A survey of Registered Dietitian Nutritionists who provide care to clients with eating disorders: Implications for education, training and clinical practice

Abstract

Successful management of eating disorder (ED) symptoms includes Registered Dietitian Nutritionists (RDNs) with specialized expertise, nutrition counseling skills, and advanced training. We conducted an anonymous on-line survey of self-identified ED-specialized RDNs about their previous education and training, workload, job duties, and job satisfaction. Respondents were 182 RDNs who were U.S. members of the International Federation of Eating Disorder Dietitians. Qualitative methods identified salient themes from narrative responses to augment survey data. Most respondents expressed confidence in their ED-related competence, however these skills were gained from post-professional, self-funded activities, not from ED-specific education or training in either school or work settings. While two-thirds of RDNs surveyed held an advanced degree and more than half held specialty certification, an inverse relationship between provider expertise and patient acuity was observed. RDNs working at the highest levels of ED care with the most medically complex patients were less likely to hold graduate degrees or have prior clinical experience. Obstacles to job satisfaction included high patient caseloads, low compensation, lack of employer support, and high burnout. Facilitators of job satisfaction included professional and client communities, and the private practice setting. Considering the essential nature of nutrition rehabilitation in ED treatment and the high prevalence of dysfunctional eating behaviors in society at-large, these observations identify gaps in RDN preparedness and facility staffing practices that may affect treatment outcomes for individuals with known and undiagnosed ED’s. Enhancements in dietetics education and heightened attention to supervision for entry-level clinicians in ED-specific treatment programs are prime targets for actioSuccessful management of eating disorder (ED) symptoms includes Registered Dietitian Nutritionists (RDNs) with specialized expertise, nutrition counseling skills, and advanced training. We conducted an anonymous on-line survey of self-identified ED-specialized RDNs about their previous education and training, workload, job duties, and job satisfaction. Respondents were 182 RDNs who were U.S. members of the International Federation of Eating Disorder Dietitians. Qualitative methods identified salient themes from narrative responses to augment survey data. Most respondents expressed confidence in their ED-related competence, however these skills were gained from post-professional, self-funded activities, not from ED-specific education or training in either school or work settings. While two-thirds of RDNs surveyed held an advanced degree and more than half held specialty certification, an inverse relationship between provider expertise and patient acuity was observed. RDNs working at the highest levels of ED care with the most medically complex patients were less likely to hold graduate degrees or have prior clinical experience. Obstacles to job satisfaction included high patient caseloads, low compensation, lack of employer support, and high burnout. Facilitators of job satisfaction included professional and client communities, and the private practice setting. Considering the essential nature of nutrition rehabilitation in ED treatment and the high prevalence of dysfunctional eating behaviors in society at-large, these observations identify gaps in RDN preparedness and facility staffing practices that may affect treatment outcomes for individuals with known and undiagnosed ED’s. Enhancements in dietetics education and heightened attention to supervision for entry-level clinicians in ED-specific treatment programs are prime targets for actioSuccessful management of eating disorder (ED) symptoms includes Registered Dietitian Nutritionists (RDNs) with specialized expertise, nutrition counseling skills, and advanced training. We conducted an anonymous on-line survey of self-identified ED-specialized RDNs about their previous education and training, workload, job duties, and job satisfaction. Respondents were 182 RDNs who were U.S. members of the International Federation of Eating Disorder Dietitians. Qualitative methods identified salient themes from narrative responses to augment survey data. Most respondents expressed confidence in their ED-related competence, however these skills were gained from post-professional, self-funded activities, not from ED-specific education or training in either school or work settings. While two-thirds of RDNs surveyed held an advanced degree and more than half held specialty certification, an inverse relationship between provider expertise and patient acuity was observed. RDNs working at the highest levels of ED care with the most medically complex patients were less likely to hold graduate degrees or have prior clinical experience. Obstacles to job satisfaction included high patient caseloads, low compensation, lack of employer support, and high burnout. Facilitators of job satisfaction included professional and client communities, and the private practice setting. Considering the essential nature of nutrition rehabilitation in ED treatment and the high prevalence of dysfunctional eating behaviors in society at-large, these observations identify gaps in RDN preparedness and facility staffing practices that may affect treatment outcomes for individuals with known and undiagnosed ED’s. Enhancements in dietetics education and heightened attention to supervision for