Background

Weight bias among registered dietitians (RD) is a concern. Understanding the factors associated with increased weight bias can inform effective reduction strategies. Our study aimed to explore the correlates of weight bias in a nationally representative sample of RDs.

Methods

167 RDs from a randomly selected sample in the Commission on Dietetic Registration Database completed an online survey from 6/5/19–7/18/19. Data on demographics, training, practice area, Health at Every Size® (HAES®) principle alignment and personal BMI were collected. Explicit weight bias was assessed with the Anti-Fat Attitude Test (AFAT), with sub-scores for social/character disparagement (AFAT-S), physical/romantic unattractiveness (AFAT-P) and weight control/blame (AFAT-B). Implicit weight bias was assessed with an online Implicit Association Test (IAT). Kruskal-Wallis test and chi-squared test was used to assess group differences. Spearman’s correlation was also used to evaluate associations.

Results

35% of RDs reported having weight bias training in their place of professional practice and 33.5% were aligned with HAES. Overall, there were significant differences in AFAT-S, AFAT-P and AFAT-B (p=0.031, p=0.002, and p=0.007, respectively) between those who are aligned with HAES, those who are not, those who are somewhat aligned and those who do not know about HAES. Those aligned with HAES had lower AFAT sub-scores. AFAT-B sub-scores were significantly lower in RDs with previous weight bias training (p=0.013). Personal BMI showed a significant negative correlation with AFAT-P scores (rs= -0.18, p= 0.02). Age, ethnicity, years of experience and practice area were not associated with AFAT sub-scores. None of the variables were associated with IAT scores.

Conclusions

In a nationally representative sample of RDs, having a higher BMI, weight bias training and being aligned with HAES principles may be associated with lower explicit weight bias, but not implicit weight bias.