An Adult Developmental Approach to Perceived Facial Attractiveness and Distinctiveness

Attractiveness and distinctiveness constitute facial features with high biological and social relevance. Bringing a developmental perspective to research on social-cognitive face perception, we used a large set of faces taken from the FACES Lifespan Database to examine effects of face and perceiver characteristics on subjective evaluations of attractiveness and distinctiveness in young (20-31 years), middle-aged (44-55 years), and older (70-81 years) men and women. We report novel findings supporting variations by face and perceiver age, in interaction with gender and emotion: although older and middle-aged compared to young perceivers generally rated faces of all ages as more attractive, young perceivers gave relatively higher attractiveness ratings to young compared to middle-aged and older faces. Controlling for variations in attractiveness, older compared to young faces were viewed as more distinctive by young and middle-aged perceivers. Age affected attractiveness more negatively for female than male faces. Furthermore, happy faces were rated as most attractive, while disgusted faces were rated as least attractive, particularly so by middle-aged and older perceivers and for young and female faces. Perceivers largely agreed on distinctiveness ratings for neutral and happy emotions, but older and middle-aged compared to young perceivers rated faces displaying negative emotions as more distinctive. These findings underscore the importance of a lifespan perspective on perception of facial characteristics and suggest possible effects of age on goal-directed perception, social motivation, and in-group bias. This publication makes available picture-specific normative data for experimental stimulus selection.

Cross-national perspectives about weight-based bullying in youth: nature, extent and remedies

BACKGROUND

No cross-national studies have examined public perceptions about weight-based bullying in youth.

OBJECTIVES

To conduct a multinational examination of public views about (i) the prevalence/seriousness of weight-based bullying in youth; (ii) the role of parents, educators, health providers and government in addressing this problem and (iii) implementing policy actions to reduce weight-based bullying.

METHODS

A cross-sectional survey of adults in the United States, Canada, Iceland and Australia (N = 2866).

RESULTS

Across all countries, weight-based bullying was identified as the most prevalent reason for youth bullying, by a substantial margin over other forms of bullying (race/ethnicity, sexual orientation and religion). Participants viewed parents and teachers as playing major roles in efforts to reduce weight-based bullying. Most participants across countries (77-94%) viewed healthcare providers to be important intervention agents. Participants (65-87%) supported government augmentation of anti-bullying laws to include prohibiting weight-based bullying. Women expressed higher agreement for policy actions than men, with no associations found for participants' race/ethnicity or weight. Causal beliefs about obesity were associated with policy support across countries.

CONCLUSIONS

Across countries, strong recognition exists of weight-based bullying and the need to address it. These findings may inform policy-level actions and clinical practices concerning youth vulnerable to weight-based bullying.

Potential Policies and Laws to Prohibit Weight Discrimination: Public Views from 4 Countries

CONTEXT

People viewed as "overweight" or "obese" are vulnerable to weight-based discrimination, creating inequities and adverse health outcomes. Given the high rates of obesity recorded globally, studies documenting weight discrimination in multiple countries, and an absence of legislation to address this form of discrimination, research examining policy remedies across different countries is needed. Our study provides the first multinational examination of public support for policies and legislation to prohibit weight discrimination.

METHODS

Identical online surveys were completed by 2,866 adults in the United States, Canada, Australia, and Iceland. We assessed public support for potential laws to prohibit weight-based discrimination, such as adding body weight to existing civil rights statutes, extending disability protections to persons with obesity, and instituting legal measures to prohibit employers from discriminating against employees because of body weight. We examined sociodemographic and weight-related characteristics predicting support for antidiscrimination policies, and the differences in these patterns across countries.

FINDINGS

The majority of participants in the United States, Canada, and Australia agreed that their government should have specific laws in place to prohibit weight discrimination. At least two-thirds of the participants in all 4 countries expressed support for policies that would make it illegal for employers to refuse to hire, assign lower wages, deny promotions, or terminate qualified employees because of body weight. Women and participants with higher body weight expressed more support for antidiscrimination measures. Beliefs about the causes of obesity were also related to support for these laws.

