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Brownell, Kelly D.

Overview:

Kelly Brownell is Dean of the Sanford School of Public Policy at Duke University, where he is also Robert L. Flowers Professor of Public Policy, Professor of Psychology and Neuroscience, and Director of the World Food Policy Center.

In 2006 Time magazine listed Brownell among “The World’s 100 Most Influential People” in its special Time 100 issue featuring those “.. whose power, talent or moral example is transforming the world.” Brownell was elected to membership in the Institute of Medicine in 2006 and has received numerous awards and honors for his work, including the Lifetime Achievement Award from the American Psychological Association, Graduate Mentoring Award from Yale, the James McKeen Cattell Award from the New York Academy of Sciences, the Distinguished Alumni Award from Purdue University, the Lifetime Achievement Award from Rutgers University, and the Distinguished Scientific Award for the Applications of Psychology from the American Psychological Association.

Prior to joining the faculty at Duke, Brownell was at Yale University where he was the James Rowland Angell Professor of Psychology, professor of epidemiology and public health, and director of the Rudd Center for Food Policy and Obesity. While at Yale he served as chair of the department of psychology and as master of Silliman College.

Brownell has published 15 books and more than 350 scientific articles and chapters. He has served as president of several national organizations, including the Society of Behavioral Medicine, Association for the Advancement of Behavior Therapy and the Division of Health Psychology of the American Psychological Association.

Brownell has advised the White House, members of congress, governors, world health and nutrition organizations, and media leaders on issues of nutrition, obesity and public policy. He was cited as a “moral entrepreneur” with special influence on public discourse in a history of the obesity field and was cited by Time magazine as a leading “warrior” in the area of nutrition and public policy.

Positions:

Dean of the Sanford School of Public Policy

Sanford School of Public Policy
Sanford School of Public Policy

Robert L. Flowers Professor of Public Policy

Sanford School of Public Policy
Sanford School of Public Policy

Professor in the Sanford School of Public Policy

Sanford School of Public Policy
Sanford School of Public Policy

Professor of Psychology and Neuroscience

Psychology and Neuroscience
Trinity College of Arts & Sciences

Affiliate, Duke Global Health Institute

Duke Global Health Institute
Institutes and Provost's Academic Units

Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1973

B.S. — Purdue University

M.S. 1975

M.S. — Rutgers University

Ph.D. 1977

Ph.D. — Rutgers University

News:

For the world's most scrutinized body, Barbie has a new look

January 29, 2016 — Midland Daily News/AP

Kelly Brownell on the sour fight over sugary sodas

August 19, 2015 — “How Do We Fix It?”

Kelly Brownell quoted: Freedom from fries

October 26, 2015 — The New Yorker

Should There Be a Tax on Soda?

July 13, 2015 — the Wall Street Journal

Why We Need a Soda Tax

May 27, 2016 — Medpage Today

Grants:

Launching a World Food Policy Center

Administered By
Social Science Research Institute
AwardedBy
Duke Endowment
Role
Principal Investigator
Start Date
July 01, 2017
End Date
June 30, 2022

World Food Policy Center Capacity & Rural NC Project

Administered By
Social Science Research Institute
AwardedBy
William R. Kenan, Jr. Charitable Trust
Role
Principal Investigator
Start Date
July 01, 2017
End Date
June 30, 2020

To fund a planning grant for a world food policy center

Administered By
Social Science Research Institute
AwardedBy
Duke Endowment
Role
Principal Investigator
Start Date
July 01, 2015
End Date
June 30, 2018

Publications:

Strategic science for eating disorders research and policy impact.

Scientific research often fails to have relevance and impact because scientists do not engage policy makers and influencers in the process of identifying information needs and generating high priority questions. To address this scholarship-policy gap, we have developed a model of Strategic Science. This research approach involves working with policy makers and influencers to craft research questions that will answer important and timely policy-related questions. The goal is to create tighter links between research and policy and ensure findings are communicated efficiently to change agents best positioned to apply the research to policy debates. In this article, we lay out a model for Strategic Science and describe how this approach may help advance policy research and action for eating disorders.

Authors
Roberto, CA; Brownell, KD
MLA Citation
Roberto, CA, and Brownell, KD. "Strategic science for eating disorders research and policy impact." The International journal of eating disorders 50.3 (March 2017): 312-314.
PMID
28170107
Source
epmc
Published In
International Journal of Eating Disorders
Volume
50
Issue
3
Publish Date
2017
Start Page
312
End Page
314
DOI
10.1002/eat.22678

U.S. Nutrition Assistance, 2018 - Modifying SNAP to Promote Population Health.

Authors
Bleich, SN; Rimm, EB; Brownell, KD
MLA Citation
Bleich, SN, Rimm, EB, and Brownell, KD. "U.S. Nutrition Assistance, 2018 - Modifying SNAP to Promote Population Health." The New England journal of medicine 376.13 (March 2017): 1205-1207.
PMID
28355501
Source
epmc
Published In
The New England journal of medicine
Volume
376
Issue
13
Publish Date
2017
Start Page
1205
End Page
1207
DOI
10.1056/nejmp1613222

The Heterogeneity of Obesity: Fitting Treatments To Individuals – Republished Article

Authors
Brownell, KD; Wadden, TA
MLA Citation
Brownell, KD, and Wadden, TA. "The Heterogeneity of Obesity: Fitting Treatments To Individuals – Republished Article." Behavior Therapy 47.6 (November 2016): 950-965.
Source
crossref
Published In
Behavior Therapy
Volume
47
Issue
6
Publish Date
2016
Start Page
950
End Page
965
DOI
10.1016/j.beth.2016.11.009

Development of the Yale Food Addiction Scale Version 2.0.

Parallels in biological, psychological, and behavioral systems have led to the hypothesis that an addictive process may contribute to problematic eating. The Yale Food Addiction Scale (YFAS) was developed to provide a validated measure of addictive-like eating behavior based upon the diagnostic criteria for substance dependence. Recently, the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) was released, which included significant changes to the substance-related and addictive disorders (SRAD) section. In the current study, the YFAS 2.0 was developed to maintain consistency with the current diagnostic understanding of addiction and to improve the psychometric properties of the original YFAS. In a sample of 550 participants, 14.6% met criteria for food addiction. The YFAS 2.0 demonstrated good internal consistency, as well as convergent, discriminant, and incremental validity. Elevated scores on the YFAS 2.0 were associated with higher rates of obesity and more severe pathological eating (e.g., binge eating). The YFAS 2.0 also appeared to capture a related, but unique construct relative to traditional eating disorders. In a separate sample of 209 participants, the YFAS and YFAS 2.0 were directly compared. Both versions of the YFAS were similarly associated with elevated body mass index, binge eating, and weight cycling. However, exceeding the food addiction threshold was more strongly associated with obesity for the YFAS 2.0 than the original YFAS. Thus, the YFAS 2.0 appears to by a psychometrically sound measure that reflects the current diagnostic understanding of addiction to further investigate the potential role of an addictive process in problematic eating behavior.

Authors
Gearhardt, AN; Corbin, WR; Brownell, KD
MLA Citation
Gearhardt, AN, Corbin, WR, and Brownell, KD. "Development of the Yale Food Addiction Scale Version 2.0." Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 30.1 (February 2016): 113-121.
PMID
26866783
Source
epmc
Published In
Psychology of Addictive Behaviors
Volume
30
Issue
1
Publish Date
2016
Start Page
113
End Page
121
DOI
10.1037/adb0000136

Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking.

Despite isolated areas of improvement, no country to date has reversed its obesity epidemic. Governments, together with a broad range of stakeholders, need to act urgently to decrease the prevalence of obesity. In this Series paper, we review several regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the scarce and fitful progress. Additionally, we preview the papers in this Lancet Series, which each identify high-priority actions on key obesity issues and challenge some of the entrenched dichotomies that dominate the thinking about obesity and its solutions. Although obesity is acknowledged as a complex issue, many debates about its causes and solutions are centred around overly simple dichotomies that present seemingly competing perspectives. Examples of such dichotomies explored in this Series include personal versus collective responsibilities for actions, supply versus demand-type explanations for consumption of unhealthy food, government regulation versus industry self-regulation, top-down versus bottom-up drivers for change, treatment versus prevention priorities, and a focus on undernutrition versus overnutrition. We also explore the dichotomy of individual versus environmental drivers of obesity and conclude that people bear some personal responsibility for their health, but environmental factors can readily support or undermine the ability of people to act in their own self-interest. We propose a reframing of obesity that emphasises the reciprocal nature of the interaction between the environment and the individual. Today's food environments exploit people's biological, psychological, social, and economic vulnerabilities, making it easier for them to eat unhealthy foods. This reinforces preferences and demands for foods of poor nutritional quality, furthering the unhealthy food environments. Regulatory actions from governments and increased efforts from industry and civil society will be necessary to break these vicious cycles.

Authors
Roberto, CA; Swinburn, B; Hawkes, C; Huang, TT-K; Costa, SA; Ashe, M; Zwicker, L; Cawley, JH; Brownell, KD
MLA Citation
Roberto, CA, Swinburn, B, Hawkes, C, Huang, TT-K, Costa, SA, Ashe, M, Zwicker, L, Cawley, JH, and Brownell, KD. "Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking." Lancet (London, England) 385.9985 (June 2015): 2400-2409. (Review)
PMID
25703111
Source
epmc
Published In
The Lancet
Volume
385
Issue
9985
Publish Date
2015
Start Page
2400
End Page
2409
DOI
10.1016/s0140-6736(14)61744-x

Strategic science with policy impact.

Authors
Brownell, KD; Roberto, CA
MLA Citation
Brownell, KD, and Roberto, CA. "Strategic science with policy impact." Lancet (London, England) 385.9986 (June 2015): 2445-2446.
PMID
25703107
Source
epmc
Published In
The Lancet
Volume
385
Issue
9986
Publish Date
2015
Start Page
2445
End Page
2446
DOI
10.1016/s0140-6736(14)62397-7

The power of industry (money) in influencing science

© Cambridge University Press 2015. An issue generating considerable controversy is whether scientists can remain objective and unbiased when accepting money from industry. Large amounts of money change hands between industry and scientists, and this practice has been challenged in prominent articles both in the profession and the press. Many thought leaders, infields where industry has a financial stake, have been approached and offered financial benefits. This takes a number of forms including research support, speaking fees, funds to serve on advisory boards, or trips to participate in meetings with other professionals. The money is consequential, sometimes amounting to more than an individual makes in his or her university salary. This leaves scientists in the difi cult position of accepting the enticements industry offers and feeling as if they can help change business practices from within, versus addressing questions of conflicts of interest and fearing the appearance and perhaps the reality of being tainted. The most extreme example in my own experience was an offer of $50,000 from a major food company for less than one day of consulting. One must guess at the motives of industry. There may be a genuine interest in input from scientists or there may be motives beyond the specific input. In the case where I was offered the payment of $50,000, I agreed to advise the company under three conditions: that I not receive payment, that I cover my own travel costs, and that my name not be listed in any publicity generated by the company. The offer to advise the company was withdrawn.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "The power of industry (money) in influencing science." Ethical Challenges in the Behavioral and Brain Sciences. January 1, 2015. 197-199.
Source
scopus
Publish Date
2015
Start Page
197
End Page
199
DOI
10.1007/9781139626491.063

Exposure to Weight-Stigmatizing Media: Effects on Exercise Intentions, Motivation, and Behavior.

This study aimed to evaluate the impact of exposure to weight-stigmatizing media on exercise intentions, motivation, and behavior, as well as to examine the interaction between this exposure and past experiences with weight stigma. A community sample of 72 women were randomly assigned to view a brief weight-stigmatizing or neutral video. Participants' choice of taking the stairs versus the elevator was observed before they completed measures of exercise intentions, motivation, and behavior; psychological well-being; and experiences with weight stigma. A follow-up survey was sent to participants 1 week later that assessed exercise behavior and intentions. Frequency of past weight stigma correlated with worse psychological well-being and more controlled (versus autonomous) exercise motivation. Significant interactions were found between past weight-stigmatizing experiences and exposure to the weight-stigmatizing video for outcomes of exercise intentions, behavior, and drive for thinness. Participants in the stigma condition with higher frequency of past experiences reported greater exercise intentions and behavior, along with higher drive for thinness. Past experiences of weight stigma interact with exposure to weight-stigmatizing media to increase exercise intentions and behavior, although this effect is accompanied by a heightened drive for thinness that may increase risk for long-term negative health consequences.

Authors
Pearl, RL; Dovidio, JF; Puhl, RM; Brownell, KD
MLA Citation
Pearl, RL, Dovidio, JF, Puhl, RM, and Brownell, KD. "Exposure to Weight-Stigmatizing Media: Effects on Exercise Intentions, Motivation, and Behavior." Journal of health communication 20.9 (January 2015): 1004-1013.
PMID
26222998
Source
epmc
Published In
Journal of Health Communication
Volume
20
Issue
9
Publish Date
2015
Start Page
1004
End Page
1013
DOI
10.1080/10810730.2015.1018601

Individual differences in striatum activity to food commercials predict weight gain in adolescents.

Adolescents view thousands of food commercials annually, but little is known about how individual differences in neural response to food commercials relate to weight gain. To add to our understanding of individual risk factors for unhealthy weight gain and environmental contributions to the obesity epidemic, we tested the associations between reward region (striatum and orbitofrontal cortex [OFC]) responsivity to food commercials and future change in body mass index (BMI).Adolescents (N = 30) underwent a scan session at baseline while watching a television show edited to include 20 food commercials and 20 nonfood commercials. BMI was measured at baseline and 1-year follow-up.Activation in the striatum, but not OFC, in response to food commercials relative to nonfood commercials and in response to food commercials relative to the television show was positively associated with change in BMI over 1-year follow-up. Baseline BMI did not moderate these effects.The results suggest that there are individual differences in neural susceptibility to food advertising. These findings highlight a potential mechanism for the impact of food marketing on adolescent obesity.

Authors
Yokum, S; Gearhardt, AN; Harris, JL; Brownell, KD; Stice, E
MLA Citation
Yokum, S, Gearhardt, AN, Harris, JL, Brownell, KD, and Stice, E. "Individual differences in striatum activity to food commercials predict weight gain in adolescents." Obesity (Silver Spring, Md.) 22.12 (December 2014): 2544-2551.
PMID
25155745
Source
epmc
Published In
Obesity (Silver Spring, Md.)
Volume
22
Issue
12
Publish Date
2014
Start Page
2544
End Page
2551
DOI
10.1002/oby.20882

Can government regulate portion sizes?

