Australian dietitians’ beliefs and attitudes towards weight loss counselling and Health at Every Size counselling for larger-bodied clients

Aim Research suggests that dietitians now employ weight-neutral approaches (Health at Every Size (HAES), Intuitive Eating and non-diet) as well as more traditional weight-centric approaches (weight loss counselling) to address adult weight concerns. This study aimed to compare the knowledge of and attitudes towards weight-neutral practice compared with weight-centric practice in Australian dietitians who work with larger-bodied clients as delineated by practice approach. Methods A cross-sectional web-based knowledge, attitudes and practices survey was conducted with Australian dietitians who counsel adults with a BMI >25kg.m2. Based on their responses dietitians were categorised into weight-centric (preferring weight loss counselling), weight-neutral (preferring HAES counselling) or mixed approach. Between group comparisons were conducted using Pearson’s chi2 tests for knowledge and practice and independent t-tests for attitudes. Results Of the 317 respondents, 18.3% fulfilled the criteria for weight-neutral practitioners, 30.3% for weight-centric practitioners and the remainder were classified as providing a mixed approach. Weight-neutral approaches were more positively regarded generally than weight-centric approaches (84.5% versus 53.9%) as well as considered professionally responsible (86% versus 58.7%) and perceived as more helpful for clients (61.2% versus 35%). Knowledge of weight-neutral practice goals was poor with only 36.9% (n=117) of the participants indicating correctly that this mode of treatment is incompatible with a weight loss goal. Conclusions Weight-neutral practice was considered acceptable by Australian dietetics professionals who counsel larger-bodied people regardless of their personal practice preference although many displayed inaccurate knowledge of weight-neutral approaches.