Date of Award

January 2017

Degree Type


Degree Name

Master of Science (MS)


Nutrition Science and Dietetics


Tanya M. Horacek

Second Advisor

Rick Welsh

Subject Categories

Medicine and Health Sciences


Background: Dieting is proven to be ineffective for weight management. Research shows that non-diet approaches, such as intuitive eating (IE), improve weight status and health outcomes. Cognitive factors may influence Registered Dietitian Nutritionists’ (RD/Ns) dietary and IE attitudes and practices. RD/Ns play an important role in communicating diet and non-diet approaches in practice with clients. IE can only be communicated to clients by RD/Ns as strongly as RD/Ns practice IE.

Objective: The primary goal of this research was to assess and evaluate Registered Dietitians intuitive eating attitudes and dietary behaviors and practices. RD/Ns IE scores were compared to their body mass index (BMI) and dietary quality. RD/Ns IE philosophies were qualitatively analyzed and compared to their IE scores. A final objective of this research was to validate a current instrument intended to measure RD/Ns IE attitudes, knowledge and practices.

Methods: A cross-sectional study design was used. Participants without the RD/N title were excluded. The survey consisted of five sections:1. Demographics; 2. 24-hour recall; 3. Eating philosophy; 4. Intuitive Eating Scale-2 (IES-2); 5. Validation instrument. IES-2 scores were calculated; the sample was divided into high, moderate and low IES-2 score groups. Twenty four-hour recalls were analyzed and Healthy Eating Index (HEI) scores were computed. Eating philosophies were analyzed for emerging IE and non-IE themes. Themes were totaled into IE and Non-IE theme scores. Validation scores were calculated and examined for the entire sample and a subsample of RD/Ns who practiced weight management counseling.

Results: Mean IES-2 score was 3.73 ± 0.47. BMI was negatively correlated to IES-2 scores (n=83, r= -.354, p=.001). No relationship was observed between IES-2 and HEI scores. A variety of non-IE themes emerged (e.g. restriction) from the qualitative analysis. There was a positive correlation between IES-2 and IE theme scores (r=.294, p=.007, n=84). Validation tool: Attitude was positively correlated to IES-2 scores (n=82, r=.242, p<.028). Subsample: Total validation score and all validation tool sub scores were positively correlated to IES-2 scores [Total (n=53, r=.413, p=.002), practices (n=55, r=.439, p=.001), knowledge (n=55, r=.282, p=.037) and attitudes (n=57, r=.291, p=.028)]. An Independent t-test confirmed significant differences between RD/Ns that practiced weight management counseling and those that did not for IE theme scores (2.03 ± 1.17 vs 1.35 ± 1.29, p=.025), attitudes (10.58 ± 2.36 vs 8.71 ± 3.39, p=.010) and knowledge (25.12 ± 3.37 vs 23.24 ± 2.74, P=.019).

Conclusion: RD/Ns reported conflicting dietary practices that were both consistent and not consistent with the IE principles. RD/Ns who practiced weight management counseling had more positive attitudes towards and knowledge of IE than those who did not. RD/Ns who practiced weight management counseling also reported IE themes more frequently. RD/Ns who practice weight management counseling may be more knowledgeable of IE related to more frequent exposure of IE. Non-IE themes were still well represented in the entire sample suggesting that RD/Ns’ may have conflicting IE attitudes and behaviors. This research can be used to assess and determine future dietetic training needs to benefit dietetic students, Registered Dietitians, clients and patients.


Open Access



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