Incorporating Nondiet and Weight-Neutral Principles in a University Dietetics Curriculum

To evaluate student attitudes toward nondiet, weight-neutral (NDWN) principles after reading Anti-Diet in a medical nutrition therapy (MNT) course.

A quasi-experimental design with no control group and a mixed-methods study approach.

Adult undergraduate students (n = 112) enrolled in an MNT course.

A traditional MNT course and reading Anti-Diet (January-May, 2021), which introduces multiple topics that support weight-inclusive approaches to health.

Change in student agreement with NDWN principles. Written reflections were collected to determine students' rationale for their level of agreement.

Likert scale responses (1-5) of student ratings were analyzed with multivariate linear regression, a linear mixed-effect model, and a Wilcoxon signed rank test with continuity correction. Reflections were analyzed using thematic analysis methods. The triangulation methods compared quantitative and qualitative data.

Students ratings shifted significantly away from dieting for weight loss and toward agreement with NDWN principles (99.7) = 7.35, P < 0.001; mean difference = 0.83 with 95% confidence interval, 0.61-1.05. Two main themes emerged: (1) NDWN topics led to critical analysis of weight-centric knowledge, and (2) specific topics were more effective at shifting weight-based attributions.

Incorporating specific NDWN principles in an undergraduate MNT curriculum can shift students' weight-based attributions. More systematic development and testing of anti-fat bias reduction curricula are needed to support broader dissemination and standardization in dietetics curricula.