Registered Dietitians’ Perspectives on Intuitive Eating, Care and Treatment

OBJECTIVES: Worldwide efforts to prevent and treat obesity have failed, weight loss follow-up studies report that 95% of people match or exceed pre-intervention weight after three years. The first principle of intuitive eating, a framework that focuses on healthy eating, invites people to reject the diet mentality and with it the pursuit of weight loss. This study explored whether a patient's weight impacts the dietitian's treatment plan given identical lab values and their willingness to incorporate intuitive eating into their practice. METHODS: Three-arm experimental design, online survey of dietitians recruited via social media or emails. Dietitians were randomized to one of three case studies with identical lab values (NA 130, BUN 31, CR 1.9, Blood glucose 475, A1c 9.1) except for the patient's BMI (23.8, 28.9, 31.6) and answered questions about intuitive eating outcome expectations. Dietitians saw a list of 14 recommendations, including using daily weights for self-monitoring, avoiding specific foods, following a dietary plan with the purpose of weight loss, and losing weight. RESULTS: Preliminary results show that all 31 respondents were female, 87% white, 61% under the age of 34 years and the median year for RD Exam was 2017. Eight respondents had a bachelor's degree as their highest level of education, 19 respondents had a master's degree and 4 had a PhD. Seven of the respondents were Intuitive Eating Certified and only 1 respondent reported having never heard of intuitive eating. Two respondents said they did not incorporate intuitive eating into their practice, 3 said yes, and 23 said some elements. Chi-square analyses showed that BMI had a significant effect on 2 of the 14 recommendations: following a dietary plan with the purpose of weight loss (p < .0001) and losing weight (p = 0.02). CONCLUSIONS: Most dietitians in our study have heard of intuitive eating and believe that they are incorporating some elements into their practice. Nevertheless, when presented with a case study with identical lab values, dietitians still recommend patients with larger BMI's lose weight against the main intuitive eating principle. Suggesting that forgoing the pursuit of weight loss is a barrier for dietitians to adequately promote intuitive eating in their practice. FUNDING SOURCES: Dietitians volunteered; no funding sources were used for this study.