Stress and Eating Behaviors of Dietitians Amidst the COVID-19 Pandemic

Abstract

Background: Registered dietitians (RDs) encounter numerous work-related stressors from a multitude of sources amidst the COVID-19 pandemic. High stress has been identified as a risk factor for orthorexia nervosa (ON), a form of disordered eating characterized by a compulsive focus on eating foods perceived as healthy. Stress has also been tied to lower eating competence.Objective: To determine the relationships between stress experienced by RDs, eating competence, and risk for ON amid the backdrop of COVID-19. Design: A cross-sectional study was used to compare Perceived Stress Scale (PSS-14), ORTO-15 Questionnaire (ORTO-15), and Satter Eating Competence Inventory 2.0 (ecSI 2.0TM) scores computed from participant responses to understand how prevalence of stress, risk for ON, and eating competence in RDs relate to one another. Independent sample t-tests, Pearson’s correlation coefficient, and two-way ANOVA were used to compare scores. Participants: A random sample of 5,000 RDs in the United States were invited to complete an online survey; 155 responses were received. Results: Scores for the final sample (N=83) suggested 63.9% had high stress, 61.4% were at risk for ON, and 80.7% were eating competent. Statistical analysis revealed a negative association between stress and eating competence, but no relationship between stress and ON risk. Risk for ON and eating competence were positively associated. Conclusions: In this sample, stress was not related to ON but was negatively associated with eating competence. Further exploration of the relationship between stress and eating competence in RDs is warranted and may offer insight into addressing stress in the dietetics profession. The positive association between ON risk and eating competence may imply the presence of healthy orthorexia, or a non-pathological focus on eating healthfully, in RDs. The simultaneous existence of eating competence and maladaptive eating behaviors calls for future research into the relationship between ON and eating competence in RDs to provide a more precise differentiation between ON and healthy orthorexia.