CONCLUSIONS

Public support for legal measures to prohibit weight discrimination can be found in the United States, Canada, Australia, and Iceland, especially for laws to remedy this discrimination in employment. Our findings provide important information for policymakers and interest groups both nationally and internationally and can help guide discussions about policy priorities to reduce inequities resulting from weight discrimination.

The Relationship between Parental Behaviors and Children's Sugary Drink Consumption Is Moderated by a Television in the Child's Bedroom

BACKGROUND

The aim of this longitudinal study was to examine the link between perceived authoritative parenting behaviors and sugary drink consumption among children from low-income families who do or do not have televisions (TVs) in their bedrooms.

METHODS

Middle school students (N = 480) completed a baseline survey in sixth grade and a follow-up survey in seventh grade. The students were recruited from 12 schools in a low-income, predominantly black (33%) and Latino (48%), urban school district. The survey assessed the children's perception of their parents' controlling and nurturing behaviors, the presence of a TV in their bedrooms, and their level of sugary drink consumption on the previous school day. Children's report of specific controlling and nurturing parental behaviors were used to create an "authoritative parenting" score. Regression analyses were used to test the main and interactive effects of authoritative parenting behaviors and having a TV in the bedroom with sugary drink consumption in seventh grade, controlling for age, race/ethnicity, gender, BMI, and sugary drink consumption in sixth grade.

RESULTS

A significant interaction emerged: The authoritative parenting score predicted lower levels of sugary drink consumption in seventh grade, but this relationship was moderated by whether or not there was a TV in the child's bedroom.

CONCLUSION

A TV in the child's bedroom may weaken the positive influence of authoritative parenting behaviors on limiting sugary drink consumption among middle school children from low-income families. Stronger initiatives are recommended to educate parents and help them refrain from placing TVs in their children's bedrooms.

Combating weight-based bullying in schools: is there public support for the use of litigation?

BACKGROUND

Bullying litigation is an emerging area of law that has increased in response to serious cases of bullying at school. Weight-based bullying is prevalent at school, but no research has examined the use of litigation to address this problem. We assessed public support for litigation approaches to address weight-based bullying at school, and whether support for litigation varies according to the reason why a student is bullied.

METHODS

A national sample of 994 adults (49% parents) completed an online questionnaire assessing their support for litigation approaches in response to hypothetical incidents of youth bullying.

RESULTS

As many as two thirds of participants supported litigation against schools for failing to intervene and protect students from weight-based bullying. Litigation remedies received slightly higher support in response to bullying due to race or sexual orientation compared to body weight. Participants favored litigation approaches that target schools for inadequate intervention or a bully's parents on behalf of their child's actions.

CONCLUSIONS

Our study offers novel findings about public and parental views of litigation as a potential approach to address weight-based (and other forms of) bullying, and introduces considerations about the potential role of litigation as part of broader remedies to address youth bullying.

A multinational examination of weight bias: predictors of anti-fat attitudes across four countries

BACKGROUND/OBJECTIVES

As rates of obesity have increased throughout much of the world, so too have bias and prejudice toward people with higher body weight (that is, weight bias). Despite considerable evidence of weight bias in the United States, little work has examined its extent and antecedents across different nations. The present study conducted a multinational examination of weight bias in four Western countries with comparable prevalence rates of adult overweight and obesity.

METHODS

Using comprehensive self-report measures with 2866 individuals in Canada, the United States, Iceland and Australia, the authors assessed (1) levels of explicit weight bias (using the Fat Phobia Scale and the Universal Measure of Bias) and multiple sociodemographic predictors (for example, sex, age, race/ethnicity and educational attainment) of weight-biased attitudes and (2) the extent to which weight-related variables, including participants' own body weight, personal experiences with weight bias and causal attributions of obesity, play a role in expressions of weight bias in different countries.

RESULTS

The extent of weight bias was consistent across countries, and in each nation attributions of behavioral causes of obesity predicted stronger weight bias, as did beliefs that obesity is attributable to lack of willpower and personal responsibility. In addition, across all countries the magnitude of weight bias was stronger among men and among individuals without family or friends who had experienced this form of bias.

