**Background:** Dietitians are considered essential members of multidisciplinary teams treating eating disorders (EDs), yet low confidence, competence, and willingness to practice in this area have been reported among dietitians and students. The extent of ED-specific training within accredited university dietetic programs in Australia and New Zealand was previously unknown. This study aimed to: (1) obtain insights into current ED-specific knowledge and training content in these curricula; (2) understand course convenors' perspectives on the dietitian's role in ED treatment and employment opportunities; and (3) identify gaps and opportunities for improvement.
**Methods:** A qualitative descriptive study using an interpretive phenomenological approach was conducted. Course convenors (or nominated representatives) from all accredited dietetic programs in Australia and New Zealand were invited to participate. A purpose-built question guide was developed, and semi-structured virtual interviews (30–45 minutes each) were conducted via Zoom between March 2019 and March 2021. Interviews were audio-recorded, transcribed verbatim using Otter.ai, and analyzed inductively using Braun and Clarke's six phases of thematic analysis. Three researchers independently coded data and reached consensus on dominant themes. Rigor was established using Lincoln and Guba's criteria (confirmability, transferability, credibility).
**Key Results:** Thirteen participants (11 female, 2 male) representing 14 universities (12 Australian, 2 New Zealand) and 19 of 23 (83%) accredited dietetic programs participated (response rate 78%). Programs included Master degrees (n=12), Bachelor degrees (n=2), and Bachelor with Honours degrees (n=5). Three dominant themes emerged:
(1) Varying ED-specific content and training: All programs included ED-specific content, but depth and type varied considerably. ED-specific lectures were limited to 1 hour (1 program), 2 hours (9 programs), 3 hours (3 programs), or 4 hours with a workshop (1 program). Content was generally introductory, focusing on diagnostic criteria and nutrition assessment rather than therapeutic engagement, counseling skills, or ED-specific treatment modalities. Risk-mitigation skill development (screening, early identification) varied. ED-specific practical placements were rare; 7 programs had no affiliated specialist ED placement partner, 4 had access but no guaranteed student exposure, and 2 could not comment. Experiential training opportunities were uncommon, with generalized skills (motivational interviewing, meal planning, refeeding syndrome management, HAES approach) more common.
(2) Unclear dietitian's role in ED treatment: Participants cited limited published guidance on the dietitian's role, varied treatment approaches, and a paucity of dietetic outcome data as barriers to including more ED-specific treatment content. Gaps identified included scope of practice, reflective practice, and risk mitigation strategies. Concerns about dietetics students with their own EDs were raised, with one participant noting they advise students not to practice if unwell.
(3) Contrasting views regarding ED clinical practice and employment: Some participants viewed EDs as a specialist area where new graduates were unlikely to work, thus not prioritizing advanced training. Others acknowledged increasing private practice employment and the likelihood of encountering undiagnosed EDs, emphasizing the need for screening skills, boundary-setting, and referral pathway knowledge.
**Clinical Implications:** The inconsistencies in ED-specific training depth, time allocation, and experiential opportunities are problematic given that both students and new-graduate dietitians report low confidence working with ED patients. Improvements in therapist confidence are correlated with better patient outcomes. The recently published ANZAED practice and training standards for dietitians (2020), Dietitians Australia ED Role Statement, consensus-based outpatient guidelines, and the NEDC Dietitian Decision-Making Tool provide frameworks that could enhance curricula. Postgraduate training and clinical supervision are critical, but access barriers (cost, limited supervisors, especially in rural areas) persist. Online group clinical supervision models have shown promise, with 98% of respondents reporting positive changes to practice. The ANZAED Eating Disorder Credential may help standardize minimum qualifications. The authors recommend enhancing ED-specific skill development and knowledge in university programs to support effective, safe, and timely care, with implications for program development and the broader dietetic workforce.