Abstract
Background
Researchers have been advocating for a new weight-inclusive paradigm that focuses
on health rather than weight. One important component of this model is intuitive eating.
Although registered dietitian nutritionists (RDNs) are the nation’s food and nutrition
experts, RDNs’ knowledge of and attitudes toward intuitive eating and use of traditional
or restrictive strategies are unknown.
Objective
The purpose of this study was to characterize RDNs’ knowledge of and attitudes toward
an intuitive eating lifestyle and describe use of traditional weight management and
nonrestrictive lifestyle practices with clients.
Design
This was a cross-sectional study.
Participants
A validated survey was distributed using online survey software to 88,834 RDNs.
Results
There were 18,622 respondents who completed the survey (25%). The majority of RDNs
were knowledgeable about intuitive eating, answering 71% of items correctly. The majority
of RDNs had a positive view on each attitude item. RDNs who work in weight management
reported using nonrestrictive/intuitive eating practices more than traditional/restrictive
practices. RDNs who were women (P<0.001), had advanced education (P<0.001), worked in a private practice setting (P<0.001), completed at least one certificate of training in weight management (P<0.001), had more experience in weight management counseling (P<0.001), and had greater intuitive eating knowledge (P<0.001) were more likely to report greater use of nonrestrictive/intuitive eating
practices.
Conclusions
This study provides evidence that RDNs are using an intuitive eating approach more
often than traditional weight management practices.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Overweight and obesity in the united states: Prevalence and trends, 1960–1994.Int J Obes & Relat Metab Disord. 1998; 22: 39
- Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010.JAMA. 2012; 307: 491-497
- Why treatments for obesity don't last.J Am Diet Assoc. 1991; 91: 1243-1247
- Weight-loss diets for the prevention and treatment of obesity.N Engl J Med. 2009; 360: 923-925
- Medicare's search for effective obesity treatments: Diets are not the answer.Am Psychol. 2007; 62: 220-233
- Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates.N Engl J Med. 2009; 360: 859-873
- Treatment of obesity by very low calorie diet, behavior therapy, and their combination: A five-year perspective.Int J Obes. 1989; 13: 39-46
- Weight science: Evaluating the evidence for a paradigm shift.Nutr J. 2011; 10: 9
- Intuitive Eating: A Revolutionary Program that Works.3rd ed. St Martin's Press, New York, NY2012
- Development and psychometric evaluation of a measure of intuitive eating.J Couns Psychol. 2006; 53: 226-240
- Relationships between intuitive eating and health indicators: Literature review.Public Health Nutr. 2014; 17: 1757-1766
- A review of interventions that promote eating by internal cues.J Acad Nutr Diet. 2014; 114: 734-760
- Validity of claims made in weight management research: A narrative review of dietetic articles.Nutr J. 2010; 20 (30-2891-9-30)
- The relationship between intuitive eating and health indicators among college women.J Health Educ. 2005; 36: 331-336
- Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors?.Appetite. 2013; 60: 13-19
- The intuitive eating scale-2: Item refinement and psychometric evaluation with college women and men.J Couns Psychol. 2013; 60: 137-153
- Sustained self-regulation of energy intake. Loss of weight in overweight subjects. Maintenance of weight in normal-weight subjects.Nutr Metab (Lond). 2010; 7: 4
- Pilot study: Mindful eating and living (MEAL): Weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity.Complement Ther Med. 2010; 18 (5-5)
- Psychological impact of a “health-at-every-size” intervention on weight-preoccupied overweight/obese women.J Obes. 2010; 2010 (Epub 2010 Jun 29): 928097
- Impact of a health-at-every-size intervention on changes in dietary intakes and eating patterns in premenopausal overweight women: Results of a randomized trial.Clin Nutr. 2012; 31: 481-488