CONCLUSIONS

These findings offer new insights and important implications regarding sociocultural factors that may fuel weight bias across different cultural contexts, and for targets of stigma-reduction efforts in different countries.

Setting policy priorities to address eating disorders and weight stigma: views from the field of eating disorders and the US general public

BACKGROUND

The prevalence and health consequences of eating disorders and weight stigmatization have prompted increasing discussion of potential policy actions to address these public health issues. The present study aimed to assess support for policy strategies to address eating disorders and weight stigmatization among the general public and relevant health professionals.

METHODS

An Internet survey was fielded to a national sample of 944 US adults and 1,420 members of professional organizations specializing in eating disorders to examine their support for 23 potential policy strategies to address eating disorders and weight stigma. Participants also rated policy actions according to their potential for positive impact and feasible implementation.

RESULTS

Support for the majority of health and social policies was high in both samples. For example, strategies to 1) improve school-based health curriculum to include content aimed at preventing eating disorders, 2) require training for educators and health providers on the prevention and early identification of eating disorders, and 3) implement school-based anti-bullying policies that that protect students from being bullied about their weight, were supported by over two-thirds of participants.

CONCLUSIONS

Our findings suggest that both health and social policy actions will be important in broader policy initiatives to address eating disorders and weight stigma.

Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines

OBJECTIVE

This study examined weight bias among students training in health disciplines and its associations with their perceptions about treating patients with obesity, causes of obesity, and observations of weight bias by instructors and peers.

METHODS

Students (N = 107) enrolled in a post-graduate health discipline (Physician Associate, Clinical Psychology, Psychiatric Residency) completed anonymous questionnaires to assess the above variables.

RESULTS

Students reported that patients with obesity are a common target of negative attitudes and derogatory humor by peers (63%), health-care providers (65%), and instructors (40%). Although 80% of students felt confident to treat obesity, many reported that patients with obesity lack motivation to make changes (33%), lead to feelings of frustration (36%), and are non-compliant with treatment (36%). Students with higher weight bias expressed greater frustration in these areas. The effect of students' weight bias on expectations for treatment compliance of patients with obesity was partially mediated by beliefs that obesity is caused by behavioral factors.

CONCLUSIONS

Weight bias is commonly observed by students in health disciplines, who themselves report frustrations and stereotypes about treating patients with obesity. These findings contribute new knowledge about weight bias among students and provide several targets for medical training and education.

Weight bias among professionals treating eating disorders: attitudes about treatment and perceived patient outcomes

OBJECTIVE

This study aimed to assess weight bias among professionals who specialize in treating eating disorders and identify to what extent their weight biases are associated with attitudes about treating obese patients.

METHOD

Participants were 329 professionals treating eating disorders, recruited through professional organizations that specialize in eating disorders. Participants completed anonymous, online self-report questionnaires, assessing their explicit weight bias, perceived causes of obesity, attitudes toward treating obese patients, perceptions of treatment compliance and success of obese patients, and perceptions of weight bias among other practitioners.

RESULTS

Negative weight stereotypes were present among some professionals treating eating disorders. Although professionals felt confident (289; 88%) and prepared (276; 84%) to provide treatment to obese patients, the majority (184; 56%) had observed other professionals in their field making negative comments about obese patients, 42% (138) believed that practitioners who treat eating disorders often have negative stereotypes about obese patients, 35% (115) indicated that practitioners feel uncomfortable caring for obese patients, and 29% (95) reported that their colleagues have negative attitudes toward obese patients. Compared to professionals with less weight bias, professionals with stronger weight bias were more likely to attribute obesity to behavioral causes, expressed more negative attitudes and frustrations about treating obese patients, and perceived poorer treatment outcomes for these patients.

DISCUSSION

Similar to other health disciplines, professionals treating eating disorders are not immune to weight bias. This has important implications for provision of clinical treatment with obese individuals and efforts to reduce weight bias in the eating disorders field.