Authors
Pomeranz, JL; Brownell, KD
MLA Citation
Pomeranz, JL, and Brownell, KD. "Can government regulate portion sizes?." The New England journal of medicine 371.21 (November 2014): 1956-1958.
PMID
25409367
Source
epmc
Published In
The New England journal of medicine
Volume
371
Issue
21
Publish Date
2014
Start Page
1956
End Page
1958
DOI
10.1056/nejmp1410076

Albert J. ("Mickey") Stunkard, M.D.

Authors
Allison, KC; Berkowitz, RI; Brownell, KD; Foster, GD; Wadden, TA
MLA Citation
Allison, KC, Berkowitz, RI, Brownell, KD, Foster, GD, and Wadden, TA. "Albert J. ("Mickey") Stunkard, M.D." Obesity (Silver Spring, Md.) 22.9 (September 2014): 1937-1938.
PMID
25164258
Source
epmc
Published In
Obesity (Silver Spring, Md.)
Volume
22
Issue
9
Publish Date
2014
Start Page
1937
End Page
1938
DOI
10.1002/oby.20869

Relation of obesity to neural activation in response to food commercials.

Adolescents view thousands of food commercials annually, but the neural response to food advertising and its association with obesity is largely unknown. This study is the first to examine how neural response to food commercials differs from other stimuli (e.g. non-food commercials and television show) and to explore how this response may differ by weight status. The blood oxygen level-dependent functional magnetic resonance imaging activation was measured in 30 adolescents ranging from lean to obese in response to food and non-food commercials imbedded in a television show. Adolescents exhibited greater activation in regions implicated in visual processing (e.g. occipital gyrus), attention (e.g. parietal lobes), cognition (e.g. temporal gyrus and posterior cerebellar lobe), movement (e.g. anterior cerebellar cortex), somatosensory response (e.g. postcentral gyrus) and reward [e.g. orbitofrontal cortex and anterior cingulate cortex (ACC)] during food commercials. Obese participants exhibited less activation during food relative to non-food commercials in neural regions implicated in visual processing (e.g. cuneus), attention (e.g. posterior cerebellar lobe), reward (e.g. ventromedial prefrontal cortex and ACC) and salience detection (e.g. precuneus). Obese participants did exhibit greater activation in a region implicated in semantic control (e.g. medial temporal gyrus). These findings may inform current policy debates regarding the impact of food advertising to minors.

Authors
Gearhardt, AN; Yokum, S; Stice, E; Harris, JL; Brownell, KD
MLA Citation
Gearhardt, AN, Yokum, S, Stice, E, Harris, JL, and Brownell, KD. "Relation of obesity to neural activation in response to food commercials." Social cognitive and affective neuroscience 9.7 (July 2014): 932-938.
PMID
23576811
Source
epmc
Published In
Social Cognitive and Affective Neuroscience
Volume
9
Issue
7
Publish Date
2014
Start Page
932
End Page
938
DOI
10.1093/scan/nst059

The trans-fat ban--food regulation and long-term health.

Authors
Brownell, KD; Pomeranz, JL
MLA Citation
Brownell, KD, and Pomeranz, JL. "The trans-fat ban--food regulation and long-term health." The New England journal of medicine 370.19 (May 2014): 1773-1775.
PMID
24806156
Source
epmc
Published In
The New England journal of medicine
Volume
370
Issue
19
Publish Date
2014
Start Page
1773
End Page
1775
DOI
10.1056/nejmp1314072

Food-addiction scale measurement in 2 cohorts of middle-aged and older women.

BACKGROUND: Excess weight is a major threat to public health. An addiction-like tendency toward certain foods may contribute to overeating. OBJECTIVE: We aimed to describe the prevalence and associated characteristics in relation to a food-addiction scale in middle-aged and older women. DESIGN: We examined the prevalence and associated characteristics of a food-addiction scale measure in a cross-sectional analysis of 134,175 women participating in 2 ongoing prospective cohort studies of US nurses. RESULTS: Overall, 7839 (5.8%) of the women surveyed met the criteria for food addiction measured by using the modified Yale Food Addiction Scale. The prevalence of food addiction was 8.4% in the younger cohort of women aged 45-64 y and 2.7% in the older cohort of women aged 62-88 y. In the multivariate model, body mass index (BMI; in kg/m²) ≥ 35.0 (compared with 18.5-22.9) was associated with food addiction, a prevalence ratio (PR) of 15.83 (95% CI: 12.58, 19.91) in the younger cohort of women, and a PR of 18.41 (95% CI: 11.63, 29.14) in the older cohort of women. Several other demographic characteristics and other factors were associated with the food-addiction measure in both cohorts of women. CONCLUSIONS: To our knowledge, for the first time in a large, US-based population of women, we documented the prevalence of food addiction by using a novel measurement scale in middle-aged and older women. The results may provide insight into the strong association between behavioral attributes of food consumption and the development of obesity.

Authors
Flint, AJ; Gearhardt, AN; Corbin, WR; Brownell, KD; Field, AE; Rimm, EB
MLA Citation
Flint, AJ, Gearhardt, AN, Corbin, WR, Brownell, KD, Field, AE, and Rimm, EB. "Food-addiction scale measurement in 2 cohorts of middle-aged and older women." The American journal of clinical nutrition 99.3 (March 2014): 578-586.
PMID
24452236
Source
epmc
Published In
American Journal of Clinical Nutrition
Volume
99
Issue
3
Publish Date
2014
Start Page
578
End Page
586
DOI
10.3945/ajcn.113.068965

The stress of stigma: exploring the effect of weight stigma on cortisol reactivity.

OBJECTIVE: To determine the physiological impact of exposure to weight stigma by examining alterations in salivary cortisol among lean and overweight women. METHODS: Participants were 123 lean and overweight adult women (mean body mass index = 26.99 [7.91] kg/m(2)). Participants' salivary cortisol was assessed both before and after either a weight stigmatizing or a neutral video. Participants completed self-report measures of mood and reactions to the video. Height and weight were obtained at the conclusion of the study. RESULTS: Participants in the stigmatizing condition exhibited significantly greater cortisol reactivity when compared with those in the neutral condition, irrespective of weight status (Pillai trace = 0.077; F(1,85) = 7.22, p = .009). Lean and overweight women in the stigmatizing condition were equally likely to find the video upsetting and were equally likely to report that they would rather not see obese individuals depicted in a stigmatizing manner in the media. CONCLUSIONS: Exposure to weight-stigmatizing stimuli was associated with greater cortisol reactivity among lean and overweight women. These findings highlight the potentially harmful physiological consequences of exposure to weight stigma.

Authors
Schvey, NA; Puhl, RM; Brownell, KD
MLA Citation
Schvey, NA, Puhl, RM, and Brownell, KD. "The stress of stigma: exploring the effect of weight stigma on cortisol reactivity." Psychosomatic medicine 76.2 (February 2014): 156-162.
PMID
24434951
Source
epmc
Published In
Psychosomatic Medicine
Volume
76
Issue
2
Publish Date
2014
Start Page
156
End Page
162
DOI
10.1097/psy.0000000000000031

Do media portrayals of obesity influence support for weight-related medical policy?

OBJECTIVE: The purpose of this research was to examine the impact of nonstigmatizing visual portrayals of obesity on support for a discriminatory weight-based medical policy. METHOD: Participants read an online news story about a policy to deny fertility treatment to obese women that was accompanied by a nonstigmatizing, stigmatizing, or no image of an obese couple. A balanced discussion of the policy was presented, with information both questioning the policy as discriminatory and supporting the policy because of weight-related medical complications. RESULTS: Results revealed that participants who viewed the nonstigmatizing image were less supportive of the policy to deny obese women fertility treatment and recommended the policy less strongly than participants who viewed the stigmatizing image. Furthermore, weaker perceptions of medical risk mediated the effect of the nonstigmatizing image on policy ratings. CONCLUSION: The findings indicate that simply eliminating stigmatizing media portrayals of obesity may help reduce bias.

Authors
Brochu, PM; Pearl, RL; Puhl, RM; Brownell, KD
MLA Citation
Brochu, PM, Pearl, RL, Puhl, RM, and Brownell, KD. "Do media portrayals of obesity influence support for weight-related medical policy?." Health psychology : official journal of the Division of Health Psychology, American Psychological Association 33.2 (February 2014): 197-200.
PMID
23668850
Source
epmc
Published In
Health Psychology
Volume
33
Issue
2
Publish Date
2014
Start Page
197
End Page
200
DOI
10.1037/a0032592

Obesity

© Cambridge University Press 2007. Introduction A critical turning point in the history of human food consumption has become evident. With famine and undernutrition the central food issues for much of human history, we now face the opposite: overnutrition and obesity. The number of individuals who are overnourished now equals or exceeds the number undernourished (WHO, 1998), and the prevalence of obesity is increasing in every corner of the world. The percentage of individuals in the USA who are either overweight or obese rose from 55.9% in 1994 to 65.7% in 2002 (Flegal et al., 2002; Hedley et al., 2004) leading the Centers for Disease Control and Prevention to apply the word ‘epidemic’ (CDC, 2004). The most widely used index of obesity is the body mass index (BMI), which is calculated as weight in kilograms divided by height in meters squared (i.e. kg/m 2 ). The World Health Organization defined obesity as a BMI ≥ 30 kg/m 2 , given epidemiological data showing that mortality at this weight is increased by 30% (Manson et al., 1995). Premature deaths associated with obesity are primarily attributable to cardiovascular disease, Type II diabetes and several cancers (Pi-Sunyer, 1993) (see chapters on ‘Coronary heart disease’ and ‘Diabetes mellitus’). Obesity also carries many additional complications including hypertension, sleep apnoea, gall bladder disease and osteoarthritis (see ‘Hypertension’, ‘Sleep apnoea’ and ‘Osteoarthritis’). Some, but not all, data suggest that obesity is associated with increased risk for psychological distress, including binge eating and depression.

Authors
Thomas, JJ; Brownell, KD
MLA Citation
Thomas, JJ, and Brownell, KD. "Obesity." Cambridge Handbook of Psychology, Health and Medicine, Second Edition. January 1, 2014. 797-800.
Source
scopus
Publish Date
2014
Start Page
797
End Page
800
DOI
10.1017/CBO9780511543579.207

Food-addiction scale measurement in 2 cohorts of middle-aged and older women

Background: Excess weight is a major threat to public health. An addiction-like tendency toward certain foods may contribute to overeating. Objective: We aimed to describe the prevalence and associated characteristics in relation to a food-addiction scale in middle-aged and older women. Design: We examined the prevalence and associated characteristics of a food-addiction scale measure in a cross-sectional analysis of 134,175 women participating in 2 ongoing prospective cohort studies of US nurses. Results: Overall, 7839 (5.8%) of the women surveyed met the criteria for food addiction measured by using the modified Yale Food Addiction Scale. The prevalence of food addiction was 8.4% in the younger cohort of women aged 45-64 y and 2.7% in the older cohort of women aged 62-88 y. In the multivariate model, body mass index (BMI; in kg/m 2) ≥35.0 (compared with 18.5-22.9) was associated with food addiction, a prevalence ratio (PR) of 15.83 (95% CI: 12.58, 19.91) in the younger cohort of women, and a PR of 18.41 (95% CI: 11.63, 29.14) in the older cohort of women. Several other demographic characteristics and other factors were associated with the food-addiction measure in both cohorts of women. Conclusions: To our knowledge, for the first time in a large, US-based population of women, we documented the prevalence of food addiction by using a novel measurement scale in middle-aged and older women. The results may provide insight into the strong association between behavioral attributes of food consumption and the development of obesity. © 2014 American Society for Nutrition.

Authors
Flint, AJ; Gearhardt, AN; Corbin, WR; Brownell, KD; Field, AE; Rimm, EB
MLA Citation
Flint, AJ, Gearhardt, AN, Corbin, WR, Brownell, KD, Field, AE, and Rimm, EB. "Food-addiction scale measurement in 2 cohorts of middle-aged and older women." American Journal of Clinical Nutrition 99.3 (2014): 578-586.
Source
scival
Published In
American Journal of Clinical Nutrition
Volume
99
Issue
3
Publish Date
2014
Start Page
578
End Page
586
DOI
10.3945/ajcn.113.068965

Corrigendum to "Preliminary Validation of the Yale Food Addiction Scale for Children" [Eat. Behav. 14 (2013) 508-512]

Authors
Gearhardt, AN; Roberto, CA; Seamans, MJ; Corbin, WR; Brownell, KD
MLA Citation
Gearhardt, AN, Roberto, CA, Seamans, MJ, Corbin, WR, and Brownell, KD. "Corrigendum to "Preliminary Validation of the Yale Food Addiction Scale for Children" [Eat. Behav. 14 (2013) 508-512]." Eating Behaviors 15.2 (2014): 334--.
Source
scival
Published In
Eating Behaviors
Volume
15
Issue
2
Publish Date
2014
Start Page
334-
DOI
10.1016/j.eatbeh.2014.03.009

Athlete endorsements in food marketing

OBJECTIVE: This study quantified professional athletes' endorsement of food and beverages, evaluated the nutritional quality of endorsed products, and determined the number of television commercial exposures of athlete-endorsement commercials for children, adolescents, and adults. METHODS: One hundred professional athletes were selected on the basis of Bloomberg Businessweek's 2010 Power 100 rankings, which ranks athletes according to their endorsement value and prominence in their sport. Endorsement information was gathered from the Power 100 list and the advertisement database AdScope. Endorsements were sorted into 11 endorsement categories (eg, food/beverages, sports apparel). The nutritional quality of the foods featured in athlete-endorsement advertisements was assessed by using a Nutrient Profiling Index, whereas beverages were evaluated on the basis of the percentage of calories from added sugar. Marketing data were collected from AdScope and Nielsen. RESULTS: Of 512 brands endorsed by 100 different athletes, sporting goods/apparel represented the largest category (28.3%), followed by food/beverages (23.8%) and consumer goods (10.9%). Professional athletes in this sample were associated with 44 different food or beverage brands during 2010. Seventy-nine percent of the 62 food products in athlete-endorsed advertisements were energy-dense and nutrient-poor, and 93.4% of the 46 advertised beverages had 100% of calories from added sugar. Peyton Manning (professional American football player) and LeBron James (professional basketball player) had the most endorsements for energy-dense, nutrient-poor products. Adolescents saw the most television commercials that featured athlete endorsements of food. CONCLUSIONS: Youth are exposed to professional athlete endorsements of food products that are energy-dense and nutrient-poor. Pediatrics 2013;132:805-810. Copyright © 2013 by the American Academy of Pediatrics.

