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The Rudd Center Health Digest

February 2009

Weight Stigma Widespread in Lives of Obese People

The stigmatization of obese adults by employers, educators, health care providers, family members, romantic partners and the media is rampant, according to a paper in the January 22 issue of the journal Obesity. The authors are Rudd Center staff members Rebecca Puhl, PhD, Director of Research & Weight Stigma Initiatives, and Chelsea Heuer, MPH, Research Associate.

In the article, they analyzed more than 150 scientific studies published since 2000 that evaluated weight-based stigma, discrimination, social inequalities and a range of harmful consequences for people who are obese, including depression, low self-esteem, poor body image, eating disorders and exercise avoidance.

“Unfortunately, it does not appear that the increasing prevalence of obesity has attenuated negative societal attitudes towards obese people. In contrast, the growing science on this topic demonstrates that weight bias persists. Research has expanded into new areas and this has shown that bias affects more areas of life than previously thought,” wrote Puhl and Heuer.

Among some of the more striking findings were:

  • Obese employees are consistently discriminated against, paid less and less likely to be hired for jobs than normal weight workers.
  • Physicians and other health care providers stereotype obese patients as lazy, lacking willpower and noncompliant with treatment.
  • Obese patients report being stigmatized and treated disrespectfully by their physicians, which leads patients to avoid and cancel important preventive health care screenings.
  • Obese adults report being stigmatized by their friends, family members and romantic partners.
  • Experiencing weight stigma poses emotional and physical health consequences such as depression, low self-esteem, poor body image, disordered eating and exercise avoidance.
  • In television and film, obese characters are portrayed in negative roles that perpetuate stereotypes and promote ridicule.

The study also summarizes the current status of legislation to prohibit weight discrimination, which, except for the state of Michigan and a few localities, is nonexistent. Despite clear evidence that weight discrimination reduces opportunities and produces inequalities for obese people, discrimination based on weight remains legal in most instances.

“Without sufficient attention to this issue, it is likely that weight bias will remain both a social injustice and a public health issue, impairing the quality of life for both present and future generations of obese individuals,” the authors concluded.

To help increase public awareness about this issue, the Rudd Center released two new videos that demonstrate the problems associated with weight bias at home, in schools and within health care settings. The videos, hosted by model, television celebrity and activist Emme and featuring Rudd Center experts, including Puhl, use expert commentary and dramatic representation to address the obstacles obese individuals encounter with weight bias in American society.

Massachusetts Announces Anti-Obesity Plan

Massachusetts is set to join the growing list of states and localities to require restaurants to post calorie labels on menus and menu boards. The Massachusetts plan would apply to restaurants with 15 or more locations statewide (an estimated 2,000 restaurants). The move is part of an anti-obesity campaign called Mass in Motion announced by Gov. Deval Patrick in response to the state’s growing rates of overweight and obesity. More than half the adults and almost one-third of high school and middle school students are obese or overweight.

Other components of the plan include:

  • An executive order for state agencies to follow healthy nutritional guidelines for their food purchases.
  • Grants to employers and communities for wellness initiatives.
  • A state-sponsored Workplace Wellness program to support healthy eating and physical activity of employees and to decrease absenteeism and health insurance prices.
  • Sending letters to the homes of first, fourth, seventh and tenth graders to provide parents with information about their child’s BMI and recommendations for healthy food choices and physical activity.
  • A Mass in Motion website to promote healthy behaviors in all aspects of life.

Following approval by the state’s Public Health Council and a public comment period, the initiative will be voted on this fall by the Public Health Council.

“The Massachusetts plan is a comprehensive, multifaceted approach to a complex problem,” said Roberta Friedman, Rudd Center Director of Public Policy. “It has the promise to help individuals and communities across Massachusetts, and set the standard for other states.”

Legislative Updates from the Rudd Center

The 111th Congress has convened, and most state legislatures are now in session. The Rudd Center will provide a weekly update on newly filed legislation on food policy and obesity throughout the legislative session. Click here for the current update. For more information, contact Roberta Friedman, Director of Public Policy, by email or phone (203-432-4717).