Eating behaviors, victimization, and desire for supportive intervention among adolescents in weight-loss camps

This study examined links between eating behaviors, weight-based victimization (WBV) and preferences for bullying intervention among adolescents. Adolescents enrolled in weight loss camps participated in an online survey (N = 361). Regression models examined relationships between key variables. Almost half of adolescents who experienced WBV engaged in unhealthy eating behaviors, which corresponded to less desire for supportive intervention. Unhealthy eating behaviors may offset adaptive coping strategies to deal with WBV, such as support from peers and family.

Parental concerns about weight-based victimization in youth

BACKGROUND

The present study aimed to assess parental perceptions of weight-based victimization (WBV) and its consequences for children's health as well as how perceptions of WBV vary by parental and child weight status.

METHODS

A national sample of American parents with children ages 2-18 years (N=918) completed an online questionnaire to assess their perceptions of how common WBV is, compared to other forms of victimization among youth, their level of concern with this issue both generally and for their own child, and their perceptions of behavioral and psychological consequences of WBV. Descriptive statistics and censored regression models with standardized coefficients were used to analyze the data.

RESULTS

Fifty-three percent of parents perceived "being overweight" to be the most common reason that youth are bullied, regardless of parental or child weight status. Parents, both with and without overweight children, endorsed similar levels of general concern about WBV and its psychological and behavioral consequences for youth. However, parents with overweight children were substantially more concerned about WBV affecting their child(ren) and perceived it to be more common, serious, and posed risks to their child(ren)'s health, compared to parents without overweight children.

CONCLUSIONS

The present study, to the best of the authors' knowledge, is the first to indicate that parents have substantial concerns about WBV and its health consequences for youth. These findings highlight the need for educators and pediatric healthcare providers to be aware that WBV is a common concern among families, and suggest that increased efforts are needed to address WBV.

Federal food package revisions: effects on purchases of whole-grain products

BACKGROUND

In 2009, the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented revisions to the composition and quantities of WIC-provided foods. New whole-grain products such as whole-wheat bread and allowable substitutes were added to encourage increased intake of whole grains and fiber among WIC participants.

PURPOSE

This paper assesses how the WIC revisions affected purchases of bread and rice among WIC-participating households in Connecticut and Massachusetts.

METHODS

Scanner data from a regional supermarket chain were used to examine bread and rice purchases of 2137 WIC households. Purchased volume of bread and rice was compared before and after implementation of the WIC revisions (2009-2010) using generalized estimating equation models. Data were analyzed in 2013.

RESULTS

Before the WIC revisions, when no bread or rice was provided through WIC, white bread dominated bread purchases among WIC households (78% of volume), and almost all rice purchased was white (94%). As a result of the WIC revisions, the share of 100% whole-grain bread in total bread purchases tripled (from 8% to 24%), replacing purchases of white bread; the share of brown rice rose to 30% of rice purchases. WIC households used WIC benefits to change some of their bread purchases, rather than to buy more bread overall, whereas total rice purchases increased.

CONCLUSIONS

The 2009 WIC revisions significantly increased purchases of whole-grain bread and rice among WIC-participating families. The likely increase in whole-grain and fiber intake among low-income communities could have important public health implications.

Impact of Connecticut legislation incentivizing elimination of unhealthy competitive foods on National School Lunch Program participation

OBJECTIVES

We analyzed the impact of Connecticut legislation incentivizing voluntary school district-level elimination of unhealthy competitive foods on National School Lunch Program (NSLP) participation.

METHODS

We analyzed data on free, reduced, and paid participation in the NSLP from 904 schools within 154 Connecticut school districts from the 2004-2005 to the 2009-2010 school year, resulting in 5064 observations of annual school-level meal participation. We used multilevel regression modeling techniques to estimate the impact of the state competitive food legislation on the count of NSLP lunches served per student in each school.

RESULTS

Overall, the state statute was associated with an increase in school lunch participation. We observed increases between 7% and 23% for middle- and high-school meal programs, and a slight decrease of 2.5% for the elementary school free meal eligibility category, leading to an estimated revenue increase of roughly $30 000 for an average school district per school year.

