Diversi T M, Hughes R, Burke K J
Faculty of Health Science and Medicine, Nutrition and Dietetics Department Bond University Robina QLD Australia; School of Human, Health and Social Sciences Central Queensland University Rockhampton QLD Australia.
Faculty of Health Science and Medicine, Nutrition and Dietetics Department Bond University Robina QLD Australia; School of Public Health Massey University Wellington New Zealand.
Obes Sci Pract. 2016 Dec;2(4):456-465. doi: 10.1002/osp4.83. Epub 2016 Nov 17.
This study explored weight bias amongst Australian Accredited Practising Dietitians (APDs) and the effect of client weight status on dietetic practice.
Participants 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.
Mean 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.
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 and how it impacts client outcomes and to test possible solutions is required.
本研究探讨了澳大利亚注册执业营养师（APD）中的体重偏见以及客户体重状况对营养实践的影响。
采用目的抽样法招募了201名APD作为参与者。完成了一份自我管理的问卷——脂肪恐惧症量表（FPS），以评估显性体重偏见。然后，参与者被随机分配，分别面对一名体重正常范围的女性或肥胖女性，并附带一个与体重无关病症的相同案例研究。参与者根据提供的数据对客户进行评估，给出建议并对他们对客户的看法进行评分。
FPS平均得分表明存在轻度脂肪恐惧症。然而，营养实践受到客户体重状况的显著影响。面对肥胖女性的营养师认为该客户健康状况明显较差，并且更有可能主动提供体重管理建议。此外，营养师认为该客户接受度较低、积极性不高，理解和坚持建议的能力也较低。
本研究的贡献在于探讨了体重状况如何影响营养实践，包括对客户的评估、建议以及看法。尽管显性的FPS仅评估出轻度脂肪恐惧症，但营养师的行为方式可能表现出或被视为负面的隐性体重偏见。需要进一步研究以了解该问题的严重程度及其对客户结果的影响，并测试可能的解决方案。