Authors
Bragg, MA; Yanamadala, S; Roberto, CA; Harris, JL; Brownell, KD
MLA Citation
Bragg, MA, Yanamadala, S, Roberto, CA, Harris, JL, and Brownell, KD. "Athlete endorsements in food marketing." Pediatrics 132.5 (November 1, 2013): 805-810.
PMID
24101762
Source
scopus
Published In
Pediatrics
Volume
132
Issue
5
Publish Date
2013
Start Page
805
End Page
810
DOI
10.1542/peds.2013-0093

Calorie estimation accuracy and menu labeling perceptions among individuals with and without binge eating and/or purging disorders.

Menu labeling is a public health policy that requires chain restaurants in the USA to post kilocalorie information on their menus to help consumers make informed choices. However, there is concern that such a policy might promote disordered eating. This web-based study compared individuals with self-reported binge eating disorder (N = 52), bulimia nervosa (N = 25), and purging disorder (N = 17) and those without eating disorders (No ED) (N = 277) on restaurant calorie information knowledge and perceptions of menu labeling legislation. On average, people answered 1.46 ± 1.08 questions correctly (out of 6) (25%) on a calorie information quiz and 92% of the sample was in favor of menu labeling. The findings did not differ based on eating disorder, dieting, or weight status, or race/ethnicity. The results indicated that people have difficulty estimating the calories in restaurant meals and individuals with and without eating disorders are largely in favor of menu labeling laws.

Authors
Roberto, CA; Haynos, AF; Schwartz, MB; Brownell, KD; White, MA
MLA Citation
Roberto, CA, Haynos, AF, Schwartz, MB, Brownell, KD, and White, MA. "Calorie estimation accuracy and menu labeling perceptions among individuals with and without binge eating and/or purging disorders." Eating and weight disorders : EWD 18.3 (September 2013): 255-261.
PMID
23760909
Source
epmc
Published In
Eating and weight disorders : EWD
Volume
18
Issue
3
Publish Date
2013
Start Page
255
End Page
261
DOI
10.1007/s40519-013-0035-x

Susan Nolen-Hoeksema (1959-2013).

Presents an obituary for Susan Nolen-Hoeksema. Susan received her bachelor's degree from Yale University and her doctorate in clinical psychology from the University of Pennsylvania. Her undergraduate and graduate school mentors were Irving Janis, Robert Sternberg, and Martin Seligman. Susan began her career at Stanford University, where she became a tenured associate professor in 1993, and moved to the University of Michigan, where she was promoted to the rank of professor and directed the Institute for Research on Women and Gender. Susan joined the Yale University Department of Psychology in 2004 as a professor and served as its chair and director of graduate studies. Few words can capture Susan's masterful approach to research, which balanced creativity with pragmatism. A pioneer in the study of depression and a leading figure in research on sex differences in depression, she transformed clinical psychology with her research. Raised in the small town of Stonington, Illinois, Susan acquired a decency, kindness, and strength of character that lasted her lifetime. Despite her academic achievements and stature in the field, she treated everyone with respect and dignity. She was remarkable in her ability to support people through difficult circumstances, fairly treat all individuals, and be a kind and dedicated mentor and colleague to those of us fortunate enough to know her. Our field is richer for her presence, and her untimely death is a tragic loss. There could be no better colleague and friend. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Authors
Kaslow, NJ; Hilt, L; Wisco, BE; Brownell, KD
MLA Citation
Kaslow, NJ, Hilt, L, Wisco, BE, and Brownell, KD. "Susan Nolen-Hoeksema (1959-2013)." The American psychologist 68.5 (July 2013): 404-.
PMID
23895616
Source
epmc
Published In
American Psychologist
Volume
68
Issue
5
Publish Date
2013
Start Page
404
DOI
10.1037/a0033053

The importance of understanding the impact of children's food marketing on the brain

Authors
Gearhardt, AN; Brownell, KD
MLA Citation
Gearhardt, AN, and Brownell, KD. "The importance of understanding the impact of children's food marketing on the brain." Journal of Pediatrics 162.4 (2013): 672-673.
Source
scival
Published In
The Journal of Pediatrics
Volume
162
Issue
4
Publish Date
2013
Start Page
672
End Page
673
DOI
10.1016/j.jpeds.2012.11.068

Redefining "child-directed advertising" to reduce unhealthy television food advertising

Background: Food and beverage companies have pledged to reduce unhealthy marketing to children through the Children's Food and Beverage Advertising Initiative (CFBAI). However, public health experts question the initiative's effectiveness because pledges apply to only some types of marketing. For instance, the CFBAI covers only TV advertising that is "child-directed, " defined as advertising during programs for which children make up 35% or more of the viewing audience. Purpose: To quantify the proportion of food and beverage TV advertisements (ads) viewed by children that is covered by current CFBAI pledges and examine the potential impact of broader definitions of child-directed advertising. Methods: Nielsen data were used to quantify percentages of children (aged 2-11 years) in the audience (i.e., child-audience share), as well as absolute numbers of child viewers, for all national TV programs in 2009. Nielsen advertising data provided the number of food and beverage ads viewed by preschoolers (aged 2-5 years); older children (aged 6-11 years); and adults (aged 18-49 years) during programs with various child-audience compositions. Data were collected in 2010 and analyzed in 2011. Results: Just 45%-48% of food ads viewed by children met current CFBAI definitions of childdirected advertising. Expanding this definition to include advertising during programs with a child-audience share of 20% or higher and/or 100,000 or more child viewers would cover 70%-71% of food advertising seen by children but just one third of ads seen by adults. Conclusions: Children viewed an estimated 35% fewer food ads during TV programs with a high child-audience share (50%) in 2009 compared with 2004. However, ensuring that nutrition standards apply to the majority of food ads viewed by children requires broader definitions of child-directed advertising. © 2013 American Journal of Preventive Medicine.

Authors
Harris, JL; Sarda, V; Schwartz, MB; Brownell, KD
MLA Citation
Harris, JL, Sarda, V, Schwartz, MB, and Brownell, KD. "Redefining "child-directed advertising" to reduce unhealthy television food advertising." American Journal of Preventive Medicine 44.4 (2013): 358-364.
PMID
23498101
Source
scival
Published In
American Journal of Preventive Medicine
Volume
44
Issue
4
Publish Date
2013
Start Page
358
End Page
364
DOI
10.1016/j.amepre.2012.11.039

Preliminary validation of the Yale Food Addiction Scale for children

Introduction: Evidence is growing that an addictive process may play a role in problematic eating behavior. The majority of research on this topic has examined the concept of "food addiction" solely in adult samples. If certain foods have addictive potential, children may be impacted as much as (or more) than adults due to psychological and neurobiological vulnerabilities at younger developmental stages. In the current study, we developed a measure of food addiction in children that reflects the diagnostic indicators of addiction. Materials and methods: The content and reading level of the Yale Food Addiction Scale (YFAS) was altered to be appropriate for children (YFAS-C). The YFAS-C and other eating-related measures were administered to study participants to examine the validity and reliability of the YFAS-C. Participants: 75 children were recruited from the community ranging from lean to obese. Results: The validation of the YFAC-C provides preliminary support for its convergent validity with like constructs and incremental validity in predicting body mass index. Internal consistency was adequate given the small number of items on the scale. Discussion: The YFAS-C appears to be a helpful tool for identifying addictive-like eating in children. © 2013 Elsevier Ltd.

Authors
Gearhardt, AN; Roberto, CA; Seamans, MJ; Corbin, WR; Brownell, KD
MLA Citation
Gearhardt, AN, Roberto, CA, Seamans, MJ, Corbin, WR, and Brownell, KD. "Preliminary validation of the Yale Food Addiction Scale for children." Eating Behaviors 14.4 (2013): 508-512.
Source
scival
Published In
Eating Behaviors
Volume
14
Issue
4
Publish Date
2013
Start Page
508
End Page
512
DOI
10.1016/j.eatbeh.2013.07.002

Can food and addiction change the game?

Authors
Gearhardt, AN; Brownell, KD
MLA Citation
Gearhardt, AN, and Brownell, KD. "Can food and addiction change the game?." Biological Psychiatry 73.9 (2013): 802-803.
PMID
22877921
Source
scival
Published In
Biological Psychiatry
Volume
73
Issue
9
Publish Date
2013
Start Page
802
End Page
803
DOI
10.1016/j.biopsych.2012.07.024

A Survey of undergraduate student perceptions and use of nutrition information labels in a university dining hall

Objective: To examine undergraduate student perceptions and reported use of nutrition information labels in campus dining halls. Design: Paper surveys were administered to a convenience sample of undergraduates. Setting: This study was conducted at an urban United States university. Method: A survey about perceptions and use of nutrition information labels in the dining halls was distributed to 487 students over a three-month period during the 2009-2010 academic year. Results: Of survey respondents, 98% were in favour of making nutrition information available to students, while 96% preferred the information to appear in the dining halls or both in the dining halls and online, rather than online only. Some 88% of survey respondents indicated that the labels affect their food choices at least sometimes. Conclusion: The results suggest that college and university dining halls should consider student opinion when deciding whether to provide nutrition information labels in the dining halls. © The Author(s) 2012.

Authors
Martinez, OD; Roberto, CA; Kim, JH; Schwartz, MB; Brownell, KD
MLA Citation
Martinez, OD, Roberto, CA, Kim, JH, Schwartz, MB, and Brownell, KD. "A Survey of undergraduate student perceptions and use of nutrition information labels in a university dining hall." Health Education Journal 72.3 (2013): 319-325.
Source
scival
Published In
Health Education Journal
Volume
72
Issue
3
Publish Date
2013
Start Page
319
End Page
325
DOI
10.1177/0017896912443120

The use of sports references in marketing of food and beverage products in supermarkets

Objective Food marketing has been identified as a significant driver of the childhood obesity epidemic. The purpose of the present study was to (i) conduct a content analysis of the types of sports references that appear on supermarket food and beverage products and (ii) assess each product's nutritional and marketing profile. Design This was a descriptive study. Every product featuring sports references on the packaging was purchased in two major supermarkets during 2010. A content analysis was conducted and nutritional evaluations were made based on the Nutrient Profile Model, a validated nutrition model. Marketing data were obtained from The Nielsen Company. Setting Two major supermarkets in Connecticut, USA. Subjects Food and beverage products (n 102) were selected from two supermarkets. Results The 102 products (fifty-three foods and forty-nine beverages) had sports references as part of their packaging: 72·5 % featured a character exercising, 42·2 % were endorsed by a professional sports entity and 34·0 % were child-targeted. The median nutrition score for food products was 36 (1 = unhealthiest and 100 = healthiest; scores of ≥63 are considered healthy according to this model). More than two-thirds of beverages (69·4 %) were 100 % sugar-sweetened. Children saw significantly more commercials for these products than adults. Conclusions Companies place sports figures on food and beverage products that are child-targeted and unhealthy. © The Authors 2012.

Authors
Bragg, MA; Liu, PJ; Roberto, CA; Sarda, V; Harris, JL; Brownell, KD
MLA Citation
Bragg, MA, Liu, PJ, Roberto, CA, Sarda, V, Harris, JL, and Brownell, KD. "The use of sports references in marketing of food and beverage products in supermarkets." Public Health Nutrition 16.4 (2013): 738-742.
PMID
22874497
Source
scival
Published In
Public health nutrition
Volume
16
Issue
4
Publish Date
2013
Start Page
738
End Page
742
DOI
10.1017/S1368980012003163

The importance of understanding the impact of children's food marketing on the brain

Authors
Gearhardt, AN; Brownell, KD
MLA Citation
Gearhardt, AN, and Brownell, KD. "The importance of understanding the impact of children's food marketing on the brain." Journal of Pediatrics 162.4 (2013): 672-673.
PMID
23305960
Source
scival
Published In
The Journal of Pediatrics
Volume
162
Issue
4
Publish Date
2013
Start Page
672
End Page
673
DOI
10.1016/j.jpeds.2012.11.068

The science on front-of-package food labels

Objective The US Food and Drug Administration and Institute of Medicine are currently investigating front-of-package (FOP) food labelling systems to provide science-based guidance to the food industry. The present paper reviews the literature on FOP labelling and supermarket shelf-labelling systems published or under review by February 2011 to inform current investigations and identify areas of future research. Design A structured search was undertaken of research studies on consumer use, understanding of, preference for, perception of and behaviours relating to FOP/shelf labelling published between January 2004 and February 2011. Results Twenty-eight studies from a structured search met inclusion criteria. Reviewed studies examined consumer preferences, understanding and use of different labelling systems as well as label impact on purchasing patterns and industry product reformulation. Conclusions The findings indicate that the Multiple Traffic Light system has most consistently helped consumers identify healthier products; however, additional research on different labelling systems' abilities to influence consumer behaviour is needed. © 2012 The Authors.

