At least not if the results from a recent study are in fact applicable to the profession as a whole.
Dr. Rebecca Puhl, one of the Rudd Center's researchers (and bloggers I might add) published a study in the Journal of the American Dietetic Association whereby she polled 200 dietitian students about their attitudes towards the obese.
Her findings were frightening.
Only 2% of those training to be dietitians had positive (and she included "neutral" as positive) attitudes towards the obese with the remaining 98% being moderately biased against prospective heavier patients.
Of course the same could be said of many health professionals (including doctors). Similar to the dietetic students in a comparable study medical students held almost universally negative beliefs while a study with practicing family physicians showed roughly 50 of them cultivating negative stereotypes.
I'm sure real-life dietitians with real-world experience are likely far less judgemental than the wide-eyed students in Rebecca's study (hint - here's a ripe study for the picking for someone with resources).
Clearly all health professionals have a long way to go at eliminating their own weight-related biases.
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Well crap, that's depressing.
ReplyDeleteRemind me never to spend my hard-earned dollars visiting one.
I'm doing just fine on my low-carb WOE, thank you very much!
Hi Squirrel,
ReplyDeleteDon't vilify the whole profession. I suspect that just as with medical students (who also almost universally scorned the overweight) by the time the dietitians have a few years under their belts, they're likely to have lost some of that bias (just as with the family docs where now "only" 50% harbor negative weight stereotypes).
We have two wonderful dietitians working with us who certainly don't share these undeserved beliefs.
Wow, that's interesting. I am an RD and I don't think I have a bias against my obese clients. Don't get me wrong, I do get frustrated when I see the amount of obese people in America (and the world) but I think that is from my desire for everyone to be healthy and happy.
ReplyDeleteWell, there's some more ammo for the Fat Acceptance crowd.
ReplyDeleteEven dietitians are prejudiced against their overweight/obese clients.
I wonder what the percentage of prejudice would be if the researchers repeated this study with the general public?
I bet it would be even higher.
Not at all surprised. Disappointed but not surprised!
ReplyDeleteA related project is called Project Implicit (started by Yale) and it's very interesting to take part in the Implicit Association Tests yourself. There is one about weight bias. The website is http://www.projectimplicit.net/ and I thnk you click on your country's flag to take you to your home site.
ReplyDeleteAs a former nutrition student, unfortunately, I am not really that surprised. My university nutrition classes were full of young women who were, frankly, obsessed with being thin and eating 'healthy'. What I found was that, for many, studying nutrition was actually a manifestation of their obsession with food.
ReplyDeleteIn fact, eating disorders ran rampant among my university classmates. There is some interesting research currently being done at the University of Alberta on the rate of eating disorders among dietetic interns.
It does not surprise me one bit that nutrition students are biased against obese people. If my experience was any indication, they are, for the most part, fat phobic. It is the dirty little secret of the profession.
Yoni, I'm a loyal dietitian reader of your blog but the title of this entry was upsetting. A great deal of the dietitian training is covered in the one year internship after the four year university. Depending on what year those dietetic students were in they might have only had a few nutrition credits. Their responses in this survey do not justify your title that implies that dietitians do not like their overweight clients.
ReplyDeleteDietitians are very aware of the many factors influencing obesity and are generally very compassionate and supportive about how challenging weight loss is.
There is a very pervasive stigma in society about obesity and most dietitians work hard on any of their own biases and treat clients in a dignified and respectful manner.
Fair comment RD.
ReplyDeleteI've tweaked the blog piece to include some of the thoughts I expressed only in these comments (comment #2)
As the only regulated nutrition professionals, and as a relatively small group, dietitians need support from the medical community, not this type of interpretive news reporting. This encourages people to turn to the diet industry, which is not regulated and is focused on turning a profit.
ReplyDeleteI agree that it'd be interesting to see whether this opinion changes amongst dietitians who have actual experience with clients. I think as students we are constantly bombarded with the idea that we need to help "fix" this obesity "epidemic".
ReplyDeleteI went into dietetics not wanting to make obesity a priority in my work, but only through school realized how this is one of the primary health issues facing our society today. At the same time, there are a lot of areas within dietetics where dietitians can work. With more experience in these different fields, I think these students will realize that weight is not the only health issue that can be influenced by diet.
