Potential unintended consequences of graphic warning labels on sugary drinks: do they promote obesity stigma?

INTRODUCTION: Public health interventions need to balance the benefits with any potential harms. One proposed intervention for reducing sugar-sweetened beverage consumption involves placing graphic warning labels on products and advertisements. A recent study found that a graphic warning label that contained negative imagery of obesity reduced purchases of sugar-sweetened beverages. However, these labels may also promote obesity stigma, which is concerning given that weight stigma is associated with harmful health consequences including weight gain and increased risk of mortality. METHODS: In Study 1 (n = 681), participants viewed a standard soda label or the graphic warning label online and then completed measures of disgust and prejudice towards people with obesity. In Study 2 (n = 506), participants who identified as having overweight or obesity viewed the graphic warning label online before or after completing measures of mood and state self-esteem. RESULTS: In Study 1, participants who had viewed the graphic warning label reported higher disgust and weight bias. In Study 2, the majority of participants perceived the warning label to be stigmatizing, and participants displayed worse mood and, through this, lower self-esteem after viewing the label. CONCLUSIONS: Although the graphic warning label has been found to reduce sugary drink purchases, it also promotes obesity stigma and is perceived as stigmatizing by individuals with overweight and obesity. Given that weight stigma predicts harmful health and well-being consequences, the benefits of graphic warning labels need to be balanced against the potential costs.

Coping with weight stigma: development and validation of a Brief Coping Responses Inventory.

People who are overweight or obese are frequently stigmatized because of their weight, but there has been limited exploration of how people cope with these experiences. The Coping Responses Inventory (CRI) assesses a wide range of coping strategies in response to weight stigma; however, its length (99 items) may have prevented it from being widely used. The aim of the current research (four studies; total N = 1,391) was to develop and validate a Brief CRI. This 10-item measure consists of two subscales that assess core coping responses to weight stigma: reappraisal and disengagement coping. Reappraisal coping is an adaptive form of coping that is associated with greater well-being, whereas disengagement coping reflects a maladaptive form of coping that is associated with poorer well-being. The Brief CRI provides a quick and effective way to assess coping with weight stigma, and its use has the potential to advance an understanding of the consequences of weight stigma.

Portion-size preference as a function of individuals' body mass index.

OBJECTIVE: Large portions of food are often blamed for rising rates of obesity. We tested the possibility that people who are heavier may tend to select or prefer larger portions than do people who are lighter. METHODS: Participants (total N = 798) were asked to choose between a small and larger portion of pasta for a hypothetical meal (Studies 1, 2 and 4), to indicate their ideal portion from a range of portion-size options (Study 2), or to select their preferred portion size from each of 28 portion pairs (Study 3). RESULTS: Across all studies, there were no significant differences between heavier and lighter participants in their portion-size selection (effect sizes ranged from d = -0.06 to 0.33). The pattern was the same regardless of whether we grouped participants as having a body mass index (BMI) <25 vs. ≥25, as having a BMI of <30 vs. ≥30, or treated BMI as a continuous predictor. CONCLUSIONS: Given the lack of association between BMI and portion-size preference, we suggest that factors other than portion size, such as differences in meal frequency, food type, plate clearing or compensation at subsequent meals, may need to be considered in order to explain the increasing prevalence of obesity.

Changes in weight bias following weight loss: the impact of weight-loss method.

BACKGROUND: Many obese individuals lose weight to reduce weight stigma; however, little is known about whether other people's attitudes actually improve towards obese individuals after they have lost weight, and whether changes in attitudes depend on the method of weight loss. This study examined changes in people's perceptions of an obese target who had lost weight through diet and exercise or through surgery. METHOD: Participants (N=73) initially viewed an image of an obese woman or a thin woman (control condition), and were asked to indicate their perceptions of the target with respect to the target's behaviors (for example, how often she exercises), as well as some personality characteristics (for example, lazy, sloppy and competent). Participants then viewed a more recent image of the target in which she had lost weight, and were informed that the target had lost weight through diet and exercise or through surgery, or were not provided with any explanation for the weight loss. Participants once again indicated their impression of the target on the same measures. RESULTS: Regardless of the method of weight loss, all targets were rated as eating more healthily, exercising more, and being more competent and less sloppy after having lost weight. Participants also rated the target as less lazy when they learned that she had lost weight through diet and exercise, or when no information was provided about the method of weight loss; the target who lost weight through surgery, however, was not seen as being any less lazy after losing weight. CONCLUSION: These findings indicate that perceptions of obese individuals can in fact improve after they have lost weight, but that this might depend on the method of weight loss.

"Obese people" vs "Fat people": impact of group label on weight bias.