Authors
Hawley, KL; Roberto, CA; Bragg, MA; Liu, PJ; Schwartz, MB; Brownell, KD
MLA Citation
Hawley, KL, Roberto, CA, Bragg, MA, Liu, PJ, Schwartz, MB, and Brownell, KD. "The science on front-of-package food labels." Public Health Nutrition 16.3 (2013): 430-439.
PMID
22440538
Source
scival
Published In
Public health nutrition
Volume
16
Issue
3
Publish Date
2013
Start Page
430
End Page
439
DOI
10.1017/S1368980012000754

The influence of a defendant's body weight on perceptions of guilt

Objective:To investigate the influence of a defendant's weight on simulated jurors' perceptions of guilt. Design and methods:Participants were 471 lean and overweight adults (mean body mass index: 25.34±5.91) who read a vignette describing a case of check fraud while viewing one of four images of the alleged defendant (a lean male, a lean female, an obese male or an obese female). Participants rated the defendant's culpability on a 5-point Likert scale and completed measures of anti-fat attitudes. Results:Male respondents endorsed greater overall weight bias than females (F (1470)=23.815, P<0.01, η2=0.048). A three-way interaction was detected between participant sex, defendant sex and defendant weight on perceptions of guilt such that when the defendant was female, male participants were significantly more likely to find her guilty if she was obese than if she was lean (guilt ratings=4.05±0.83; 3.31±1.03, respectively; F(1467)=5.935, P=0.015, R2=0.060). In addition, lean male participants were significantly more likely to believe that the obese female defendant met criteria for check fraud, and indicated greater belief she would be a repeat offender, compared with the lean female defendant (t(90)=2.081, P=0.040; t(90)=2.395 P=0.019, respectively). There were no differences in perceptions of guilt or responsibility between the obese male and the lean male defendants. Conclusion:The results of this novel study indicate that both weight and gender of a defendant may affect juror perceptions of guilt and responsibility.International Journal of Obesity advance online publication, 8 January 2013; doi:10.1038/ijo.2012.211.

Authors
Schvey, NA; Puhl, RM; Levandoski, KA; Brownell, KD
MLA Citation
Schvey, NA, Puhl, RM, Levandoski, KA, and Brownell, KD. "The influence of a defendant's body weight on perceptions of guilt." International Journal of Obesity (2013).
PMID
23295503
Source
scival
Published In
International Journal of Obesity
Publish Date
2013
DOI
10.1038/ijo.2012.211

Preliminary validation of the Yale Food Addiction Scale for children

Introduction: Evidence is growing that an addictive process may play a role in problematic eating behavior. The majority of research on this topic has examined the concept of "food addiction" solely in adult samples. If certain foods have addictive potential, children may be impacted as much as (or more) than adults due to psychological and neurobiological vulnerabilities at younger developmental stages. In the current study, we developed a measure of food addiction in children that reflects the diagnostic indicators of addiction. Materials and methods: The content and reading level of the Yale Food Addiction Scale (YFAS) was altered to be appropriate for children (YFAS-C). The YFAS-C and other eating-related measures were administered to study participants to examine the validity and reliability of the YFAS-C. Participants: 75 children were recruited from the community ranging from lean to obese. Results: The validation of the YFAC-C provides preliminary support for its convergent validity with like constructs and incremental validity in predicting body mass index. Internal consistency was adequate given the small number of items on the scale. Discussion: The YFAS-C appears to be a helpful tool for identifying addictive-like eating in children. © 2013 Elsevier Ltd. All rights reserved.

Authors
Gearhardt, AN; Roberto, CA; Seamans, MJ; Corbin, WR; Brownell, KD
MLA Citation
Gearhardt, AN, Roberto, CA, Seamans, MJ, Corbin, WR, and Brownell, KD. "Preliminary validation of the Yale Food Addiction Scale for children." Eating Behaviors (2013).
PMID
24183146
Source
scival
Published In
Eating Behaviors
Publish Date
2013
DOI
10.1016/j.eatbeh.2013.07.002

Heightened vagal activity during high-calorie food presentation in obese compared with non-obese individuals-Results of a pilot study

Eating behaviours are highly cue-dependent. Changes in mood states and exposure to palatable food both increase craving and consumption of food. Vagal activity supports adaptive modulation of physiological arousal and has an important role in cue-induced appetitive behaviours. Using high-frequency heart rate variability (HF HRV), this preliminary study compared vagal activity during positive and negative mood induction, and presentation of preferred high-calorie food items between obese (n = 12; BMI ≥ 30) and non-obese individuals (n = 14; 18.5 < BMI < 30). Participants completed two laboratory sessions (negative vs. positive mood conditions). Following 3-h of food deprivation, all participants completed a mood induction, and then were exposed to their preferred high-calorie food items. HF HRV was assessed throughout. Obese and non-obese individuals were not significantly different in HF HRV during positive or negative mood induction. Obese individuals showed significantly greater levels of HF HRV during presentation of their preferred high-calorie food items than non-obese individuals, particularly in the positive mood condition. This is the first study to demonstrate increased vagal activity in response to food cues in obese individuals compared with non-obese individuals. Our findings warrant further investigation on the potential role of vagally-mediated cue reactivity in overeating and obesity. © 2013 Asian Oceanian Association for the Study of Obesity.

Authors
Udo, T; Weinberger, AH; Grilo, CM; Brownell, KD; DiLeone, RJ; Lampert, R; Matlin, SL; Yanagisawa, K; McKee, SA
MLA Citation
Udo, T, Weinberger, AH, Grilo, CM, Brownell, KD, DiLeone, RJ, Lampert, R, Matlin, SL, Yanagisawa, K, and McKee, SA. "Heightened vagal activity during high-calorie food presentation in obese compared with non-obese individuals-Results of a pilot study." Obesity Research and Clinical Practice (2013).
PMID
24847667
Source
scival
Published In
Obesity Research & Clinical Practice
Publish Date
2013
DOI
10.1016/j.orcp.2013.05.006

Modeling the effects of positive and negative mood on the ability to resist eating in obese and non-obese individuals

This pilot study adapted a well-established drug self-administration paradigm to examine the effects of mood induction on the ability to resist high-calorie foods and subsequent food consumption differently in 15 obese individuals (40.0% women, BMI: 35.1 ± 3.70) and 15 non-obese individuals (46.7% women, BMI: 23.0 ± 1.96). Participants completed two laboratory sessions (positive vs. negative mood conditions) consisting of 3-hour food deprivation, followed by mood induction, and a 3-hour ad-lib eating period, where they were asked to choose between favorite high-calorie snacks and monetary reinforcement. Obese individuals were less able to resist eating and increased high-calorie food consumption during the positive mood condition than the negative condition. Non-obese individuals were less able to resist eating during the negative mood condition than the positive condition, but their total consumption was not affected by the mood conditions. In obese individuals, food craving was associated with less ability to resist eating and greater calorie consumption during the negative mood condition. This is the first study to experimentally demonstrate that mood state may increase vulnerability to food consumption by reducing the ability to resist eating. The ability to resist eating may be a novel dimension of eating behaviors that has a significant contribution to understanding mood-eating relationships. © 2012.

Authors
Udo, T; Grilo, CM; Brownell, KD; Weinberger, AH; DiLeone, RJ; McKee, SA
MLA Citation
Udo, T, Grilo, CM, Brownell, KD, Weinberger, AH, DiLeone, RJ, and McKee, SA. "Modeling the effects of positive and negative mood on the ability to resist eating in obese and non-obese individuals." Eating Behaviors 14.1 (2013): 40-46.
PMID
23265400
Source
scival
Published In
Eating Behaviors
Volume
14
Issue
1
Publish Date
2013
Start Page
40
End Page
46
DOI
10.1016/j.eatbeh.2012.10.010

The Imperative of Changing Public Policy to Address Obesity

© 2011 by Oxford University Press, Inc. All rights reserved. This chapter discusses the responsibility of changing public policy to address obesity. The understanding of obesity as an issue of personal responsibility has led to weak government action. The chapter notes that the environment is the major force underlying the obesity crisis and then addresses school food environments, food access and cost, sugared beverage consumption, food marketing, and restaurant food nutrition content and portion size. Comprehensive bans on advertising are difficult to develop, given the range of ways in which foods are advertised, such as on the Internet and through videogames. Menu labeling could promote healthier food choices when dining out. Public health policies that target the school food environment, issues of access and cost of foods, sugar beverage consumption, food marketing, restaurant food nutrition content and portion size can have far-reaching effects in curbing the obesity epidemic and in improving the world's diet and health in cost-effective ways.

Authors
Roberto, CA; Brownell, KD
MLA Citation
Roberto, CA, and Brownell, KD. "The Imperative of Changing Public Policy to Address Obesity." (September 18, 2012). (Chapter)
Source
scopus
Publish Date
2012
DOI
10.1093/oxfordhb/9780199736362.013.0035

Food and Addiction: A Comprehensive Handbook

Food and Addiction: A Comprehensive Handbook brings scientific order to the issue of food and addiction, spanning multiple disciplines to create the foundation for what is a rapidly advancing field and to highlight needed advances in science and public policy. The book assembles leading scientists and policy makers from fields such as nutrition, addiction, psychology, epidemiology, and public health to explore and analyze the scientific evidence for the addictive properties of food.

MLA Citation
Food and Addiction: A Comprehensive Handbook. Ed. KD Brownell and MS Gold. Oxford University Press, August 30, 2012. (Edited Book)
Source
manual
Publish Date
2012

A test of different menu labeling presentations

Chain restaurants will soon need to disclose calorie information on menus, but research on the impact of calorie labels on food choices is mixed. This study tested whether calorie information presented in different formats influenced calories ordered and perceived restaurant healthfulness. Participants in an online survey were randomly assigned to a menu with either (1) no calorie labels (No Calories); (2) calorie labels (Calories); (3) calorie labels ordered from low to high calories (Rank-Ordered Calories); or (4) calorie labels ordered from low to high calories that also had red/green circles indicating higher and lower calorie choices (Colored Calories). Participants ordered items for dinner, estimated calories ordered, and rated restaurant healthfulness. Participants in the Rank-Ordered Calories condition and those in the Colored Calories condition ordered fewer calories than the No Calories group. There was no significant difference in calories ordered between the Calories and No Calories groups. Participants in each calorie label condition were significantly more accurate in estimating calories ordered compared to the No Calories group. Those in the Colored Calories group perceived the restaurant as healthier. The results suggest that presenting calorie information in the modified Rank-Ordered or Colored Calories formats may increase menu labeling effectiveness. © 2012 Elsevier Ltd.

Authors
Liu, PJ; Roberto, CA; Liu, LJ; Brownell, KD
MLA Citation
Liu, PJ, Roberto, CA, Liu, LJ, and Brownell, KD. "A test of different menu labeling presentations." Appetite 59.3 (2012): 770-777.
PMID
22918176
Source
scival
Published In
Appetite
Volume
59
Issue
3
Publish Date
2012
Start Page
770
End Page
777
DOI
10.1016/j.appet.2012.08.011

Role of policy and government in the obesity epidemic

Authors
Novak, NL; Brownell, KD
MLA Citation
Novak, NL, and Brownell, KD. "Role of policy and government in the obesity epidemic." Circulation 126.19 (2012): 2345-2352.
PMID
23129701
Source
scival
Published In
Circulation
Volume
126
Issue
19
Publish Date
2012
Start Page
2345
End Page
2352
DOI
10.1161/CIRCULATIONAHA.111.037929

Positive media portrayals of obese persons: Impact on attitudes and image preferences

Objective: The purpose of this research was to assess the impact of nonstereotypical, positive media portrayals of obese persons on biased attitudes, as well as propose a change in media practices that could reduce public weight bias and consequent negative health outcomes for those who experience weight stigma. Method: Two online experiments were conducted in which participants viewed either a stigmatizing or a positive photograph of an obese model. In Experiment 1 (N = 146), participants viewed a photograph of either a Caucasian or African American obese woman; in Experiment 2 (N = 145), participants viewed either a Caucasian male or female obese model. Multiple linear regression models were used to analyze outcomes for social distance attitudes toward the obese models depicted in the images, in addition to other negative attitudes and image preferences. Results: Participants who viewed the stigmatizing images endorsed stronger social distance attitudes and more negative attitudes toward obese persons than participants who viewed the positive images, and there was a stronger preference for the positive images than the stigmatizing images. These results were consistent regardless of the race or gender of the obese model pictured. Conclusion: The findings indicate that more positive media portrayals of obese individuals may help reduce weight stigma and its associated negative health outcomes. © 2012 American Psychological Association.

Authors
Pearl, RL; Puhl, RM; Brownell, KD
MLA Citation
Pearl, RL, Puhl, RM, and Brownell, KD. "Positive media portrayals of obese persons: Impact on attitudes and image preferences." Health Psychology 31.6 (2012): 821-829.
PMID
22309884
Source
scival
Published In
Health Psychology
Volume
31
Issue
6
Publish Date
2012
Start Page
821
End Page
829
DOI
10.1037/a0027189

Portion sizes and beyond - Government's legal authority to regulate food-industry practices

Authors
Pomeranz, JL; Brownell, KD
MLA Citation
Pomeranz, JL, and Brownell, KD. "Portion sizes and beyond - Government's legal authority to regulate food-industry practices." New England Journal of Medicine 367.15 (2012): 1383-1385.
PMID
22998343
Source
scival
Published In
The New England journal of medicine
Volume
367
Issue
15
Publish Date
2012
Start Page
1383
End Page
1385
DOI
10.1056/NEJMp1208167

Facts up front versus traffic light food labels: A randomized controlled trial

Background: The U.S. food and beverage industry recently released a new front-of-package nutrition labeling system called Facts Up Front that will be used on thousands of food products. Purpose: To test consumer understanding of the Facts Up Front system (Facts Up Front) compared to the Multiple Traffic Light system (Traffic Light). Facts Up Front displays grams/milligrams and percentage daily value information for various nutrients; Traffic Light uses an interpretive color-coded scheme to alert consumers to low, medium, and high levels of certain nutrients. Design: Participants in an Internet-based study were randomized to one of five front-of-package label conditions: (1) no label; (2) Traffic Light; (3) Traffic Light plus information about protein and fiber (Traffic Light+); (4) Facts Up Front; or (5) Facts Up Front plus information about "nutrients to encourage" (Facts Up Front+). Setting/ participants: A total of 703 adults recruited through an online database in May 2011 participated in this study, and data were analyzed in June 2011. Main outcome measures: Total percentage correct quiz scores were generated reflecting participants' ability to compare two foods on nutrient levels, based on their labels, and to estimate amounts of saturated fat, sugar, sodium, fiber and protein in the foods. Results: The front-of-package label groups outperformed the control group on nearly all of the nutrient quizzes (p<0.05). The control group did not differ from the Facts Up Front group on the saturated fat quiz, or from the Facts Up Front+ group on the sugars quiz. Those in the Traffic Light+ group had the best overall performance (>80% on all quizzes). Conclusions: Overall, those in the Traffic Light+ condition performed better than those in the Facts Up Front conditions on measures of nutrition knowledge and label perceptions. Trial registration: This study is registered at clinicaltrials.gov NCT01626729. © 2012 American Journal of Preventive Medicine.