CONCLUSIONS

This study provides support for national implementation of proposed rigorous competitive food standards that can improve the health of students while supporting local school district finances.

Public reactions to obesity-related health campaigns: a randomized controlled trial

BACKGROUND

Despite numerous obesity-related health campaigns throughout the U.S., public perceptions of these campaigns have not been formally assessed. In addition, several recent publicized campaigns have come under criticism in the popular media for reinforcing stigmatization of obese people. Thus, research in this area is warranted.

PURPOSE

To systematically assess public perceptions of recent obesity-related public health campaigns in the U.S.

DESIGN

RCT.

SETTING/PARTICIPANTS

The data were collected online in summer 2012 from a nationally representative sample of American adults (N=1085).

INTERVENTION

Participants were randomly assigned to view 10 obesity-related health campaigns that were pretested and publicly criticized as being stigmatizing of obese people, or 10 campaigns that contained more-neutral content.

MAIN OUTCOME MEASURES

Participants provided evaluations of each of the campaigns regarding the extent to which campaigns were rated to be stigmatizing of obese people, motivating for improving lifestyle behaviors, and promoting of self-efficacy for healthy behavior change. Participants additionally evaluated the appropriateness of the visual content depicted in each campaign. Analysis was completed in 2012.

RESULTS

Stigmatizing campaigns were no more likely to instill motivation for improving lifestyle behaviors among participants than campaigns that were more neutral (OR=1.095, 95% CI=0.736, 1.630). Stigmatizing campaigns were also rated as inducing less self-efficacy (adjusted mean difference = -0.171 SD, 95% CI= -0.266, -0.076) and having less-appropriate visual content compared to less stigmatizing campaigns (adjusted difference in probability = -0.092, 95% CI= -0.124, -0.059). These findings remained consistent regardless of participants' body weight, and were generally consistent across sociodemographic predictors.

CONCLUSIONS

This study highlights the need for careful selection of language and visual content used in obesity-related health campaigns, and provides support for efforts to portray obese people in a nonstigmatizing manner.

Effects of reduced juice allowances in food packages for the women, infants, and children program

OBJECTIVES

In 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented revisions to the composition and quantities of WIC food packages. Juice allowances were reduced by approximately half. This report describes changes in purchases of 100% juice and other beverages among WIC participants after the WIC revisions.

METHODS

Scanner data from a New England supermarket chain were used to assess juice and other beverage purchases among 2137 WIC-participating households during a 2-year period (N = 36 051 household-months). Purchased beverage amounts were compared before (January-September 2009) and after (January-September 2010) implementation of the revised WIC packages. Generalized estimating equation models were used.

RESULTS

Before the revisions, WIC juice accounted for two-thirds of purchased juice volume among WIC households. After implementation of the revisions, WIC juice purchases were reduced on par with allowance changes (43.5% of juice volume, 95% confidence interval [CI] 41.9%-45.1%). This reduction was only partly compensated for by an increase of 13.6% (8.4%-19.0%) in juice purchases using personal and other non-WIC funds. In total, juice purchases declined by 23.5% (21.4%-25.4%) from an adjusted monthly total of 238 oz to 182 oz per household. WIC households increased purchases of fruit drinks by 20.9% (14.9%-27.3%) and other noncarbonated beverages by 21.3% (12.1%-31.2%) but purchased 12.1% (8.1%-15.0%) less soft drinks.

CONCLUSIONS

After the WIC revisions, total purchases of 100% juice among WIC households declined by about a quarter, with little compensation occurring from non-WIC funds for juice and other beverages. The public health impact of the shift in beverage purchase patterns could be significant.

The stigmatizing effect of visual media portrayals of obese persons on public attitudes: does race or gender matter?