- The solution method: 2-year trends in weight, blood pressure, exercise, depression, and functioning of adults trained in development skills.J Am Diet Assoc. 1997; 97: 1133-1138
- Short-term effects of a “health-at-every-size” approach on eating behaviors and appetite ratings.Obesity (Silver Spring). 2007; 15: 957-966
- The effect of a mindful restaurant eating intervention on weight management in women.J Nutr Educ Behav. 2012; 44: 22-28
- Long-term effects of a psychologically based group programme for women preoccupied with body weight and eating behaviour.Int J Obesity. 1990; 14: 135-147
- Evaluating a ‘non-diet’ wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors.Int J Obes Relat Metab Disord. 2002; 26: 854-865
- Size acceptance and intuitive eating improve health for obese, female chronic dieters.J Am Diet Assoc. 2005; 105: 929-936
- Effectiveness of the “my body knows when” intuitive-eating pilot program.Am J Health Behav. 2010; 34: 286-297
- Evaluation of two nondieting interventions for obese women.West J Nurs Res. 1998; 20: 119-135
- Evaluation of a “nondieting” stress reduction program for overweight women: A randomized trial.Am J Health Promot. 2008; 22: 264-274
- Undieting: A program to help people stop dieting.Int J Eat Disord. 1992; 11: 261-268
- Outcomes of a traditional weight control program and a nondiet alternative: A one-year comparison.J Psychol. 1999; 133: 495-513
- Health-at-every-size and eating behaviors: 1-year follow-up results of a size acceptance intervention.J Am Diet Assoc. 2009; 109: 1854-1861
- Short-term effects of a non-dieting lifestyle intervention program on weight management, fitness, metabolic risk, and psychological well-being in obese premenopausal females with the metabolic syndrome.Appl Physiol Nutr Metab. 2007; 32: 125-142
- Changing the body image concern and eating behaviour of chronic dieters: The effects of a psychoeducational intervention.Psychol Health. 1998; 13: 1045-1060
- Eating order: A 13-week trust model class for dieting casualties.J Nutr Educ Behav. 2008; 40: 43-48
- Well-being and morbid obesity in women: A controlled therapy evaluation.Int J Eat Disord. 1998; 23: 325-339
- The weight dilemma: A range of philosophical perspectives.Int J Obes Relat Metab Disord. 1999; 23: S31-S37
- Management of obesity: Attitudes and practices of Australian dietitians.Int J Obes Relat Metab Disord. 2000; 24: 701-710
- Canadian dietitians’ approaches to counseling adult clients seeking weight-management advice.J Am Diet Assoc. 2005; 105: 1275-1279
- Canadian dietitians’ views and practices regarding obesity and weight management.J Hum Nutr Diet. 2004; 17: 503-512
- Dietitians' views of overweight and obese people and reported management practices.J Hum Nutr Diet. 2002; 15: 331-347
- Canadian dietitians' understanding of non-dieting approaches in weight management.Can J Diet Pract Res. 2007; 68: 67-72
- Attitudes of registered dietitians toward personal overweight and overweight clients.J Am Diet Assoc. 1997; 97: 63-66
- Attitude of dietetics students and registered dietitians toward obesity.J Am Diet Assoc. 1995; 95: 914-916
- Validation of an instrument to measure registered dietitians'/nutritionists' knowledge, attitudes, and practices of an intuitive eating approach.Public Health Nutr. 2016; June: 1-9
- Measurement scales and statistics: Resurgence of an old misconception.Psychol Bull. 1980; 87: 564-567
- Use and misuse of likert scales.Med Educ. 2005; 39: 970
- Resolving the 50-year debate around using and misusing likert scales.Med Educ. 2008; 42: 1150-1152
- Likert scales, levels of measurement and the “laws” of statistics.Adv Health Sci Educ Theory Pract. 2010; 15: 625-632
Biography
J. T. Schaefer is adjunct faculty, College of Public Health, Kent State University, Kent, OH.
Biography
M. D. Zullo is an associate professor, College of Public Health, Kent State University, Kent, OH.
Article info
Publication history
Published online: June 13, 2017
Accepted:
April 20,
2017
Received:
August 16,
2016
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT There is no funding to disclose.
Identification
Copyright
© 2017 by the Academy of Nutrition and Dietetics.