Authors
Roberto, CA; Bragg, MA; Schwartz, MB; Seamans, MJ; Musicus, A; Novak, N; Brownell, KD
MLA Citation
Roberto, CA, Bragg, MA, Schwartz, MB, Seamans, MJ, Musicus, A, Novak, N, and Brownell, KD. "Facts up front versus traffic light food labels: A randomized controlled trial." American Journal of Preventive Medicine 43.2 (2012): 134-141.
PMID
22813677
Source
scival
Published In
American Journal of Preventive Medicine
Volume
43
Issue
2
Publish Date
2012
Start Page
134
End Page
141
DOI
10.1016/j.amepre.2012.04.022

Evaluation of consumer understanding of different front-of-package nutrition labels, 2010-2011

Introduction: Governments throughout the world are using or considering various front-of-package (FOP) food labeling systems to provide nutrition information to consumers. Our web-based study tested consumer understanding of different FOP labeling systems. Methods: Adult participants (N = 480) were randomized to 1 of 5 groups to evaluate FOP labels: 1) no label; 2) multiple traffic light (MTL); 3) MTL plus daily caloric requirement icon (MTL+caloric intake); 4) traffic light with specific nutrients to limit based on food category (TL+SNL); or 5) the Choices logo. Total percentage correct quiz scores were created reflecting participants' ability to select the healthier of 2 foods and estimate amounts of saturated fat, sugar, and sodium in foods. Participants also rated products on taste, healthfulness, and how likely they were to purchase the product. Quiz scores and product perceptions were compared with 1-way analysis of variance followed by post-hoc Tukey tests. Results: The MTL+caloric intake group (mean [standard deviation], 73.3% [6.9%]) and Choices group (72.5% [13.2%]) significantly outperformed the no label group (67.8% [10.3%]) and the TL+SNL group (65.8% [7.3%]) in selecting the more healthful product on the healthier product quiz. The MTL and MTL+caloric intake groups achieved average scores of more than 90% on the saturated fat, sugar, and sodium quizzes, which were significantly better than the no label and Choices group average scores, which were between 34% and 47%. Conclusion: An MTL+caloric intake label and the Choices symbol hold promise as FOP labeling systems and require further testing in different environments and population subgroups.

Authors
Roberto, CA; Bragg, MA; Seamans, MJ; Mechulan, RL; Novak, N; Brownell, KD
MLA Citation
Roberto, CA, Bragg, MA, Seamans, MJ, Mechulan, RL, Novak, N, and Brownell, KD. "Evaluation of consumer understanding of different front-of-package nutrition labels, 2010-2011." Preventing Chronic Disease 9.9 (2012).
PMID
22995103
Source
scival
Published In
Preventing Chronic Diseases: Public health research, practice, and policy
Volume
9
Issue
9
Publish Date
2012
DOI
10.5888/pcd9.120015

Food industry front groups and conflicts of interest: The case of Americans against food taxes

Authors
Yanamadala, S; Bragg, MA; Roberto, CA; Brownell, KD
MLA Citation
Yanamadala, S, Bragg, MA, Roberto, CA, and Brownell, KD. "Food industry front groups and conflicts of interest: The case of Americans against food taxes." Public Health Nutrition 15.8 (2012): 1331-1332.
PMID
22687144
Source
scival
Published In
Public health nutrition
Volume
15
Issue
8
Publish Date
2012
Start Page
1331
End Page
1332
DOI
10.1017/S1368980012003187

Thinking forward: The quicksand of appeasing the food industry

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Thinking forward: The quicksand of appeasing the food industry." PLoS Medicine 9.7 (2012).
PMID
22802734
Source
scival
Published In
PLoS medicine
Volume
9
Issue
7
Publish Date
2012
DOI
10.1371/journal.pmed.1001254

The Smart Choices front-of-package nutrition label. Influence on perceptions and intake of cereal

Numerous front-of-package (FOP) nutrition labeling systems exist, but it is unclear if such labels influence behavior. A single-summary label called Smart Choices (SC) appeared briefly on products in the United States in 2009. The current study aimed to evaluate (1) the influence the SC symbol has on the serving and consumption of cereal; and (2) the impact of providing calorie and serving size information on a FOP label. Two hundred and sixteen adults were randomized to a high-sugar breakfast cereal that had either (1) no label; (2) the SC symbol; or (3) a modified SC symbol with serving size information. Participants rated perceptions of healthfulness, taste, and purchase intent, estimated calories per serving and poured and ate the cereal for breakfast. Participants in the SC label conditions were better able to estimate calories per serving, but there were no differences across groups on perceptions of healthfulness, taste, purchase intent, and levels of vitamins, and sugar or amount of cereal poured or consumed. These results suggest that calories per serving information on FOP labels can increase knowledge, but the SC symbol had little impact on behavior. Studies examining FOP label influence on purchasing, consumption, and product reformulation are greatly needed to determine label utility. © 2012 Elsevier Ltd.

Authors
Roberto, CA; Shivaram, M; Martinez, O; Boles, C; Harris, JL; Brownell, KD
MLA Citation
Roberto, CA, Shivaram, M, Martinez, O, Boles, C, Harris, JL, and Brownell, KD. "The Smart Choices front-of-package nutrition label. Influence on perceptions and intake of cereal." Appetite 58.2 (2012): 651-657.
PMID
22248710
Source
scival
Published In
Appetite
Volume
58
Issue
2
Publish Date
2012
Start Page
651
End Page
657
DOI
10.1016/j.appet.2012.01.003

Obesity and public policy

There is a pressing need to reduce both the prevalence and impact of obesity. This review begins with a discussion of the roles of treatment and prevention. Two overriding issues, weight bias and the addictive nature of food, are covered because of their importance not only to the individuals affected but also to public policy. We then cover promising policy areas in which changes can be implemented to support healthy behaviors: school policy, food marketing, food labeling and packaging, and taxes on unhealthy foods. The roles of the food industry and federal, state, and local governments are also discussed. © Copyright ©2012 by Annual Reviews. All rights reserved.

Authors
Gearhardt, AN; Bragg, MA; Pearl, RL; Schvey, NA; Roberto, CA; Brownell, KD
MLA Citation
Gearhardt, AN, Bragg, MA, Pearl, RL, Schvey, NA, Roberto, CA, and Brownell, KD. "Obesity and public policy." Annual Review of Clinical Psychology 8 (2012): 405-430.
PMID
22224839
Source
scival
Published In
Annual Review of Clinical Psychology
Volume
8
Publish Date
2012
Start Page
405
End Page
430
DOI
10.1146/annurev-clinpsy-032511-143129

Choosing front-of-package food labelling nutritional criteria: How smart were 'Smart Choices'?

Objective The 'Smart Choices' programme was an industry-driven, front-of-package (FOP) nutritional labelling system introduced in the USA in August 2009, ostensibly to help consumers select healthier options during food shopping. Its nutritional criteria were developed by members of the food industry in collaboration with nutrition and public health experts and government officials. The aim of the present study was to test the extent to which products labelled as 'Smart Choices' could be classified as healthy choices on the basis of the Nutrient Profile Model (NPM), a non-industry- developed, validated nutritional standard. Design A total of 100 packaged products that qualified for a 'Smart Choices' designation were sampled from eight food and beverage categories. All products were evaluated using the NPM method.Results In all, 64 % of the products deemed 'Smart Choices' did not meet the NPM standard for a healthy product. Within each 'Smart Choices' category, 0 % of condiments, 8•70 % of fats and oils, 15•63 % of cereals and 31•58 % of snacks and sweets met NPM thresholds. All sampled soups, beverages, desserts and grains deemed 'Smart Choices' were considered healthy according to the NPM standard. Conclusions The 'Smart Choices' programme is an example of industries' attempts at self-regulation. More than 60 % of foods that received the 'Smart Choices' label did not meet standard nutritional criteria for a 'healthy' food choice, suggesting that industries' involvement in designing labelling systems should be scrutinized. The NPM system may be a good option as the basis for establishing FOP labelling criteria, although more comparisons with other systems are needed. © 2011 The Authors.

Authors
Roberto, CA; Bragg, MA; Livingston, KA; Harris, JL; Thompson, JM; Seamans, MJ; Brownell, KD
MLA Citation
Roberto, CA, Bragg, MA, Livingston, KA, Harris, JL, Thompson, JM, Seamans, MJ, and Brownell, KD. "Choosing front-of-package food labelling nutritional criteria: How smart were 'Smart Choices'?." Public Health Nutrition 15.2 (2012): 262-267.
PMID
21729490
Source
scival
Published In
Public health nutrition
Volume
15
Issue
2
Publish Date
2012
Start Page
262
End Page
267
DOI
10.1017/S1368980011000826

Foreword

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Foreword." Encyclopedia of Body Image and Human Appearance 1 (2012): xxi-xxii.
Source
scival
Published In
Encyclopedia of Body Image and Human Appearance
Volume
1
Publish Date
2012
Start Page
xxi
End Page
xxii
DOI
10.1016/B978-0-12-384925-0.09008-8

Sugar-sweetened beverages in the Supplemental Nutrition Assistance Program: Reply

Authors
Brownell, KD; Ludwig, DS
MLA Citation
Brownell, KD, and Ludwig, DS. "Sugar-sweetened beverages in the Supplemental Nutrition Assistance Program: Reply." JAMA - Journal of the American Medical Association 306.24 (2011): 2670--.
Source
scival
Published In
JAMA : the journal of the American Medical Association
Volume
306
Issue
24
Publish Date
2011
Start Page
2670-
DOI
10.1001/jama.2011.1885

Nutrition-related claims on children's cereals: What do they mean to parents and do they influence willingness to buy?

Objective To examine parents' beliefs about the meaning of common front-of-package nutrition-related claims on children's cereals and determine whether the claims would make them more willing to buy the cereals. Design Parents viewed images of box fronts for children's cereals of below-average nutritional quality, as assessed by a validated nutrient profiling model. These boxes featured various nutrition-related claims including 'supports your child's immunity', 'whole grain', 'fibre', 'calcium and vitamin D' and 'organic'. Participants were provided possible meanings for these claims and asked to select any that applied with the option to write in additional meanings. They also indicated how the claim would affect their willingness to buy the product. Setting Online survey. Subjects Parents with children between the ages of 2 and 11 years (n 306) recruited through an online panel. Results The majority of parents misinterpreted the meaning of claims commonly used on children's cereals. They inferred that cereals with claims were more nutritious overall and might provide specific health-related benefits for their children; and these beliefs predicted greater willingness to buy the cereals. Conclusions These findings indicate that common front-of-package nutrition-related claims are potentially misleading, especially when placed on products with high levels of nutrients to limit (e.g. sugar, sodium) and low levels of other nutrients to encourage (e.g. fibre, protein). Additional regulation is needed to protect consumers in the USA. © 2011 The Authors.

Authors
Harris, JL; Thompson, JM; Schwartz, MB; Brownell, KD
MLA Citation
Harris, JL, Thompson, JM, Schwartz, MB, and Brownell, KD. "Nutrition-related claims on children's cereals: What do they mean to parents and do they influence willingness to buy?." Public Health Nutrition 14.12 (2011): 2207-2212.
PMID
21806872
Source
scival
Published In
Public health nutrition
Volume
14
Issue
12
Publish Date
2011
Start Page
2207
End Page
2212
DOI
10.1017/S1368980011001741

The impact of weight stigma on caloric consumption

The present study assessed the influence of exposure to weight stigma on energy intake in both overweight and normal-weight adult women. Seventy-three women (mean age: 31.71±12.72 years), both overweight (n = 34) and normal weight (n = 39), were randomly assigned to view one of two videos depicting either weight stigmatizing material or neutral material, after which they consumed snacks ad libitum. Pre-and post-video measures included blood pressure, attitudes toward overweight individuals, and positive and negative affect. Participants' body weight was measured, as was the number of kilocalories consumed following video exposure. Overweight women who watched the stigmatizing video ate more than three times as many kilocalories as overweight women who watched the neutral video (302.82 vs. 89.00kcal), and significantly more calories than the normal-weight individuals who watched either the stigmatizing or the neutral video. A two-by-two analysis of covariance revealed that even after adjusting for relevant covariates, there was a significant interaction between video type and weight status in that when overweight, individuals consumed significantly more calories if they were in the stigmatizing condition vs. the neutral condition (F(1,65) = 4.37, P = 0.04, η 2 = 0.03). These findings suggest that among overweight women, exposure to weight stigmatizing material may lead to increased caloric consumption. This directly challenges the notion that pressure to lose weight in the form of weight stigma will have a positive, motivating effect on overweight individuals. © 2011 The Obesity Society.

Authors
Schvey, NA; Puhl, RM; Brownell, KD
MLA Citation
Schvey, NA, Puhl, RM, and Brownell, KD. "The impact of weight stigma on caloric consumption." Obesity 19.10 (2011): 1957-1962.
PMID
21760636
Source
scival
Published In
Obesity (Silver Spring, Md.)
Volume
19
Issue
10
Publish Date
2011
Start Page
1957
End Page
1962
DOI
10.1038/oby.2011.204

Obesity: A public health approach

Authors
Novak, NL; Brownell, KD
MLA Citation
Novak, NL, and Brownell, KD. "Obesity: A public health approach." Psychiatric Clinics of North America 34.4 (2011): 895-909.
PMID
22098812
Source
scival
Published In
Psychiatric Clinics of North America
Volume
34
Issue
4
Publish Date
2011
Start Page
895
End Page
909
DOI
10.1016/j.psc.2011.08.001

The Supplemental Nutrition Assistance Program, Soda, and USDA Policy: Who benefits?

Authors
Brownell, KD; Ludwig, DS
MLA Citation
Brownell, KD, and Ludwig, DS. "The Supplemental Nutrition Assistance Program, Soda, and USDA Policy: Who benefits?." JAMA - Journal of the American Medical Association 306.12 (2011): 1370-1371.
PMID
21954481
Source
scival
Published In
JAMA : the journal of the American Medical Association
Volume
306
Issue
12
Publish Date
2011
Start Page
1370
End Page
1371
DOI
10.1001/jama.2011.1382

The addiction potential of hyperpalatable foods

Scientific interest in "food addiction" continues to grow due both to neurobiological and behavioral similarities between substance dependence and excessive food consumption. An important next step is to examine the addictive potential of highly processed foods. In this paper, we explore addiction-related changes in the modern food environment (e.g., increased potency, elevated speed of absorption), examine the historical and modern understanding of addictive substances as applied to hyperpalatable foods, and outline shared factors that increase the public health costs of both addictive drugs and certain foods. © 2011 Bentham Science Publishers.

