Healthy Eating

FNCE: RDNs, Weight Bias, and Health at Every Size

Do dietitians who align themselves with Health at Every Size (HAES, a registered trademark) have less weight bias? Does weight bias training help? New research presented at FNCE aimed to find out. The answers were a bit mixed, though. It all depends upon whether you look at explicit or implicit bias.

If a dietitian was aligned with HAES, then they were less likely to show explicit bias. But it made no difference in their implicit bias: unconsciously favoring thin over fat people. However, these researchers did find a significant link between weight bias training and less bias of either kind – implicit or explicit.

A Third of RDNs Aligned with HAES

In this research, Nadeeja Wijayatunga and colleagues found that about a third (34%) of dietitians said they fully align themselves with HAES. Another third called themselves “somewhat” aligned. The others either didn’t know or did not identify with it.

These findings come from surveying a sample  of 246 registered dietitians in the summer of 2019.

Differences Between Implicit and Explicit Bias

Both explicit and implicit bias are important. The explicit bias is the stuff a person says right out loud. No holding back. But implicit bias can be just as noxious. It fuels actions and judgments taken without thinking to favor thinner people. It’s sneaky and as we’ve noted before, implicit weight bias is actually on the rise.

Senior author Emily Dhurandhar explained:

“If dietitians were aligned with HAES, that was associated with lower ‘blame’ explicit bias, but not a significant difference in implicit weight bias.

“Thirty-seven percent of dietitians had prior weight bias training. That is encouraging, but ideally it will rise to 100% in the near future.

“Finally, and importantly, prior weight bias training in dietitians was associated with lower ‘blame’ weight bias, and lower implicit weight bias.”

More Progress Needed

This research is encouraging, but we need more. Weight bias appears to be less explicit from dietitians who align themselves with Health at Every Size. However, this research tells us that HAES alignment offers no guarantee for less implicit bias.

The most encouraging note was the finding that weight bias training might help with both explicit and implicit bias. With more of such training for all healthcare professionals, perhaps we can raise the standard of care and slowly, but surely, erase weight bias from healthcare.

Click here for the research poster from FNCE and here for a twitter thread on the research. For more on efforts to reduce weight bias, click here, here, and here.

Healthy Eating, U.S. Army photo by Sgt. Ryan Hallock / flickr

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October 20, 2020