Overweight and obese persons are frequently stigmatized in news media. The present study is the first to systematically compare public reactions to positive and negative images of obese persons accompanying news reports on obesity (while manipulating gender and race of the target)and their effects on generalized attitudes and social distance toward obese persons. The authors conducted 3 randomized experimental studies using online surveys to assess public perceptions of positive versus stereotypical images of obese adults (who varied by gender and race) accompanying a neutral news report about obesity. The sample included 1,251 adults, who were recruited through a national survey panel during May of 2010. Participants who viewed negative, stereotypical images of obese targets increased social distance, antifat attitudes, and ratings of laziness and dislike toward obese persons, whereas positive, nonstereotypical images induced more positive attitudes. These findings remained consistent when accounting for sociodemographic variables. African American female obese targets portrayed in images evoked higher ratings of dislike and social distance compared with Caucasian targets, but ratings were similar for male and female targets. This study provides evidence that images of obese person accompanying written media influence public attitudes toward obese people, and may reinforce weight stigmatization if images contain stereotypical portrayals of obese persons. Implications for efforts to report about obesity in the news media are discussed.

Headless, hungry, and unhealthy: a video content analysis of obese persons portrayed in online news

The news media has substantial influence on public perceptions of social and health issues. This study conducted a video content analysis to examine portrayals of obese persons in online news reports about obesity. The authors downloaded online news videos about obesity (N = 371) from 5 major news websites and systematically coded visual portrayals of obese and nonobese adults and youth in these videos. The authors found that 65% of overweight/obese adults and 77% of overweight/obese youth were portrayed in a negative, stigmatizing manner across multiple obesity-related topics covered in online news videos. In particular, overweight/obese individuals were significantly more likely than were nonoverweight individuals to be portrayed as headless, with an unflattering emphasis on isolated body parts, from an unflattering rear view of their excess weight, eating unhealthy foods, engaging in sedentary behavior, and dressed in inappropriately fitting clothing. Nonoverweight individuals were significantly more likely to be portrayed positively. In conclusion, obese children and adults are frequently stigmatized in online news videos about obesity. These findings have important implications for public perceptions of obesity and obese persons and may reinforce negative societal weight bias.

Weight-based victimization: bullying experiences of weight loss treatment-seeking youth

OBJECTIVE

Few studies have comprehensively examined weight-based victimization (WBV) in youth, despite its serious consequences for their psychosocial and physical health. Given that obese and treatment-seeking youth may be highly vulnerable to WBV and its negative consequences, the current study provides a comprehensive assessment of WBV in a weight loss treatment-seeking sample.

METHODS

Adolescents (aged 14-18 years; N = 361) enrolled in 2 national weight loss camps were surveyed. An in-depth assessment of WBV was conducted by using an online survey, in which participants indicated the duration, typical locations, frequent perpetrators, and forms of WBV they had experienced.

RESULTS

Findings indicate that 64% of the study participants reported WBV at school, and the risk of WBV increased with body weight. Most participants reported WBV enduring for 1 year (78%), and 36% were teased/bullied for 5 years. Peers (92%) and friends (70%) were the most commonly reported perpetrators, followed by adult perpetrators, including physical education teachers/sport coaches (42%), parents (37%), and teachers (27%). WBV was most frequently reported in the form of verbal teasing (75%-88%), relational victimization (74%-82%), cyberbullying (59%-61%), and physical aggression (33%-61%). WBV was commonly experienced in multiple locations at school.

CONCLUSIONS

WBV is a prevalent experience for weight loss treatment-seeking youth, even when they are no longer overweight. Given the frequent reports of WBV from adult perpetrators in addition to peers, treatment providers and school personnel can play an important role in identifying and supporting youth who may be at risk for pervasive teasing and bullying.