Authors
Gearhardt, AN; Davis, C; Kuschner, R; Brownell, KD
MLA Citation
Gearhardt, AN, Davis, C, Kuschner, R, and Brownell, KD. "The addiction potential of hyperpalatable foods." Current Drug Abuse Reviews 4.3 (2011): 140-145.
PMID
21999688
Source
scival
Published In
Current Drug Abuse Reviews
Volume
4
Issue
3
Publish Date
2011
Start Page
140
End Page
145

Neural correlates of food addiction

Context: Research has implicated an addictive process in the development and maintenance of obesity. Although parallels in neural functioning between obesity and substance dependence have been found, to our knowledge, no studies have examined the neural correlates of addictive-like eating behavior. Objective: To test the hypothesis that elevated "food addiction" scores are associated with similar patterns of neural activation as substance dependence. Design: Between-subjects functional magnetic resonance imaging study. Setting: A university neuroimaging center. Participants: Forty-eight healthy young women ranging from lean to obese recruited for a healthy weight maintenance trial. Main Outcome Measure: The relation between elevated food addiction scores and blood oxygen level - dependent functional magnetic resonance imaging activation in response to receipt and anticipated receipt of palatable food (chocolate milkshake). Results: Food addiction scores (N=39) correlated with greater activation in the anterior cingulate cortex, medial orbitofrontal cortex, and amygdala in response to anticipated receipt of food (P<.05, false discovery rate corrected for multiple comparisons in small volumes). Participants with higher (n=15) vs lower (n=11) food addiction scores showed greater activation in the dorsolateral prefrontal cortex and the caudate in response to anticipated receipt of food but less activation in the lateral orbitofrontal cortex in response to receipt of food (false discovery rate-corrected P<.05). Conclusions: Similar patterns of neural activation are implicated in addictive-like eating behavior and substance dependence: elevated activation in reward circuitry in response to food cues and reduced activation of inhibitory regions in response to food intake. ©2011 American Medical Association. All rights reserved.

Authors
Gearhardt, AN; Yokum, S; Orr, PT; Stice, E; Corbin, WR; Brownell, KD
MLA Citation
Gearhardt, AN, Yokum, S, Orr, PT, Stice, E, Corbin, WR, and Brownell, KD. "Neural correlates of food addiction." Archives of General Psychiatry 68.8 (2011): 808-816.
PMID
21464344
Source
scival
Published In
Archives of General Psychiatry
Volume
68
Issue
8
Publish Date
2011
Start Page
808
End Page
816
DOI
10.1001/archgenpsychiatry.2011.32

Mind Over Milkshakes: Mindsets, Not Just Nutrients, Determine Ghrelin Response

Objective: To test whether physiological satiation as measured by the gut peptide ghrelin may vary depending on the mindset in which one approaches consumption of food. Methods: On 2 separate occasions, participants (n = 46) consumed a 380-calorie milkshake under the pretense that it was either a 620-calorie " indulgent" shake or a 140-calorie " sensible" shake. Ghrelin was measured via intravenous blood samples at 3 time points: baseline (20 min), anticipatory (60 min), and postconsumption (90 min). During the first interval (between 20 and 60 min) participants were asked to view and rate the (misleading) label of the shake. During the second interval (between 60 and 90 min) participants were asked to drink and rate the milkshake. Results: The mindset of indulgence produced a dramatically steeper decline in ghrelin after consuming the shake, whereas the mindset of sensibility produced a relatively flat ghrelin response. Participants' satiety was consistent with what they believed they were consuming rather than the actual nutritional value of what they consumed. Conclusions: The effect of food consumption on ghrelin may be psychologically mediated, and mindset meaningfully affects physiological responses to food. © 2011 American Psychological Association.

Authors
Crum, AJ; Corbin, WR; Brownell, KD; Salovey, P
MLA Citation
Crum, AJ, Corbin, WR, Brownell, KD, and Salovey, P. "Mind Over Milkshakes: Mindsets, Not Just Nutrients, Determine Ghrelin Response." Health Psychology 30.4 (2011): 424-429.
PMID
21574706
Source
scival
Published In
Health Psychology
Volume
30
Issue
4
Publish Date
2011
Start Page
424
End Page
429
DOI
10.1037/a0023467

Important next steps in evaluating food's addictive potential

Authors
Gearhardt, AN; Dileone, RJ; Grilo, CM; Brownell, KD; Potenza, MN
MLA Citation
Gearhardt, AN, Dileone, RJ, Grilo, CM, Brownell, KD, and Potenza, MN. "Important next steps in evaluating food's addictive potential." Addiction 106.7 (2011): 1219-1220.
Source
scival
Published In
Addiction
Volume
106
Issue
7
Publish Date
2011
Start Page
1219
End Page
1220
DOI
10.1111/j.1360-0443.2011.03454.x

Can food be addictive? Public health and policy implications

Aims Data suggest that hyperpalatable foods may be capable of triggering an addictive process. Although the addictive potential of foods continues to be debated, important lessons learned in reducing the health and economic consequences of drug addiction may be especially useful in combating food-related problems. Methods In the current paper, we review the potential application of policy and public health approaches that have been effective in reducing the impact of addictive substances to food-related problems. Results Corporate responsibility, public health approaches, environmental change and global efforts all warrant strong consideration in reducing obesity and diet-related disease. Conclusions Although there exist important differences between foods and addictive drugs, ignoring analogous neural and behavioral effects of foods and drugs of abuse may result in increased food-related disease and associated social and economic burdens. Public health interventions that have been effective in reducing the impact of addictive drugs may have a role in targeting obesity and related diseases. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Authors
Gearhardt, AN; Grilo, CM; Dileone, RJ; Brownell, KD; Potenza, MN
MLA Citation
Gearhardt, AN, Grilo, CM, Dileone, RJ, Brownell, KD, and Potenza, MN. "Can food be addictive? Public health and policy implications." Addiction 106.7 (2011): 1208-1212.
PMID
21635588
Source
scival
Published In
Addiction
Volume
106
Issue
7
Publish Date
2011
Start Page
1208
End Page
1212
DOI
10.1111/j.1360-0443.2010.03301.x

Front-of-package nutrition labeling - An abuse of trust by the food industry?

Authors
Brownell, KD; Koplan, JP
MLA Citation
Brownell, KD, and Koplan, JP. "Front-of-package nutrition labeling - An abuse of trust by the food industry?." New England Journal of Medicine 364.25 (2011): 2373-2375.
PMID
21696305
Source
scival
Published In
The New England journal of medicine
Volume
364
Issue
25
Publish Date
2011
Start Page
2373
End Page
2375
DOI
10.1056/NEJMp1101033

Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue

Objective: Beverage taxes came into light with increasing concerns about obesity, particularly among youth. Sugar-sweetened beverages have become a target of anti-obesity initiatives with increasing evidence of their link to obesity. Our paper offers a method for estimating revenues from an excise tax on sugar-sweetened beverages that governments of various levels could direct towards obesity prevention. Model: We construct a model projecting beverage consumption and tax revenues based on best available data on regional beverage consumption, historic trends and recent estimates of the price elasticity of sugar-sweetened beverage demand. Results: The public health impact of beverage taxes could be substantial. An estimated 24% reduction in sugar-sweetened beverage consumption from a penny-per-ounce sugar-sweetened beverage tax could reduce daily per capita caloric intake from sugar-sweetened beverages from the current 190-200. cal to 145-150. cal, if there is no substitution to other caloric beverages or food. A national penny-per-ounce tax on sugar-sweetened beverages could generate new tax revenue of $79 billion over 2010-2015. Conclusion: A modest tax on sugar-sweetened beverages could both raise significant revenues and improve public health by reducing obesity. To the extent that at least some of the tax revenues get invested in obesity prevention programs, the public health benefits could be even more pronounced. © 2011 Elsevier Inc.

Authors
Andreyeva, T; Chaloupka, FJ; Brownell, KD
MLA Citation
Andreyeva, T, Chaloupka, FJ, and Brownell, KD. "Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue." Preventive Medicine 52.6 (2011): 413-416.
PMID
21443899
Source
scival
Published In
Preventive Medicine
Volume
52
Issue
6
Publish Date
2011
Start Page
413
End Page
416
DOI
10.1016/j.ypmed.2011.03.013

Industry response to the obesity threat: Reply

Authors
Koplan, JP; Brownell, K
MLA Citation
Koplan, JP, and Brownell, K. "Industry response to the obesity threat: Reply." JAMA - Journal of the American Medical Association 305.4 (2011): 362--.
Source
scival
Published In
JAMA : the journal of the American Medical Association
Volume
305
Issue
4
Publish Date
2011
Start Page
362-
DOI
10.1001/jama.2011.21

Advancing public health obesity policy through state attorneys general

Obesity in the United States exacts a heavy health and financial toll, requiring new approaches to address this public health crisis. State attorneys general have been underutilized in efforts to formulate and implement food and obesity policy solutions. Their authority lies at the intersection of law and public policy, creating unique opportunities unavailable to other officials and government entities. Attorneys general have a broad range of authority over matters specifically relevant to obesity and nutrition policy, including parens patriae (parent of the country) authority, protecting consumer interests, enacting and supporting rules and regulations, working together across states, engaging in consumer education, and drafting opinions and amicus briefs. Significant room exists for greater attorney general involvement in formulating and championing solutions to public health problems such as obesity.

Authors
Pomeranz, JL; Brownell, KD
MLA Citation
Pomeranz, JL, and Brownell, KD. "Advancing public health obesity policy through state attorneys general." American Journal of Public Health 101.3 (2011): 425-431.
PMID
21233428
Source
scival
Published In
American journal of public health
Volume
101
Issue
3
Publish Date
2011
Start Page
425
End Page
431
DOI
10.2105/AJPH.2010.198697

Effects of serving high-sugar cereals on children's breakfast-eating behavior

OBJECTIVES: To test (1) whether children will consume low-sugar ready-to-eat (RTE) cereals and (2) the effects of serving high- versus low-sugar cereals on the consumption of cereal, refined sugar, fresh fruit, and milk. PARTICIPANTS AND METHODS: Using an experimental design, we randomly assigned children (n = 91) who were attending summer day camp to receive a breakfast that included either the choice of 1 of 3 high-sugar cereals (high-sugar condition) or low-sugar cereals (low-sugar condition), as well as low-fat milk, orange juice, bananas, strawberries, and sugar packets. Participants served themselves and completed a background questionnaire after eating. Researchers measured the amount and calories consumed of each food. RESULTS: In both conditions, children reported "liking" or "loving" the cereal they chose. Children in the low-sugar cereal condition consumed, on average, slightly more than 1 serving of cereal (35 g), whereas children in the high-sugar condition consumed significantly more (61 g) and almost twice the amount of refined sugar in total (24.4 vs 12.5 g). Milk and total calories consumed did not differ significantly between conditions, but children in the low-sugar condition were more likely to put fruit on their cereal (54% vs 8%) and consumed a greater portion of total calories from fresh fruit (20% vs 13%). CONCLUSIONS: Compared with serving low-sugar cereals, high-sugar cereals increase children's total sugar consumption and reduce the overall nutritional quality of their breakfast. Children will consume low-sugar cereals when offered, and they provide a superior breakfast option. Copyright © 2011 by the American Academy of Pediatrics.

Authors
Harris, JL; Schwartz, MB; Ustjanauskas, A; Ohri-Vachaspati, P; Brownell, KD
MLA Citation
Harris, JL, Schwartz, MB, Ustjanauskas, A, Ohri-Vachaspati, P, and Brownell, KD. "Effects of serving high-sugar cereals on children's breakfast-eating behavior." Pediatrics 127.1 (2011): 71-76.
PMID
21149436
Source
scival
Published In
Pediatrics
Volume
127
Issue
1
Publish Date
2011
Start Page
71
End Page
76
DOI
10.1542/peds.2010-0864

Taxation as prevention and as a treatment for obesity: The case of sugar-sweetened beverages

The contemporary American food environment makes energy-dense, nutrient-poor foods and beverages the "default" option for most consumers. Economic interventions like taxes can shift the relative prices of unhealthy foods to nudge consumers towards healthier options. Beverages with added sugar are a good starting point for food taxation; they constitute over 10 percent of caloric intake nationwide and provide little or no nutritional value. Current levels of taxation on sugar-sweetened beverages (SSBs) are too low to affect consumer behavior, but the implementation of a penny-per-ounce excise tax could lead to substantial public health benefits. Current estimates predict that a tax that raised the cost of SSBs by 20 percent could lead to an average reduction of 3.8 pounds per year for adults, causing the prevalence of obesity to decline from 33 to 30 percent. SSB taxes would also generate considerable revenue for public health and obesity prevention programs. Although the beverage industry is fighting such taxes with massive lobbying and public relations campaigns, support for the policies is increasing, especially when revenue is earmarked for obesity prevention. © 2011 Bentham Science Publishers Ltd.

Authors
Novak, NL; Brownell, KD
MLA Citation
Novak, NL, and Brownell, KD. "Taxation as prevention and as a treatment for obesity: The case of sugar-sweetened beverages." Current Pharmaceutical Design 17.12 (2011): 1218-1222.
PMID
21492083
Source
scival
Published In
Current Pharmaceutical Design
Volume
17
Issue
12
Publish Date
2011
Start Page
1218
End Page
1222

The need for courageous action to prevent obesity

© Oxford University Press 2010. All rights reserved. This chapter focuses on three key issues: firstly, the necessity of a shared vision; secondly, whether or not to trust the food industry; and thirdly, what should be done next. In order to move forward, a shared vision is needed of the causes of obesity and a philosophy of prevention. The strategy of trying to increase personal responsibility has not worked. Instead, the focus must be shifted to changing the environment so that it facilitates healthy eating behaviours and physical activity. The next question to be asked is: can the food instustry be trusted? In watching the behaviour of the food industry in recent years, their strategies have become apparent. The chapter describes elements of the food industry 'playbook' and questions the influence of the industry on the government. Finally, it recommends a number of targeted actions. Among these are making policy changes to protect children from commercialism, and creating coalitions with groups concerned about the environment and sustainability. Finally, the chapter also describes a more productive role for the food industry, and ends with example innovations that have succeeded at the local level.