Upcoming Seminar Speakers

February 11, 12:30 pm
Susan Peters, APRN, MPH
Director of the Physical Activity & Wellness Project for New Haven Public Schools; Supervisor/Clinician in School Based Health Center: Yale-New Haven Hospital
Sonia Pereira, PhD
Term Assistant Professor, Barnard College, Columbia University
Is PAW Working? Results from an Evaluation of the New Haven Public Schools Health/Wellness Initiative: Physical Activity & Wellness (PAW)

February 18, 12:30 pm
Marian Tanofsky-Kraff, PhD
Assistant Professor, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences; Researcher, Unit on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
Preventing Excessive Weight Gain in Adolescent Girls at High-Risk for Adult Obesity

February 25, 12:30 pm
David Wallinga, MD, MPA
Wm T Grant Foundation Fellow, University of Minnesota; Director, Food and Health Program Institute for Agriculture and Trade Policy
Overfed and Undernourished: Downstream Impacts of a Flawed Farm Policy?

March 4, 12:30 pm
Marcia L. Pelchat, PhD
Associate Member, Monell Chemical Senses Center
Human Food Addiction?

Our seminars are held at the Rudd Center, located at 309 Edwards Street in New Haven, Connecticut, 06511. They are free and open to the public. Seating is limited. The full schedule for our Spring Seminar Series is available online and for download as a PDF document.

To receive a weekly email from the Rudd Center detailing upcoming seminars and schedule changes, please click here.

Spotlight on Rudd Center Affiliated Faculty: Robert D. Kerns, PhD

KernsRobert Kerns concentrates on behavioral medicine and health psychology in his research. His specific area of interest is pain and pain management.

Kerns is Professor of Psychiatry, Neurology and Psychology at Yale University, Chief of Psychology Service at the Veterans Affairs (VA) Connecticut Healthcare System and National Program Director for Pain Management for the Department of Veterans Affairs. He works with the Rudd Center on issues related to the influence of overweight and obesity on chronic disease self-management, particularly their impact on chronic pain and their role in pain management.

As primary investigator of a VA-funded Health Services Research and Development Center, his work focuses on the interface between the field of medical informatics and the study of co-morbidities. He also works on health policy related to quality pain care.

Kerns’ research has been continuously funded by the VA and other federal and private sources for nearly 30 years. In his role as National Program Director for Pain Management for the VA, he is responsible for establishing policy and for oversight of a comprehensive, interdisciplinary approach to pain care in VA health care facilities.

Dr. Kerns received his MA and PhD in Bioclinical Psychology from Southern Illinois University at Carbondale. He serves on the editorial board of four scientific journals, The Clinical Journal of Pain, Pain Medicine, Psychological Services and Cancer Pain and Palliative Care. He serves in leadership roles in the American Psychological Association, the Society of Behavioral Medicine and the American Pain Society.

Coca-Cola Sued Over VitaminWater Claims

VitaminWater, a product of Coca-Cola, has been advertised as a health drink. It has been advertised for such health benefits as reducing the risk of chronic disease and promoting healthy joints, according to the Center for Science in the Public Interest.

In a class action lawsuit against Coca-Cola, the nutrition advocacy group is challenging that such health claims are excessive and go beyond regulatory limits. The beverage also contains 33 grams of sugar per bottle, which can increase the risk of diabetes and obesity, according to the group.

Litigation against the food industry has been used in the past to protect the public’s health. “Only time will tell how important litigation will be as a tool for improving the nutrition landscape – it has been important in areas like tobacco and auto safety,” said Kelly D. Brownell, Rudd Center Director. “When companies overstate the benefits of their products, and government does not execute its regulatory responsibility, litigation can sometimes be a means for promoting change.”

The Latest Rudd Center Podcasts

Lori Dorfman, DrPH
Director of Berkeley Media Studies Group, a project of the Public Health Institute
The Eyeballs Have Moved: Marketing to Children and Youth in the Digital Age

Lori Dorfman, DrPH
Director of Berkeley Media Studies Group, a project of the Public Health Institute
News Frames of Health Issues

Michael S. Kaufman, JD
Chairman of the National Restaurant Association Board of Directors and Co-President of Enovo Restaurant Ventures LLC
America’s Restaurants: Serving Our Nation

Our collection of podcasts is available for download on iTunes U, under the Yale University Health & Medicine – Nutrition & Obesity section, or you may subscribe to a RSS Feed that will automatically update whenever new content is released. Podcasts can be listened to on a computer or downloaded to a music player.