entry-level clinicians in ED-specific treatment programs are prime targets for actioSuccessful management of eating disorder (ED) symptoms includes Registered Dietitian Nutritionists (RDNs) with specialized expertise, nutrition counseling skills, and advanced training. We conducted an anonymous on-line survey of self-identified ED-specialized RDNs about their previous education and training, workload, job duties, and job satisfaction. Respondents were 182 RDNs who were U.S. members of the International Federation of Eating Disorder Dietitians. Qualitative methods identified salient themes from narrative responses to augment survey data. Most respondents expressed confidence in their ED-related competence, however these skills were gained from post-professional, self-funded activities, not from ED-specific education or training in either school or work settings. While two-thirds of RDNs surveyed held an advanced degree and more than half held specialty certification, an inverse relationship between provider expertise and patient acuity was observed. RDNs working at the highest levels of ED care with the most medically complex patients were less likely to hold graduate degrees or have prior clinical experience. Obstacles to job satisfaction included high patient caseloads, low compensation, lack of employer support, and high burnout. Facilitators of job satisfaction included professional and client communities, and the private practice setting. Considering the essential nature of nutrition rehabilitation in ED treatment and the high prevalence of dysfunctional eating behaviors in society at-large, these observations identify gaps in RDN preparedness and facility staffing practices that may affect treatment outcomes for individuals with known and undiagnosed ED’s. Enhancements in dietetics education and heightened attention to supervision for entry-level clinicians in ED-specific treatment programs are prime targets for actioSuccessful management of eating disorder (ED) symptoms includes Registered Dietitian Nutritionists (RDNs) with specialized expertise, nutrition counseling skills, and advanced training. We conducted an anonymous on-line survey of self-identified ED-specialized RDNs about their previous education and training, workload, job duties, and job satisfaction. Respondents were 182 RDNs who were U.S. members of the International Federation of Eating Disorder Dietitians. Qualitative methods identified salient themes from narrative responses to augment survey data. Most respondents expressed confidence in their ED-related competence, however these skills were gained from post-professional, self-funded activities, not from ED-specific education or training in either school or work settings. While two-thirds of RDNs surveyed held an advanced degree and more than half held specialty certification, an inverse relationship between provider expertise and patient acuity was observed. RDNs working at the highest levels of ED care with the most medically complex patients were less likely to hold graduate degrees or have prior clinical experience. Obstacles to job satisfaction included high patient caseloads, low compensation, lack of employer support, and high burnout. Facilitators of job satisfaction included professional and client communities, and the private practice setting. Considering the essential nature of nutrition rehabilitation in ED treatment and the high prevalence of dysfunctional eating behaviors in society at-large, these observations identify gaps in RDN preparedness and facility staffing practices that may affect treatment outcomes for individuals with known and undiagnosed ED’s. Enhancements in dietetics education and heightened attention to supervision for entry-level clinicians in ED-specific treatment programs are prime targets for actioSuccessful management of eating disorder (ED) symptoms includes Registered Dietitian Nutritionists (RDNs) with specialized expertise, nutrition counseling skills, and advanced training. We conducted an anonymous on-line survey of self-identified ED-specialized RDNs about their previous education and training, workload, job duties, and job satisfaction. Respondents were 182 RDNs who were U.S. members of the International Federation of Eating Disorder Dietitians. Qualitative methods identified salient themes from narrative responses to augment survey data. Most respondents expressed confidence in their ED-related competence, however these skills were gained from post-professional, self-funded activities, not from ED-specific education or training in either school or work settings. While two-thirds of RDNs surveyed held an advanced degree and more than half held specialty certification, an inverse relationship between provider expertise and patient acuity was observed. RDNs working at the highest levels of ED care with the most medically complex patients were less likely to hold graduate degrees or have prior clinical experience. Obstacles to job satisfaction included high patient caseloads, low compensation, lack of employer support, and high burnout. Facilitators of job satisfaction included professional and client communities, and the private practice setting. Considering the essential nature of nutrition rehabilitation in ED treatment and the high prevalence of dysfunctional eating behaviors in society at-large, these observations identify gaps in RDN preparedness and facility staffing practices that may affect treatment outcomes for individuals with known and undiagnosed ED’s. Enhancements in dietetics education and heightened attention to supervision for entry-level clinicians in ED-specific treatment programs are prime targets for action.