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TOPLINE:

A narrower focus on weight loss by patients, health professionals, and clinical practice guidelines may hinder dieticians from implementing nonweight-focused approaches (NWFAs) to support healthy outcomes for adults with higher weight.

METHODOLOGY:

• The 2020 Canadian Adult Obesity clinical practice guideline includes recommendations for nondieting approaches that promote overall nutrition and positive relationships with food, and joyful movement over weight loss for adults with higher weight (body mass index, > 30).
• However, implementing a new approach is challenging, especially when it contradicts long-standing practices and beliefs of healthcare providers, patients, and other guidelines, such as the emphasis on weight loss.
• The study aimed to explore factors that inhibit or support dieticians to adopt and implement NWFAs for clients at a higher weight.
• The researchers conducted an online survey guided by the Consolidated Framework for Implementation Research among 383 registered Canadian dieticians (94.8% women; 82.2% White population) from May to July 2021.
• The survey questionnaire assessed the extent to which a dietician focuses on weight loss as a primary outcome of nutrition therapy while working with clients at a higher weight, as well as the barriers and favored supportive factors.

TAKEAWAY:

• Among the 54 participants who hadn't integrated NWFAs into their practice, 9.2% lacked interest, 51.8% expressed curiosity but were yet to implement, and 20.3% were in the process of learning how to implement NWFAs.
• The major barriers among dieticians to implementing NWFAs included:
  • Other health professionals who focus on weight loss.
  • Dieticians practice philosophy, knowledge, and confidence.
  • Weight loss as a condition to access enhanced healthcare services.
  • Clients focus on weight loss outcomes.
• Clinical practice guidelines without NWFAs were a major barrier for dieticians who had not implemented NWFAs compared with those who had (P < .001).
• To drive NWFA adoption and implementation, dieticians prefer mentors, undergraduate training, practice guidelines, and best practice clinical care pathways.

IN PRACTICE:

The authors wrote, "Our study provides an important benchmark on the use of NWFAs as an effective evidence‐based practice to work with higher-weight adult clients, which ultimately can help improve health outcomes of Canadians."

SOURCE:

This study, led by Kori Lichtfuss, Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada, was published online in the Journal of Human Nutrition and Dietetics.

LIMITATIONS:

A higher number of dieticians were from Ontario and Alberta, which may affect the generalizability of the findings. Participants were recruited by social media via professional groups and networks, which may have introduced sampling bias. The survey was offered only in English, which may have omitted solely French-speaking Canadians.

DISCLOSURES:

This research was funded by internal start‐up research funds from Ontario Tech University to Arcand. The authors declared no conflicts of interest.