made by healthcare professionals regarding patients with obesity have previously only been studied in the US and in Australia [10-14]. Despite widespread anti-fat bias, we did not detect a tendency for GPs to treat patients with obesity differently in medically relevant decisions.…”

“…Doctors in hospitals in the US reported that they would spend less time with patients classified as overweight/obese [10], but in two US studies of medical students, separated by about 10 years, there were no signs of differences in treatment for patients with obesity [11, 12]. A study of Australian physiotherapists also failed to identify any differences in treatment for patients with obesity [13], while another Australian investigation found that dieticians were more likely to provide unsolicited weight management recommendations to women with obesity [14]. …”

“…These studies pertain to only two countries and a limited number of disease-specific cases [10-14]. Therefore, additional investigations are needed to broaden the range of treatment cases and countries considered.…”

Recruiting young women to weight management programs: Barriers and enablers

“…Weight stigma can lead to an intense fear of being judged by health professionals/researchers or other participants. This fear is not unfounded as health care professionals may hold negative judgements and biased thinking about individuals with obesity . Potential participants may also interpret the invitation to participate in a weight management program as intrinsically stigmatising in that such programs are designed for change, indicating that their current body weight must be considered inappropriate.…”