Disordered eating and eating disorders in nutrition and dietetics students: Is it time to talk?

A Systematic Review on the Prevalence and Risk of Orthorexia Nervosa in Health Workers and Students

Extensive knowledge on nutrition and dieting has been associated with an increased risk of orthorexia (an obsession with food that one considers healthy) within the research literature. A systematic review was conducted to identify the prevalence of orthorexia in individuals who were employed in, or studying, health careers. The databases Psychinfo and Pubmed were searched to obtain research articles. Studies assessing orthorexia and either students or workers within health-related fields were included. A study merit rating system was utilised to assess the quality of each study included. In total, 26 articles were included in the current review after applying inclusion and exclusion criteria. The prevalence of orthorexia was the greatest in dietetic students. Research findings consistently demonstrated that the prevalence of orthorexia was higher in those working or studying in health fields than the general population. Individuals in their early stages of study or career appear most at risk. Orthorexia prevalence, however, does not appear to differ by sex or BMI. Orthorexia is novel research area. The trends in the current review suggest that individuals in health-related careers appear to be more at risk of orthorexic patterns. More research in this area is needed through the use of scales with greater psychometric properties.

Supporting nutrition and dietetics students' relationships with food and body image: Adopting a co-created curricula approach

AIMS

The aims of this study were to: (1) explore perspectives of university students' and academics' regarding disordered eating, eating disorders and body image in relation to pedagogy and curricula and (2) to evaluate a co-designed student seminar and an academic workshop on these topics.

METHODS

A participatory action research approach was employed whereby an educational intervention was co-created by academics and students. An online seminar was presented to students and a 1-h workshop was presented to academic staff. Evaluation was conducted via a post-seminar anonymous survey for students and a pre- and post-anonymous workshop survey for academics with a mix of Likert-scale questions and open text boxes. Qualitative data were open coded, both deductively and inductively, and quantitative data were analysed descriptively.

RESULTS

One hundred and seventeen students attended the voluntary education seminar. Six themes were identified from student qualitative data which included feeling safe, empowered, inspired, connected, emotional and reflective. Problematic aspects of pedagogy and curricula were identified by students and included: using personal data for teaching, demonising language to describe food/bodies and not always feeling safe or supported to discuss disordered eating. Twenty academics shared divergent perspectives-some reported feeling concerned and challenged by the content (exploring disordered eating with students), others noted the complexity of the area, and others reported low/moderate confidence or indifference in the space and felt this content outside of their scope as educators.

CONCLUSION

Curricula interventions that reduce triggering and shaming and increase space and support for strengthening students' relationships with food and their bodies are valued by nutrition and dietetics students. We encourage academics to consider pedagogical approaches and expand discourse in this space.

'Through education, we can make change': A design thinking approach to entry-level dietetics education regarding eating disorders

AIMS

To co-create strategies and identify opportunities to integrate eating disorder content within dietetics curricula at one Australian university with stakeholders using a design thinking approach.

METHODS

A pragmatic mixed-methods, participatory design approach was used. An online survey explored the learning needs of dietetic students and recent graduates regarding eating disorders. Following the survey, a one-day design thinking retreat was held with stakeholders who were identified from the research team's professional networks. Eating disorder dietitians, learning experts, dietetic students, graduates, and those with lived experience were asked to identify strategies to enhance students' confidence and competence to provide care for people living with eating disorders. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using inductive coding and reflexive thematic analysis.

RESULTS

Sixty-four students (n = 55, 86%) and recent graduates (n = 9, 14%) completed the online survey (26% response). Seventeen stakeholders attended the retreat. Four themes were identified: (1) changing perceptions of eating disorder care from specialist to 'core business'; (2) desiring and advocating for a national change to dietetics curricula; (3) importance of lived experience at the centre of curriculum design and delivery; and (4) collaborating to co-design and deliver eating disorder content at university.

CONCLUSION

Raising awareness, upskilling students and educators, enhanced collaboration between universities and stakeholders, and the inclusion of lived experience were key to preparing students to provide care to people seeking support for eating disorders. Further research is needed to assess the impact these strategies have on dietetic students' confidence and competence.

Global Prevalence of Eating Disorders in Nutrition and Dietetic University Students: A Systematic Scoping Review

BACKGROUND

Nutrition and dietetics (ND) training encourages behaviors that can be considered risk factors for eating disorders or disordered eating. This paper aims to explore the prevalence of eating disorders (EDs) and predictors of eating disorders (/P-EDs) in ND students.

METHODS

A systematic scoping review of the literature was performed on PubMed, ERIC, PsychINFO, OVID Medline, and Scopus in October 2022.

RESULTS

A total of 2097 papers were retrieved from the search, of which 19 studies met the inclusion criteria. The resultant literature reported that 4-32% of ND students were at high risk of EDs (n = 6 studies), and 23-89% could be classified as having orthorexia nervosa (n = 7 studies). Further, 37-86% reported body image/fat dissatisfaction (n = 10 studies), and 100% of students reported weight dissatisfaction (n = 1 study).

CONCLUSIONS

This paper highlights the prevalence of EDs and P-EDs across ND students. Further research is warranted to explore the cause, context, and impact on ND students' wellbeing and professional identity and supporting diversity within the profession. Future studies should also consider curriculum approaches to address this occupational hazard.