To evaluate student agreement with weight-inclusive principles in a university Medical Nutrition Therapy (MNT) course.
Use of Theory or Research
Preoccupation with diet culture is an emerging topic in dietetics education that is shifting how students view weight and body image. This course introduced Health at Every Size® and Intuitive Eating concepts to the existing weight-normative approaches typically delivered in dietetics coursework.
One hundred undergraduate students enrolled in a senior-level MNT course.
The 4-credit course includes weight-normative approaches to obesity prevention and treatment with an emphasis on body weight in defining health and disease management, including diet, exercise, and behavior change. Weight-inclusive concepts, which uncouple weight and health, center body diversity, and advocate for non-stigmatizing healthcare, were added to the course in spring 2020 through class discussions, guest speakers, and the assigned popular-press book Anti-Diet, along with required reflections after each chapter.
Student agreement with weight inclusive principles was assessed using a 5-point scale with 1 referring to agreement that dieting is appropriate for weight loss and 5 in agreement of the use of weight inclusive approaches. Statistical analyses included multivariate linear regression, paired t test, and Wilcoxon signed rank test.
Agreement with weight-inclusive principles increased significantly by 0.051 units/chapter, with statistically significant spikes in upward agreement after chapters 3, 6, and 8. The paired t test showed a mean gain in agreement from the end of chapter 1 to the end of chapter 11 of 0.565 points (33%) with a 95% CI of (0.369, 0.760). A Wilcoxon signed rank test likewise showed a significant increase in agreement from chapters 1-11 (P < 0.0001).
Introducing anti-diet principles into a traditional weight-normative curriculum was effective in shifting student agreement with weight-inclusive practices. This project also demonstrated feasibility of incorporating a contemporary companion book project within a pre-existing MNT curriculum that is inclusive of the many ways in which nutrition professionals approach health.