I agree with Anonymous's comment that reports like this only turn people (like Squirrel) away from this profession, when the point of the study was probably for educators to pay more attention to what they're teaching prospective dietitians.
I know this is from yesterday's blog but I want to add in my 2 cents.
ReplyDeleteI am a dietitian...not yet a RD. I have recently finished my internship of 1 year and I must agree with the study...I have realized how much learning I have gained during my internship...I was too a part of the group of bias nutrition students and yes I have personally observed eating disorders amongst my peers as a student so many of the comments are true. What I want to say however is that now that I have started working and interact with real life people, my views have also changed...I have learned that there are so many factors that affect peoples lives/health. As a student, its difficult to understand because food/health/exercise is all we learn about and for the most part I think the nutrition students are more likely to try to implement the ideas/concepts in our lives re:health and diet. The business of obesity/health is no longer black and white to me...I know that now from my short experience so far in the "real" world and I would like to believe that is also what other dietitians also believe. There's always some that are bias...but like you said, that's with every profession.
A little disappointing that of all the posts from dietitians, not one decided to take onus and say that perhaps something should be done in the four years of education before the internship (this of course under the assumption that there is a significant difference after the internship as stated on this blog).
ReplyDeleteA sad statement when the common focus is that the blogs title is mean/offensive rather than being what can we do to help change this problem.
Yoni - as a fellow blogger and marathoner - and a registered dietitian, I would encourage you to choose your blog titles carefully. You are spreading misinformation on the web.
ReplyDeleteIt's hard in our busy days to get good blog posts out and it is easy to "copy and paste" with a little opinion added in.
You just followed what the mainstream media did and used the word "dietitian" in your title in place of what the study really did, which was survey "nutrition students".
I won't repeat exactly what other RDs said here... but consider that the students were 19-20 years old and a good 2-3 years away from even being able to sit for the RD exam IF they are talented enough to get a highly competitive dietetic internship. Just to give you an idea... the internship I did has over 100 applicants for 10 spots. Many "students" who don't get internships work in a hospital for a year and re-apply.
I also question the quality of a survey of only 200 students.
I don't blame you personally for writing on this headline grabber, but as a weight management dietitian with a mom and sister who each weigh 250+ pounds, I am disheartened that it is national nutrition month and the attention dietitians get is negative (inaccurately). I am even more disturbed that this oversight resulted in comments where people are talking about never wanting to see a dietitian.
Your blog is your voice and it is very powerful. I would encourage you to consider that. I've been working really hard on that myself lately.
I wrote my grad school thesis on health misinformation and it is pervasive - especially on the web.
I agree with you that our society judges obese people. The worst is when people look at them as lazy and they really don't understand that some obese people have metabolic conditions and many have disordered eating, and other emotional problems.
I'm all for more high quality research in this area AND for adding CADE requirements at the undergrad level to deal with bias. But I am not for junk media.
Doesn't there need to be some sort of bias towards overweight people? Like smokers? Or are we to condone it and not want people to change to become healthier? In striving to be politically correct and not wanting to hurt peoples' feelings, by not saying anything we are silently accepting an unhealthy lifestyle. Who says dietitians need to like their patients? Shouldn't they only need to be able to feel empathy for their patients and recommend the best course of action based on their needs?
ReplyDeleteThis is what I have found in the last five years. All my life I was very thin (almost sixty now) then the thyroid quit and menopause kicked in and wham! 40 pounds and a change in my doctor's attitude I could not believe. All he would say is your eating too much. To make a long story short, I changed doctors and have been very happy since. If you are treated badly by a doctor choose a different one.
ReplyDeleteThe study was based on undergraduate nutrition students, NOT professional dietitians. There's a difference. Do your research before you post something on the internet, because people will believe everything they read.
ReplyDeleteAnonymous - read much?
ReplyDeletePerhaps you should check out the part where Dr. Freedhoff noted the 200 "dietitian students", or maybe the part where he mentioned, "those training to be dietitians" or maybe the part where he says "real life dietitians with rela work experiences are less likely to be judgemental".
I'm guessing you weren't breast fed (breast feeding adds 4 IQ points on average).