Prevalence of weight bias amongst New Zealand Registered Dietitians and its effects on dietetic practice - A pilot study

Abstract

Background: The current obesity issue has become a worldwide public health issue affecting many countries including New Zealand. Health professionals have responded to this health issue by focusing on weight loss. However, growing evidence is suggesting that the global focus on obesity may be harmful to some, reinforcing negative attitudes towards, prejudice against or associated stereotypes towards persons because of their weight. This behaviour is termed ‘weight bias’ or ‘weight stigma’. Aims: This study aims to examine dietitians' views of overweight and obese people and to explore how these views may influence dietetic practice. Design: A self-administered online questionnaire to assess explicit weight bias. Participants: Purposive sampling of 109 New Zealand Registered Dietitians and seven New Zealand Dietetic Students. Measurements: To investigate the views, attitudes, perceptions and practices of the participants, the following measurements were used: The short form of the 14-item Fat Phobia Scale (FPS) - a measure of a person’s attitude towards people with obesity, accompanied by two psychology instruments: The Revised Life Orientation Test (LOT-R) – a 10-item measure of optimism versus pessimism and The Perfectionism Inventory (PI) – a new 8 scale measure of perfectionism; ending with questions about a client in a manufactured case study. Results: Mean FPS scores indicated mild fat phobia. However, dietetic practice was mildly affected by the client’s weight status. Dietitians presented with the “female with obesity” profile assessed the client to have lower health and were more likely to provide unsolicited weight management recommendations. In addition, dietitians rated the client as receptive, motivated and able to understand the recommendations adequately, however having a slightly lower ability to comply and sustain these recommendations. Conclusions: The 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 in New Zealand and how it impacts client outcomes and to test possible solutions is required.