Authors
Schwartz, MB; Brownell, KD
MLA Citation
Schwartz, MB, and Brownell, KD. "The need for courageous action to prevent obesity." (September 9, 2010). (Chapter)
Source
scopus
Publish Date
2010
DOI
10.1093/acprof:oso/9780199571512.003.0025

Stigma and Social Consequences of Obesity

Authors
Puhl, RM; Heuer, CA; Brownell, KD
MLA Citation
Puhl, RM, Heuer, CA, and Brownell, KD. "Stigma and Social Consequences of Obesity." Clinical Obesity in Adults and Children (2010): 25-40.
Source
scival
Published In
Clinical Obesity in Adults and Children
Publish Date
2010
Start Page
25
End Page
40
DOI
10.1002/9781444307627.ch3

An observational study of consumer use of fast-food restaurant drive-through lanes: Implications for menu labelling policy

Objective Some versions of restaurant menu labelling legislation do not require energy information to be posted on menus for drive-through lanes. The present study was designed to quantify the number of customers who purchase fast food through drive-in windows as a means of informing legislative labelling efforts.Design This was an observational study.Setting The study took place at two McDonalds and Burger King restaurants, and single Dairy Queen, Kentucky Fried Chicken, Taco Bell and Wendys restaurants.Subjects The number of customers entering the chain restaurants and purchasing food via the drive-through lane were recorded. A total of 3549 patrons were observed.Results The percentage of customers who made their purchases at drive-throughs was fifty-seven. The overall average (57 %) is likely a conservative estimate because some fast-food restaurants have late-night hours when only the drive-throughs are open.Conclusions Since nearly six in ten customers purchase food via the drive-through lanes, menu labelling legislation should mandate the inclusion of menu labels on drive-through menu boards to maximise the impact of this public health intervention. Copyright © 2010 The Authors.

Authors
Roberto, CA; Hoffnagle, E; Bragg, MA; Brownell, KD
MLA Citation
Roberto, CA, Hoffnagle, E, Bragg, MA, and Brownell, KD. "An observational study of consumer use of fast-food restaurant drive-through lanes: Implications for menu labelling policy." Public Health Nutrition 13.11 (2010): 1826-1828.
PMID
20236561
Source
scival
Published In
Public health nutrition
Volume
13
Issue
11
Publish Date
2010
Start Page
1826
End Page
1828
DOI
10.1017/S136898001000039X

Influence of licensed characters on children's taste and snack preferences

OBJECTIVE: The goal was to study how popular licensed cartoon characters appearing on food packaging affect young children's taste and snack preferences. METHODS: Forty 4- to 6-year-old children tasted 3 pairs of identical foods (graham crackers, gummy fruit snacks, and carrots) presented in packages either with or without a popular cartoon character. Children tasted both food items in each pair and indicated whether the 2 foods tasted the same or one tasted better. Children then selected which of the food items they would prefer to eat for a snack. RESULTS: Children significantly preferred the taste of foods that had popular cartoon characters on the packaging, compared with the same foods without characters. The majority of children selected the food sample with a licensed character on it for their snack, but the effects were weaker for carrots than for gummy fruit snacks and graham crackers. CONCLUSIONS: Branding food packages with licensed characters substantially influences young children's taste preferences and snack selection and does so most strongly for energy-dense, nutrient-poor foods. These findings suggest that the use of licensed characters to advertise junk food to children should be restricted. Copyright © 2010 by the American Academy of Pediatrics.

Authors
Roberto, CA; Baik, J; Harris, JL; Brownell, KD
MLA Citation
Roberto, CA, Baik, J, Harris, JL, and Brownell, KD. "Influence of licensed characters on children's taste and snack preferences." Pediatrics 126.1 (2010): 88-93.
PMID
20566614
Source
scival
Published In
Pediatrics
Volume
126
Issue
1
Publish Date
2010
Start Page
88
End Page
93
DOI
10.1542/peds.2009-3433

The humbling experience of treating obesity: Should we persist or desist?

Obesity has humbled one research group after another. Some of the field's brightest scientists have attempted to subdue obesity by treating it, but now, after decades of work, treatment gains remain small, maintenance is poor, and the field produces effects far below what patients want or expect. This can be explained by strong biological and environmental forces that oppose weight loss and foster regain. Attempts to improve treatment must continue, but with recognition that treatment is a clinical measure and will not affect prevalence (because treatments are too expensive to be used broadly). Policy change and prevention will be necessary to improve public health. © 2010.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "The humbling experience of treating obesity: Should we persist or desist?." Behaviour Research and Therapy 48.8 (2010): 717-719.
PMID
20691330
Source
scival
Published In
Behaviour Research and Therapy
Volume
48
Issue
8
Publish Date
2010
Start Page
717
End Page
719
DOI
10.1016/j.brat.2010.05.018

Response of the food and beverage industry to the obesity threat

Authors
Koplan, JP; Brownell, KD
MLA Citation
Koplan, JP, and Brownell, KD. "Response of the food and beverage industry to the obesity threat." JAMA - Journal of the American Medical Association 304.13 (2010): 1487-1488.
PMID
20924016
Source
scival
Published In
JAMA : the journal of the American Medical Association
Volume
304
Issue
13
Publish Date
2010
Start Page
1487
End Page
1488
DOI
10.1001/jama.2010.1436

Predicting support for restricting food marketing to youth

To address the obesity crisis, public health experts recommend major reductions in the marketing of unhealthy food to youth. However, policies to restrict food marketing are not currently viewed as politically feasible. This paper examines attitudes and knowledge about food marketing and support for restricting unhealthy food marketing among one group of constituents: parents. A survey of 807 parents found that those most likely to support food marketing restrictions were also more likely to have negative views of current food practices. These findings suggest that increased public education about the harm caused by food marketing may increase public support for policy interventions. © 2010 Project HOPE-The People-to-People Health Foundation, Inc.

Authors
Goren, A; Harris, JL; Schwartz, MB; Brownell, KD
MLA Citation
Goren, A, Harris, JL, Schwartz, MB, and Brownell, KD. "Predicting support for restricting food marketing to youth." Health Affairs 29.3 (2010): 419-424.
PMID
20194982
Source
scival
Published In
Health Affairs
Volume
29
Issue
3
Publish Date
2010
Start Page
419
End Page
424
DOI
10.1377/hlthaff.2009.0734

Personal responsibility and obesity: A constructive approach to a controversial issue

The concept of personal responsibility has been central to social, legal, and political approaches to obesity. It evokes language of blame, weakness, and vice and is a leading basis for inadequate government efforts, given the importance of environmental conditions in explaining high rates of obesity. These environmental conditions can override individual physical and psychological regulatory systems that might otherwise stand in the way of weight gain and obesity, hence undermining personal responsibility, narrowing choices, and eroding personal freedoms. Personal responsibility can be embraced as a value by placing priority on legislative and regulatory actions such as improving school nutrition, menu labeling, altering industry marketing practices, and even such controversial measures as the use of food taxes that create healthier defaults, thus supporting responsible behavior and bridging the divide between views based on individualistic versus collective responsibility. © 2010 Project HOPE-The People-to-People Health Foundation, Inc.

Authors
Brownell, KD; Kersh, R; Ludwig, DS; Post, RC; Puhl, RM; Schwartz, MB; Willett, WC
MLA Citation
Brownell, KD, Kersh, R, Ludwig, DS, Post, RC, Puhl, RM, Schwartz, MB, and Willett, WC. "Personal responsibility and obesity: A constructive approach to a controversial issue." Health Affairs 29.3 (2010): 379-387.
PMID
20194976
Source
scival
Published In
Health Affairs
Volume
29
Issue
3
Publish Date
2010
Start Page
379
End Page
387
DOI
10.1377/hlthaff.2009.0739

Evaluating the impact of menu labeling on food choices and intake

Objectives. We assessed the impact of restaurant menu calorie labels on food choices and intake. Methods. Participants in a study dinner (n=303) were randomly assigned to either (1 ) a menu without calorie labels (no calorie labels), (2) a menu with calorie labels (calorie labels), or (3) a menu with calorie labels and a label stating the recommended daily caloric intake for an average adult (calorie labels plus information). Food choices and intake during and after the study dinner were measured. Results. Participants in both calorie label conditions ordered fewer calories than those in the no calorie labels condition. When calorie label conditions were combined, that group consumed 14% fewer calories than the no calorie labels group. Individuals in the calorie labels condition consumed more calories after the study dinner than those in both other conditions. When calories consumed during and after the study dinner were combined, participants in the calorie labels plus information group consumed an average of 250 fewer calories than those In the other groups. Conclusions. Calorie labels on restaurant menus impacted food choices and intake; adding a recommended daily caloric requirement label Increased this effect, suggesting menu label legislation should require such a label. Future research should evaluate menu labeling's impact on children's food choices and consumption.

Authors
Roberto, CA; Larsen, PD; Agnew, H; Baik, J; Brownell, KD
MLA Citation
Roberto, CA, Larsen, PD, Agnew, H, Baik, J, and Brownell, KD. "Evaluating the impact of menu labeling on food choices and intake." American Journal of Public Health 100.2 (2010): 312-318.
PMID
20019307
Source
scival
Published In
American journal of public health
Volume
100
Issue
2
Publish Date
2010
Start Page
312
End Page
318
DOI
10.2105/AJPH.2009.160226

Government intervention and the nation's diet: The slippery slope of inaction

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Government intervention and the nation's diet: The slippery slope of inaction." American Journal of Bioethics 10.3 (2010): 1-2.
PMID
20229400
Source
scival
Published In
American Journal of Bioethics
Volume
10
Issue
3
Publish Date
2010
Start Page
1
End Page
2
DOI
10.1080/15265161003697313

The food industry and self-regulation: Standards to promote success and to avoid public health failures

Threatened by possible government regulation and critical public opinion, industries often undertake self-regulatory actions, issue statements of concern for public welfare, and assert that self-regulation is sufficient to protect the public. The food industry has made highly visible pledges to curtail children's food marketing, sell fewer unhealthy products in schools, and label foods in responsible ways. Ceding regulation to industry carries opportunities but is highly risky. In some industries (e.g., tobacco), self-regulation has been an abject failure, but in others (e.g., forestry and marine fisheries), it has been more successful. We examined food industry self-regulation in the context of other self-regulatory successes and failures and defined 8 standards that should be met if self-regulation is to be effective.

Authors
Sharma, LL; Teret, SP; Brownell, KD
MLA Citation
Sharma, LL, Teret, SP, and Brownell, KD. "The food industry and self-regulation: Standards to promote success and to avoid public health failures." American Journal of Public Health 100.2 (2010): 240-246.
PMID
20019306
Source
scival
Published In
American journal of public health
Volume
100
Issue
2
Publish Date
2010
Start Page
240
End Page
246
DOI
10.2105/AJPH.2009.160960

The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food.

In light of proposals to improve diets by shifting food prices, it is important to understand how price changes affect demand for various foods. We reviewed 160 studies on the price elasticity of demand for major food categories to assess mean elasticities by food category and variations in estimates by study design. Price elasticities for foods and nonalcoholic beverages ranged from 0.27 to 0.81 (absolute values), with food away from home, soft drinks, juice, and meats being most responsive to price changes (0.7-0.8). As an example, a 10% increase in soft drink prices should reduce consumption by 8% to 10%. Studies estimating price effects on substitutions from unhealthy to healthy food and price responsiveness among at-risk populations are particularly needed.

Authors
Andreyeva, T; Long, MW; Brownell, KD
MLA Citation
Andreyeva, T, Long, MW, and Brownell, KD. "The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food." American journal of public health 100.2 (2010): 216-222.
PMID
20019319
Source
scival
Published In
American journal of public health
Volume
100
Issue
2
Publish Date
2010
Start Page
216
End Page
222
DOI
10.2105/AJPH.2008.151415

Marketing foods to children and adolescents: Licensed characters and other promotions on packaged foods in the supermarket

Objective To analyse cross-promotions targeted to children and adolescents on packaging in the supermarket.Design On three occasions from 2006 to 2008, researchers purchased all foods in a large supermarket that included a cross-promotion on the package. A total of 397 products were categorized by promotional partner, food category, targeted age group, promotion type, product nutrition, and company policies on marketing to children.Results The number of products with youth-oriented cross-promotions increased by 78 % during the period examined. Overall, 71 % of cross-promotions involved third-party licensed characters and 57 % appealed primarily to children under 12 years of age; however, the use of other forms of promotions increased from 5 % of the total in 2006 to 53 % in 2008, and promotions targeting pre-school and general audiences increased from 23 % to 54 % of the total. Only 18 % of products met accepted nutrition standards for foods sold to youth, and nutritional quality declined during the period examined. Food manufacturers with policies limiting marketing to children represented 65 % of all youth-oriented cross-promotions, their use of cross-promotions increased significantly, and the nutritional quality of their products did not improve. Some media companies did reduce the use of their properties on food promotions.Conclusions Overall, the supermarket environment worsened due to an increase in cross-promotions targeted to children and adolescents and a decline in the nutritional quality of these products. This analysis failed to find improvements in food marketing to youth and highlights the need to expand current industry self-regulatory pledges. © 2009 The Authors.

Authors
Harris, JL; Schwartz, MB; Brownell, KD
MLA Citation
Harris, JL, Schwartz, MB, and Brownell, KD. "Marketing foods to children and adolescents: Licensed characters and other promotions on packaged foods in the supermarket." Public Health Nutrition 13.3 (2010): 409-417.
PMID
19719889
Source
scival
Published In
Public health nutrition
Volume
13
Issue
3
Publish Date
2010
Start Page
409
End Page
417
DOI
10.1017/S1368980009991339

Breakfast cereal industry pledges to self-regulate advertising to youth: Will they improve the marketing landscape

In 2007, the Council of Better Business Bureaus created the Children's Food and Beverage Advertising Initiative to improve the nutritional profile of products marketed to children in the United States. We provide quantitative baseline data describing (a) the amount of child-directed breakfast cereal advertising in 2007; (b) an assessment of the nutritional value for all cereals advertised on television; and (c) the relationship between nutrition quality and child exposure to television advertising for major cereal brands. In 2007, the average American child viewed 757 cereal ads, and 98 per cent of these ads promoted unhealthy cereals that would be prohibited from advertising to children in the United Kingdom. Healthy cereals were advertised in 2007 in the United States, but adults, not children, were predominantly exposed to these ads. These quantitative methods can be used in the future to evaluate the impact of industry self-regulation efforts to improve the marketing landscape. © 2010 Macmillan Publishers Ltd.

