A new and exciting change is happening in nutrition and dietetics in Australia. A no-diets approach to health is being incorporated into many university programs.
Now you may be wondering why dietitians wouldn’t use diets to help patients and clients? Isn’t there an ‘Obesity Crisis’ and isn’t helping people to lose weight what a dietitian does?
Let’s find out more.
The ‘non-diet approach’, sometimes shortened to ‘NDA’, is a method health professionals including dietitians, can support community members to make changes to their health without a focus on weight loss.
There are four main reasons why many health professionals don’t recommend weight loss programs or diets as a means for good health anymore:
1. Diets don’t work
Weight loss techniques, whether that be advice from a dietitian or other community-based programs do not work in the long term. Results of a 2013 systematic review from the National Health and Medical Research Council’s Clinical Management Guidelines for Obesity, showed that many people can lose weight initially, however after 2-5 years they return to their previous weight.
2. The relationship between weight and health is complex
The standard advice patients would have often received in the past, is that if they lose weight, their particular health concerns (for example diabetes, high cholesterol or high blood pressure) will improve. Yes, this can most definitely happen. The nutrients associated with such health conditions (such as saturated fat, added sugars and salt) are often found in foods with a higher amount of energy or calories. Therefore, when we follow a weight loss diet, our health can sometimes improve.
However, contrary to popular belief, living in a larger body is not necessarily “bad for our health”. There are studies showing people who simply focused on healthy behaviours (and not weight) have improved their health and this happened even when their weight stayed the same.
3. Weight loss diets can be harmful
There is evidence that those people who frequently follow weight-loss diets are at a higher risk of developing an eating disorder, developing body dissatisfaction, depression and anxiety.
Additionally, weight cycling (where our weight goes up and down – which is what happens when we frequently diet) can increase inflammatory responses in our body. This can increase the risk of chronic health conditions such as insulin resistance and high blood pressure.
4. Judging someone by their weight is a discrimination issue
Given the research on the effectiveness of dieting and potential harm from dieting, we now know focusing health promotion strategies on body weight and assuming larger bodies are unhealthier than smaller bodies is a social justice issue. It is viewed by some as a form of discrimination. Therefore, many universities are including discussions on social justice in their nutrition and dietetics curriculum.
How are students learning the non-diet approach?
Australian universities are now offering a more diverse mix of learning opportunities in the non-diet approach. Students are:
- Gaining a chance to research the effects of social media and marketing strategies on body image.
- Learning to review the literature and evidence for using body mass index (BMI) with patients and clients.
- Researching discrimination within health systems and its impact on equity of access to health care.
- Practicing counselling skills to apply in clinical settings, particularly with community members who have been dieting for years.
- Learning how to support people to make changes to eating that are all about health (and not weight loss).
I know from our dietetics program at Bond University, some students have even been blogging about it. Here is one recent blog article from student, Charlene Matthews on how to apply the non-diet approach at Christmas time.
Similarly in our Community and Public Health Nutrition Internships in the Solomon Islands, students have been learning to embrace the local foods and food culture and avoid enforcing our ‘Western Diet mentality’ into health promotion projects.
This is a fairly new area of nutrition globally and Australian university dietetics programs are leading the world by including this approach as part of the curriculum.
It will be exciting to see where we are in 10 years’ time.
Want to learn more?
Here’s a recent article from ABC news discussing more of the research in this area. If you are interested in studying nutrition at University, have a chat to your preferred university program. Ask about how they are incorporating the non-diet approach in their teaching.
Christina Turner is an Accredited Practising Dietitian who specialises in Eating Disorders and the Non-Diet Approach. She currently works as Senior Teaching Fellow and Internships Coordinator in the Master of Nutrition and Dietetic Practice program at Bond University.
Applications for Master of Nutrition & Dietetics Practice at Bond University are taken for course commencement in May 2019.