Strategies to address weight-based victimization: youths' preferred support interventions from classmates, teachers, and parents

Weight-Based Victimization is a frequent experience for adolescents who are overweight or obese, and is associated with numerous psychosocial and physical consequences for those who are targets of victimization. Assessing targets` preferences for different types of support and intervention has been absent in the context of weight-based victimization, but is needed to help inform potential interventions, motivate action, and identify strategies to help adolescents cope with experiences of weight-related teasing or bullying. Adolescents (14-18 years, N = 361, 40 % female, 71 % Caucasian) enrolled in national weight-loss camps completed an on-line survey. Participants who reported previous experiences of weight-based victimization were surveyed about their preferred interventions from peers, friends, teachers, Physical Education (PE) teachers/coaches, and parents. Participants indicated their preferences for specific strategies pertaining to target support, bullying intervention and prevention (e.g., inclusion in peer activities, confronting the bully, telling an adult, and improving anti-bullying policies). Friends (66 %) and peers (58 %) were the most highly preferred intervention agents followed by teachers (55 %), PE teachers/coaches (44 %), and parents (43 %). Participants who experienced more weight-based victimization expressed increased desire for intervention. The frequency of victimization, social support from friends and family, and perceived likelihood and helpfulness of intervention significantly influenced participant preferences for certain types of intervention, although preferences were generally consistent across participants' characteristics. The current study is the first to document youth's preferences for interventions in response to weight-based victimization. The findings have important implications for encouraging appropriate intervention and informing bystanders, which may help to reduce the prevalence, recurrence, and consequences for youth who are targets of weight-based teasing or bullying.

Grocery store beverage choices by participants in federal food assistance and nutrition programs

BACKGROUND

Sugar-sweetened beverages are a target for reduction in the 2010 Dietary Guidelines for Americans. Concerns have been raised about sugar-sweetened beverages purchased with Supplemental Nutrition Assistance Program (SNAP) benefits.

PURPOSE

This paper describes purchases of non-alcoholic refreshment beverages among participants in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and SNAP.

METHODS

Grocery store scanner data from a regional supermarket chain were used to assess refreshment beverage purchases of 39,172 households in January-June 2011. The sample consisted of families with a history of WIC participation in 2009-2011; about half also participated in SNAP. Beverage spending and volume purchased were compared for WIC sampled households either using SNAP benefits (SNAP) or not (WIC-only). Analyses were completed in 2012.

RESULTS

Refreshment beverages were a significant contributor to expenditure on groceries by SNAP and WIC households. Sugar-sweetened beverages accounted for 58% of refreshment beverage purchases made by SNAP households and 48% of purchases by WIC-only households. Soft drinks were purchased most by all households. Fruit-based beverages were mainly 100% juice for WIC-only households and sugary fruit drinks for SNAP households. SNAP benefits paid for 72% of the sugar-sweetened beverage purchases made by SNAP households. Nationwide, SNAP was estimated to pay at least $1.7 to $2.1 billion annually for sugar-sweetened beverages purchased in grocery stores.

CONCLUSIONS

Considerable amounts of sugar-sweetened beverages are purchased by households participating in WIC and SNAP. The SNAP program pays for most of the sugar-sweetened beverage purchases among SNAP households. The upcoming SNAP reauthorization could be a good time to reconsider the program priorities to align public funds with public health.

Fighting obesity or obese persons? Public perceptions of obesity-related health messages

OBJECTIVE

This study examined public perceptions of obesity-related public health media campaigns with specific emphasis on the extent to which campaign messages are perceived to be motivating or stigmatizing.

METHOD

In summer 2011, data were collected online from a nationally representative sample of 1014 adults. Participants viewed a random selection of 10 (from a total of 30) messages from major obesity public health campaigns from the United States, the United Kingdom and Australia, and rated each campaign message according to positive and negative descriptors, including whether it was stigmatizing or motivating. Participants also reported their familiarity with each message and their intentions to comply with the message content.

RESULTS

Participants responded most favorably to messages involving themes of increased fruit and vegetable consumption, and general messages involving multiple health behaviors. Messages that have been publicly criticized for their stigmatizing content received the most negative ratings and the lowest intentions to comply with message content. Furthermore, messages that were perceived to be most positive and motivating made no mention of the word 'obesity' at all, and instead focused on making healthy behavioral changes without reference to body weight.

CONCLUSION

These findings have important implications for framing messages in public health campaigns to address obesity, and suggest that certain types of messages may lead to increased motivation for behavior change among the public, whereas others may be perceived as stigmatizing and instill less motivation to improve health.

