Centre for Obesity Research, University College London, London, UK.
Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, UK.
J Hum Nutr Diet. 2024 Oct;37(5):1143-1158. doi: 10.1111/jhn.13337. Epub 2024 Aug 7.
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.
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.
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.
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.
体重歧视在医疗保健领域普遍存在,对获得医疗服务和医患关系都有负面影响。尽管有数据显示肥胖患者会受到与体重相关的偏见,但在英国,注册营养师中体重歧视的相关证据有限。本研究旨在调查英国注册营养师中明显和隐性的体重歧视,以及营养师自身和对他人的体重歧视的实际经历。
2022 年 2 月至 5 月期间,采用滚雪球抽样法在网上开展横断面调查。纳入标准为年龄在 20-70 岁之间的英国注册营养师。
共有 402 名营养师对该调查做出回应(女性占 94.1%,平均年龄为 40.2 岁[标准差(SD)为 10.7];白种人占 90%;中位数为 12 年[四分位距(IQR)为 6-22]从事营养实践)。报告的平均自我报告体重指数为 25.1kg/m²(SD 为 8.7)。大多数营养师报告说,在注册前后都经历过体重歧视(注册前为 51%,注册后为 59.7%),而近四分之一(21.1%)的人认为体重会影响他们作为营养师的能力。体重歧视发生在整个体重范围内。总体而言,参与者报告了明显的体重偏见态度、认为肥胖可以控制的中等信念和隐性的反肥胖偏见。在开放式回答中,营养师报告了与他们个人体重歧视经历相关的三个关键主题:(1)在营养实践中经历的歧视,(2)体重歧视的影响,(3)对体重、外貌和工作的看法。
本研究表明,英国营养师对肥胖患者表现出明显和隐性的体重偏见。营养师报告说经历过体重歧视,这影响了他们的职业相关决策以及他们对自己作为营养师的能力的看法。该研究强调了在营养专业中解决体重歧视及其影响的必要性。