‘My words would have more weight’: exploring weight stigma in UK dietetic practice and dietitian's lived experiences of weight stigma

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS Journal of Human Nutrition and Dietetics Pub Date : 2024-08-07 DOI:10.1111/jhn.13337

Adrian Brown, Stuart W. Flint

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Abstract

Background

Weight stigma is pervasive within healthcare and negatively impacts both access to care and the patient-practitioner relationship. There is limited evidence on weight stigma among registered dietitians, particularly in the United Kingdom, though data show weight-related prejudice towards people living with obesity. The aim of this study was to examine both explicit and implicit weight stigma in practicing dietitians in the United Kingdom, as well as the lived experience of weight stigma among dietitians, both towards themselves and towards others.

Methods

An online cross-sectional survey was disseminated between February and May 2022 using snowball sampling. Inclusion criteria were that participants were UK registered dietitians aged 20–70 years.

Results

Four hundred and two dietitians responded to the survey (female [94.1%], mean age 40.2 years [standard deviation (SD) 10.7]; White ethnicity [90%]; median 12 years [interquartile range (IQR) 6, 22] within dietetic practice). Mean self-reported body mass index was 25.1 kg/m² (SD 8.7). Most dietitians reported experiencing weight stigma prior to (51%) and postregistration (59.7%), whereas nearly a quarter (21.1%) felt that weight influenced their ability as a dietitian. Weight stigma was experienced across the weight spectrum. Overall participants reported explicit weight bias attitudes, moderate beliefs that obesity is controllable and implicit antifat bias. Within open-ended responses, dietitians reported three key themes related to their personal experiences of weight stigma: (1) experiences of stigma in dietetic practice, (2) impact of weight stigma and (3) perception of weight, appearance and job.

Conclusion

This study shows that UK dietitians exhibit both explicit and implicit weight bias towards people living with obesity. Dietitians reported experiencing weight stigma, which impacted their career-related decisions and their perception of their own ability to perform as dietitians. The study highlights the need to address weight stigma and its implications within the dietetic profession.

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我的话会更有分量"：探究英国营养学实践中的体重污名化问题以及营养师的体重污名化生活经历。

背景：体重烙印在医疗保健领域普遍存在，对获得医疗服务以及患者与医生之间的关系都产生了负面影响。尽管有数据显示人们对肥胖患者存在与体重相关的偏见，但有关注册营养师体重鄙视的证据有限，尤其是在英国。本研究旨在调查英国执业营养师中显性和隐性的体重污名，以及营养师对自己和他人的体重污名的生活体验：在 2022 年 2 月至 5 月期间，采用滚雪球抽样法进行了在线横截面调查。纳入标准为英国注册营养师，年龄在 20-70 岁之间：42 名营养师对调查做出了回应（女性[94.1%]，平均年龄 40.2 岁[标准差（SD）10.7]；白人[90%]；从事营养师工作的时间中位数为 12 年[四分位距（IQR）6，22]）。自我报告的平均体重指数为 25.1 kg/m²（标准差为 8.7）。大多数营养师在注册前（51%）和注册后（59.7%）都曾遭遇过体重羞辱，而近四分之一（21.1%）的营养师认为体重影响了他们作为营养师的能力。体重成见在不同的体重范围内都存在。总体而言，参与者报告了明确的体重偏见态度、认为肥胖可控的适度信念和隐性的反胖偏见。在开放式回答中，营养师报告了与体重鄙视的个人经历有关的三个关键主题：（1）营养学实践中的鄙视经历；（2）体重鄙视的影响；（3）对体重、外貌和工作的看法：本研究表明，英国营养师对肥胖症患者表现出显性和隐性体重偏见。营养师报告称，他们经历了体重鄙视，这影响了他们与职业相关的决定，以及他们对自己作为营养师的能力的看法。这项研究强调了解决体重成见及其对营养师行业影响的必要性。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.