An experimental assessment of physical educators' expectations and attitudes: the importance of student weight and gender

BACKGROUND

At school, physical education (PE) teachers and coaches may be key supports for physical activity. Unfortunately, PE teachers may endorse negative stereotypes and attitudes toward overweight youth. These biases may influence the amount of instruction physical educators provide to students and their participation in PE or other physical activity.

METHODS

This study assessed physical educators' (N = 162) ability and performance expectations, attributions, and attitudes toward overweight and non-overweight students.

RESULTS

Physical educators endorsed inferior ability expectations for overweight students compared to non-overweight students. Poorer performance expectations were limited to overweight female targets, but when controlling for participant characteristics, this effect became marginally significant for overweight male targets. There was a trend such that participants endorsed more external attributions for the abilities and performance of overweight female students, yet this effect was reduced to marginal significance when controlling for participant characteristics. Participants endorsed more negative attitudes for both overweight males and females compared to non-overweight youth.

CONCLUSIONS

Findings indicate that physical educators' expectations, attributions, and attitudes regarding students may be negatively influenced by youth body weight, and differ by student gender. The potential effect of physical educators' weight bias on adolescent participation in physical activity and its implications for students' physical health, academic achievement, and social development are discussed.

Weight-based victimization toward overweight adolescents: observations and reactions of peers

BACKGROUND

Weight-based victimization has become increasingly reported among overweight youth, but little is known about adolescents' perceptions and observations of weight-based teasing and bullying. This study examined adolescents' observations of and reactions to weight-based victimization toward overweight students at school.

METHODS

Adolescents (N = 1555) at 2 high schools in central Connecticut completed a questionnaire that examined their perceptions of how common weight-based victimization is compared to other forms of teasing at school, what types of weight-based teasing are frequently observed, who typical perpetrators of weight-based victimization are, and their own reactions to observed teasing incidents. Participants also completed the Fat Phobia Scale.

RESULTS

Participants perceived being overweight as a primary reason that peers are victimized at school. At least 84% of participants observed overweight students being teased in a mean way and teased during physical activities, and 65% to 77% of students observed overweight and obese peers being ignored, avoided, excluded from social activities, having negative rumors spread about them, and being teased in the cafeteria. Most students also observed verbal threats and physical harassment toward overweight and obese students. Although the majority of participants felt comfortable stepping in to help an overweight peer who has been teased, many remain passive bystanders following these incidents.

CONCLUSION

Youth perceive frequent and multiple forms of weight-based victimization. Schools' efforts to address weight bias and assist overweight and obese students are important.

Parental perceptions of weight terminology that providers use with youth

OBJECTIVES

Little research has been performed to examine patient perceptions of weight-related language, especially related to childhood obesity. In this study we assessed parental perceptions of weight-based terminology used by health care providers to describe a child's excess weight and assessed perceived connotations associated with these terms including stigma, blame, and motivation to reduce weight.

METHODS

A national sample of American parents with children aged 2 to 18 years (N = 445) completed an online survey to assess their perceptions of 10 common terms to describe excess body weight in youth (including "extremely obese," "high BMI," "weight problem," "unhealthy weight," "weight," "heavy," "obese," "overweight," "chubby," and "fat"). Parents were asked to use a 5-point rating scale to indicate how much they perceived each term to be desirable, stigmatizing, blaming, or motivating to lose weight.

RESULTS

Regression models revealed that the terms "weight" and "unhealthy weight" were rated as most desirable, and "unhealthy weight" and "weight problem" were rated as the most motivating to lose weight. The terms "fat," "obese," and "extremely obese" were rated as the most undesirable, stigmatizing, blaming, and least motivating. Parents' ratings were consistent across sociodemographic variables, body weight, and child's body weight.

CONCLUSIONS

The results of this study have important implications for the improvement of health care for youth with obesity; it may be advantageous for health care providers to use or avoid using specific weight-based language during discussions about body weight with families. Pediatricians play a key role in obesity prevention and treatment, but their efforts may be undermined by stigmatizing or offensive language that can hinder important discussions about children's health.