OBJECTIVE: The present study examined whether the terms "obese people" vs "fat people" impact evaluations of a target group. METHOD: Participants answered a number of questions about obese people (N=300) or fat people (N=125), including how favorable their attitudes are toward the target group, how disgusted they are with the target group, and how similar they are to the target group. RESULTS: Compared to fat people, obese people were rated as less favorable and as more disgusting. In addition, participants saw themselves as being less similar to obese people than to fat people, and as less likely to become an obese person than a fat person. CONCLUSION: Overall, the term "obese people" evokes stronger negative evaluations than the term "fat people." Researchers investigating weight bias should be aware that the specific terms used to refer to overweight and obese people can impact study outcomes and interpretations.

Disgust and perceived control in attitudes toward obese people.

BACKGROUND: Efforts to explain negative attitudes toward obese people have centered on beliefs about the controllability of body weight, whereas other processes (such as the emotion of disgust) have been largely ignored. This study examined the role of disgust in evaluations of obese people, as well as other social groups (for example smokers, drug addicts, women, homosexuals, politicians). METHOD: In three studies, participants (total N=524) made ratings of how much they believe that obesity is a matter of personal control, indicated how disgusted they are with obese people, and reported their attitudes toward obese people. In Study 1, participants also made similar ratings (perceptions of control over group membership, disgust, and attitudes) for 15 additional social groups. RESULTS: Disgust was the strongest predictor of negative attitudes toward obese people, and disgust fully mediated the association between perceptions of control and attitudes toward obese people. In addition, obese people were rated less favorably, and as more disgusting, than almost all social groups. Across all social groups, perceived control over group membership was positively correlated with disgust ratings, and disgust mediated the link between perceived control and favorability ratings. CONCLUSION: These findings indicate that disgust is an important, yet understudied, component of weight bias. Furthermore, these findings situate representations of obesity in a broader context by establishing similarities with other social groups.

Adolescents' reactions to hypothetical peer group conversations: evidence for an imaginary audience?

The theory of adolescent egocentrism holds that early adolescents have a distorted understanding of self-other relations; because of flaws in the traditional methods used to assess adolescent egocentrism, this notion has never received adequate empirical scrutiny. In the present research, the nature of early adolescent social cognition as characterized by that theory was investigated by examining age differences in judgments of hypothetical peer group conversations. In Study 1, children and early adolescents (N = 264) rated the attentiveness, criticalness, and admiration expressed in three conversations, in which the subject or a peer was mentioned in either an admiring, critical, or nonevaluative manner. In Study 2, a similar procedure was used with middle and late adolescents, as well as children and early adolescents (N = 187); two memory tasks were also administered to visit the issue of distortion in social cognition. In Study 3, a new sample (N = 1,019) representing the four age groups from Study 2 was presented with an ambiguous conversation and then asked to interpret who was the target (object of focus) and how that target was regarded. The findings from the three studies do not support the notion that adolescents believe others are attentive to and critical of their every move, or that their social cognition and perception is egocentric and distorted. Conceptual and methodological contributions are discussed, along with directions for additional research.

Demand characteristics and self-report measures of imaginary audience sensitivity: implications for interpreting age differences in adolescent egocentrism.

Self-consciousness during early adolescence has been explained as an outcome of adolescent egocentrism, in which adolescents create an imaginary audience (IA) of attentive, critical peers. The possibility that such self-consciousness might result from contact with peers who are more attentive and critical than those encountered during childhood or adulthood has not been considered. Study 1 tested whether young adults, who are not theoretically susceptible to IA, could be made to receive high scores on IA and self-consciousness measures by having them complete a procedure in 1 of 3 laboratory conditions-a critical audience, a noncritical audience, or no audience. However, participants in the critical-audience condition received significantly lower IA and self-consciousness scores than participants in the no-audience condition did. Study 2 tested whether the directions given to Study 1 participants might have been responsible for the unexpected findings. Results indicated that participants instructed to give mature-sounding responses received lower IA/self-consciousness scores than did those asked to report their honest opinions. Together, the results of Studies 1 and 2 indicated that survey measures of IA are subject to demand characteristics and highlighted the need to interpret with caution age differences in IA as traditionally assessed.

Revisiting the imaginary audience and personal fable constructs of adolescent egocentrism: a conceptual review.

Adolescents are thought to believe that others are always watching and evaluating them, and that they are special and unique, labeled the imaginary audience and the personal fable, respectively. These two constructs have been fixtures in textbooks on adolescent development, and have been offered as explanations for self-consciousness and risk-taking. However, their characterization of adolescent social cognition as biased has not been supported empirically, the measures used to assess them lack construct validity, and alternative explanations for both ideation patterns have not been explored. Despite these issues, the imaginary audience and personal fable constructs continue to be considered prototypical representations of social cognitive processes during adolescence. This paper (1) reviews theoretical models of the imaginary audience and the personal fable, and the empirical data pertaining to each model, (2) highlights problems surrounding the two most commonly used measures, and (3) outlines directions for future research, so that a better understanding of the imaginary audience and personal fable, and their roles in adolescent development, may be achieved.