Front Burner News

Mercury Detected in High-Fructose Corn Syrup

Mercury was found in one third of popular brand named food products containing high-fructose corn syrup evaluated by the Institute for Agriculture Trade and Policy. The Institute is requesting that the FDA prevent mercury contamination in food. Click here for the full article.

Pregnancy Diet May Affect Babies' Brains

A new study in Neuroscience indicates that a high-fat fetal diet may contribute to changes in a baby’s brain that lead to overeating and obesity. Researchers suggest the diet influences babies’ satiety levels. Read the full article.

Anti-Obesity Effort Launched in Britain

The British government began a national healthy living campaign called “Change4Life” to combat the country’s high obesity rates. The initiative, which will include television advertisements, will be backed by food companies such as Unilever and PepsiCo. Read the full article.

Diabetic Adolescents May Be Unhealthy Dieters

Research published in Diabetes Care shows that some diabetic youth use unhealthy approaches to weight loss. These tactics including fasting, using laxatives and diet aids, vomiting and missing insulin doses. Read the full article.

Doctors Fail to Discuss Overweight with Kids

A new study published in Pediatrics shows that just 10 percent of overweight children were given a weight-related diagnosis by his or her doctor. Researchers advise doctors to discuss overweight to prevent obesity. For the full article, click here.

Breastfeeding Linked to Lower Weight

According to an article in Journal of Nutrition, breastfeeding for a longer period was connected to a lower BMI in children up to age 7. The investigators found no significant relationship between breastfeeding and BMI at age 60. Click here for the full article.

Bariatric Surgery Helps Obesity-Related Liver Disease

New research in Clinical Gastroenterology and Hepatology suggests that liver problems may be improved or reversed by weight-loss surgery. Non-alcoholic fatty liver disease affects about 70 percent of obese people. Click here for the full article.

Preschoolers' Physical Activity Drops

Activity levels of children decline between ages 3 and 5, according to an article in Medicine & Science in Sports & Exercise. Experts recommend one hour of daily physical activity for children and teens. For the full article, click here.

Food Manufacturers Urged to Use Less Salt in New York City

At a recent meeting of food company executives, New York City Department of Public Health and Mental Hygiene Commissioner Dr. Thomas Frieden advocated for a 25 percent drop in salt rates of processed foods within 10 years. Dr. Frieden favors a realistic, slow reduction that could lead to a decrease in high blood pressure. Read the full article.

Fruits and Vegetables in Spanish Mediterranean Diet Affect Weight Gain

A recent article in the journal Obesity shows that Spanish Mediterranean residents with a high fruit and vegetable intake had a significantly lower risk of gaining 7.5 pounds (considered a medium weight gain) over a 10 year period as adults. Click here for the full article.

Obesity Woes Influence Sleep

Insulin resistance, liver disease progression and an inactive lifestyle are all connected to obesity, according to a study published in the American Journal of Respiratory and Critical Care Medicine. The researchers show the health issues are also independently linked to sleep apnea. Read the full article.

Infant Mortality Risk Increased by Mother's Obesity

According to a new study in the journal Epidemiology, babies born to obese women are more likely to die within the first year and the first 28 days after birth, when compared to babies born to normal weight women. Researchers also found that the pre-pregnancy BMI of a woman is linked to complications in pregnancy, labor and delivery, as well as preterm birth and low birth weight. For the full article, click here.

More Americans Obese than Overweight

The National Center for Health Statistics reported that more Americans are now obese than overweight. More than two-thirds of Americans fall into either category. Click here for the full article.

Improved Memory Due to Low-Calorie Diet

Research published in The Proceedings of the National Academy of Sciences is the first to show an association between low-calorie diets and better memory. A decrease in insulin and inflammation may be the cause. Read the full article.

Poverty Influences Obesity in Mexican-American and White Women

Mexican-American and White women who were poor as children are at an increased risk for obesity, according to an article published in Public Health Nursing. The pattern does not occur for African-American women. For the full article, click here.

Difficulty Found Suppressing Hunger in Women

Recent research findings published in Proceedings of the National Academy of Sciences indicate women may be more susceptible to overeating than men. Researchers suggest the sexes may have differing nutritional needs. Read the full article.