Authors
Schwartz, MB; Ross, C; Harris, JL; Jernigan, DH; Siegel, M; Ostroff, J; Brownell, KD
MLA Citation
Schwartz, MB, Ross, C, Harris, JL, Jernigan, DH, Siegel, M, Ostroff, J, and Brownell, KD. "Breakfast cereal industry pledges to self-regulate advertising to youth: Will they improve the marketing landscape." Journal of Public Health Policy 31.1 (2010): 59-73.
PMID
20200526
Source
scival
Published In
Journal of Public Health Policy
Volume
31
Issue
1
Publish Date
2010
Start Page
59
End Page
73
DOI
10.1057/jphp.2009.50

Considerations for an Obesity Policy Research Agenda

The rise in obesity levels in the U.S. in the past several decades has been dramatic, with serious implications for public health and the economy. Experiences in tobacco control and other public health initiatives have shown that public policy may be a powerful tool to effect structural change to alter population-level behavior. In 2007, the National Cancer Institute convened a meeting to discuss priorities for a research agenda to inform obesity policy. Issues considered were how to define obesity policy research, key challenges and key partners in formulating and implementing an obesity policy research agenda, criteria by which to set research priorities, and specific research needs and questions. Themes that emerged were: (1) the embryonic nature of obesity policy research, (2) the need to study "natural experiments" resulting from policy-based efforts to address the obesity epidemic, (3) the importance of research focused beyond individual-level behavior change, (4) the need for economic research across several relevant policy areas, and (5) the overall urgency of taking action in the policy arena. Moving forward, timely evaluation of natural experiments is of especially high priority. A variety of policies intended to promote healthy weight in children and adults are being implemented in communities and at the state and national levels. Although some of these policies are supported by the findings of intervention research, additional research is needed to evaluate the implementation and quantify the impact of new policies designed to address obesity. © 2009 American Journal of Preventive Medicine.

Authors
McKinnon, RA; Orleans, CT; Kumanyika, SK; Haire-Joshu, D; Krebs-Smith, SM; Finkelstein, EA; Brownell, KD; Thompson, JW; Ballard-Barbash, R
MLA Citation
McKinnon, RA, Orleans, CT, Kumanyika, SK, Haire-Joshu, D, Krebs-Smith, SM, Finkelstein, EA, Brownell, KD, Thompson, JW, and Ballard-Barbash, R. "Considerations for an Obesity Policy Research Agenda." American Journal of Preventive Medicine 36.4 (2009): 351-357.
PMID
19211215
Source
scival
Published In
American Journal of Preventive Medicine
Volume
36
Issue
4
Publish Date
2009
Start Page
351
End Page
357
DOI
10.1016/j.amepre.2008.11.017

The Food Marketing Defense Model: Integrating Psychological Research to Protect Youth and Inform Public Policy

Marketing practices that promote calorie-dense, nutrient-poor foods directly to children and adolescents present significant public health risk. Worldwide, calls for government action and industry change to protect young people from the negative effects of food marketing have increased. Current proposals focus on restricting television advertising to children under 12 years old, but current psychological models suggest that much more is required. All forms of marketing pose considerable risk; adolescents are also highly vulnerable; and food marketing may produce far-reaching negative health outcomes. We propose a food marketing defense model that posits four necessary conditions to effectively counter harmful food marketing practices: awareness, understanding, ability, and motivation to resist. A new generation of psychological research is needed to examine each of these processes, including the psychological mechanisms through which food marketing affects young people, to identify public policy that will effectively protect them from harmful influence. © 2009 The Society for the Psychological Study of Social Issues.

Authors
Harris, JL; Brownell, KD; Bargh, JA
MLA Citation
Harris, JL, Brownell, KD, and Bargh, JA. "The Food Marketing Defense Model: Integrating Psychological Research to Protect Youth and Inform Public Policy." Social Issues and Policy Review 3.1 (2009): 211-271.
Source
scival
Published In
Social Issues and Policy Review
Volume
3
Issue
1
Publish Date
2009
Start Page
211
End Page
271
DOI
10.1111/j.1751-2409.2009.01015.x

The public health and economic benefits of taxing sugar-sweetened beverages

Authors
Brownell, KD; Farley, T; Willett, WC; Popkin, BM; Chaloupka, FJ; Thompson, JW; Ludwig, DS
MLA Citation
Brownell, KD, Farley, T, Willett, WC, Popkin, BM, Chaloupka, FJ, Thompson, JW, and Ludwig, DS. "The public health and economic benefits of taxing sugar-sweetened beverages." New England Journal of Medicine 361.16 (2009): 1599-1605.
PMID
19759377
Source
scival
Published In
The New England journal of medicine
Volume
361
Issue
16
Publish Date
2009
Start Page
1599
End Page
1605
DOI
10.1056/NEJMhpr0905723

Rationale and Evidence for Menu-Labeling Legislation

Menu-labeling legislation is a proposed public health intervention for poor diet and obesity that requires chain restaurants to provide nutrition information on menus and menu boards. The restaurant industry has strongly opposed menu-labeling legislation. Using scientific evidence, this paper counters industry arguments against menu labeling by demonstrating that consumers want chain restaurant nutrition information to be disclosed; the current methods of providing nutrition information are inadequate; the expense of providing nutrition information is minimal; the government has the legal right to mandate disclosure of information; consumers have the right to know nutrition information; a lack of information reduces the efficiency of a market economy; and menu labeling has the potential to make a positive public health impact. © 2009 American Journal of Preventive Medicine.

Authors
Roberto, CA; Schwartz, MB; Brownell, KD
MLA Citation
Roberto, CA, Schwartz, MB, and Brownell, KD. "Rationale and Evidence for Menu-Labeling Legislation." American Journal of Preventive Medicine 37.6 (2009): 546-551.
PMID
19944923
Source
scival
Published In
American Journal of Preventive Medicine
Volume
37
Issue
6
Publish Date
2009
Start Page
546
End Page
551
DOI
10.1016/j.amepre.2009.07.015

The Need for Bold Action to Prevent Adolescent Obesity

Record levels of obesity in children and adolescents are predictable in light of powerful conditions that promote high consumption of calorie-dense, nutrient-poor foods and discourage physical activity. Default conditions for youth are dangerous, and include multiple and relentless forms of marketing, poor foods promoted in schools, and a variety of other conditions that undermine personal resources, individual responsibility, and parental authority. This article discusses how optimal defaults can be created using five issues as examples: framing of the obesity issue, treating versus preventing obesity, nutrition in schools, marketing, and addressing weight bias and discrimination. By adopting a public health approach that addresses the conditions causing obesity, there is hope of reversing troubling trends in prevalence. © 2009 Society for Adolescent Medicine.

Authors
Brownell, KD; Schwartz, MB; Puhl, RM; Henderson, KE; Harris, JL
MLA Citation
Brownell, KD, Schwartz, MB, Puhl, RM, Henderson, KE, and Harris, JL. "The Need for Bold Action to Prevent Adolescent Obesity." Journal of Adolescent Health 45.3 SUPPL. (2009): S8-S17.
PMID
19699441
Source
scival
Published In
Journal of Adolescent Health
Volume
45
Issue
3 SUPPL.
Publish Date
2009
Start Page
S8
End Page
S17
DOI
10.1016/j.jadohealth.2009.03.004

Priming Effects of Television Food Advertising on Eating Behavior

Objective: Health advocates have focused on the prevalence of advertising for calorie-dense low-nutrient foods as a significant contributor to the obesity epidemic. This research tests the hypothesis that exposure to food advertising during TV viewing may also contribute to obesity by triggering automatic snacking of available food. Design: In Experiments 1a and 1b, elementary-school-age children watched a cartoon that contained either food advertising or advertising for other products and received a snack while watching. In Experiment 2, adults watched a TV program that included food advertising that promoted snacking and/or fun product benefits, food advertising that promoted nutrition benefits, or no food advertising. The adults then tasted and evaluated a range of healthy to unhealthy snack foods in an apparently separate experiment. Main Outcome Measures: Amount of snack foods consumed during and after advertising exposure. Results: Children consumed 45% more when exposed to food advertising. Adults consumed more of both healthy and unhealthy snack foods following exposure to snack food advertising compared to the other conditions. In both experiments, food advertising increased consumption of products not in the presented advertisements, and these effects were not related to reported hunger or other conscious influences. Conclusion: These experiments demonstrate the power of food advertising to prime automatic eating behaviors and thus influence far more than brand preference alone. © 2009 American Psychological Association.

Authors
Harris, JL; Bargh, JA; Brownell, KD
MLA Citation
Harris, JL, Bargh, JA, and Brownell, KD. "Priming Effects of Television Food Advertising on Eating Behavior." Health Psychology 28.4 (2009): 404-413.
PMID
19594263
Source
scival
Published In
Health Psychology
Volume
28
Issue
4
Publish Date
2009
Start Page
404
End Page
413
DOI
10.1037/a0014399

Public health action amid scientific uncertainty: The case of restaurant calorie labeling regulations

Authors
Ludwig, DS; Brownell, KD
MLA Citation
Ludwig, DS, and Brownell, KD. "Public health action amid scientific uncertainty: The case of restaurant calorie labeling regulations." JAMA - Journal of the American Medical Association 302.4 (2009): 434-435.
PMID
19622824
Source
scival
Published In
JAMA : the journal of the American Medical Association
Volume
302
Issue
4
Publish Date
2009
Start Page
434
End Page
435
DOI
10.1001/jama.2009.1045

An observational study of consumers' accessing of nutrition information in chain restaurants

In this observational study, we determined how frequently consumers accessed on-premises nutrition information provided at chain restaurants. The number of patrons entering and accessing nutrition information was recorded at 8 locations that were part of 4 major restaurant chains (McDonald's, Burger King, Starbucks, and Au Bon Pain). Only 6 (0.1%) of 4311 patrons accessed on-premises nutrition information before purchasing food. This verysmall percentage suggests that such information should be more prominently displayed, such as on restaurant menu boards, to help customers make informed decisions.

Authors
Roberto, CA; Agnew, H; Brownell, KD
MLA Citation
Roberto, CA, Agnew, H, and Brownell, KD. "An observational study of consumers' accessing of nutrition information in chain restaurants." American Journal of Public Health 99.5 (2009): 820-821.
PMID
19299679
Source
scival
Published In
American journal of public health
Volume
99
Issue
5
Publish Date
2009
Start Page
820
End Page
821
DOI
10.2105/AJPH.2008.136457

Eighty-five per cent of what? Discrepancies in the weight cut-off for anorexia nervosa substantially affect the prevalence of underweight

Background. DSM-IV cites <85% of expected body weight (EBW) as a guideline for the diagnosis of anorexia nervosa (AN) but does not require a specific method for calculating EBW. The purpose of the present study was to determine the degree to which weight cut-off calculations vary across studies, and to evaluate whether differential cut-offs lead to discrepancies in the prevalence of individuals who are eligible for the AN diagnosis. Method. Two coders independently recorded the EBW calculation methods from 99 studies that either (a) compared individuals with AN to those with subclinical eating disorders or (b) conducted AN treatment trials. Each weight cut-off was applied to a nationally representative (n=12001) and treatment-seeking (n=189) sample to determine the impact of EBW calculation on the proportion who met the AN weight criterion. Results. Coders identified 10 different EBW methods, each of which produced different weight cut-offs for the diagnosis of AN. Although only 0.23% of the national sample met the lowest cut-off, this number increased 43-fold to 10.10% under the highest cut-off. Similarly, only 48.1% of treatment seekers met the lowest cut-off, whereas 89.4% met the highest. Conclusions. There is considerable variance across studies in the determination of the AN weight cut-off. Discrepancies substantially affect the proportion of individuals who are eligible for diagnosis, treatment and insurance reimbursement. However, differences may not be fully appreciated because the ubiquitous citation of the 85% criterion creates a sense of false consensus. © Cambridge University Press 2008.

Authors
Thomas, JJ; Roberto, CA; Brownell, KD
MLA Citation
Thomas, JJ, Roberto, CA, and Brownell, KD. "Eighty-five per cent of what? Discrepancies in the weight cut-off for anorexia nervosa substantially affect the prevalence of underweight." Psychological Medicine 39.5 (2009): 833-843.
PMID
18775087
Source
scival
Published In
Psychological Medicine
Volume
39
Issue
5
Publish Date
2009
Start Page
833
End Page
843
DOI
10.1017/S0033291708004327

Ounces of prevention - The public policy case for taxes on sugared beverages

Authors
Brownell, KD; Frieden, TR
MLA Citation
Brownell, KD, and Frieden, TR. "Ounces of prevention - The public policy case for taxes on sugared beverages." New England Journal of Medicine 360.18 (2009): 1805-1808.
PMID
19357400
Source
scival
Published In
The New England journal of medicine
Volume
360
Issue
18
Publish Date
2009
Start Page
1805
End Page
1808
DOI
10.1056/NEJMp0902392

The Relationship Between Eating Disorder Not Otherwise Specified (EDNOS) and Officially Recognized Eating Disorders: Meta-Analysis and Implications for DSM

Eating disorder not otherwise specified (EDNOS) is the most prevalent eating disorder (ED) diagnosis. In this meta-analysis, the authors aimed to inform Diagnostic and Statistical Manual of Mental Disorders revisions by comparing the psychopathology of EDNOS with that of the officially recognized EDs: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). A comprehensive literature search identified 125 eligible studies (published and unpublished) appearing in the literature from 1987 to 2007. Random effects analyses indicated that whereas EDNOS did not differ significantly from AN and BED on eating pathology or general psychopathology, BN exhibited greater eating and general psychopathology than EDNOS. Moderator analyses indicated that EDNOS groups who met all diagnostic criteria for AN except for amenorrhea did not differ significantly from full syndrome cases. Similarly, EDNOS groups who met all criteria for BN or BED except for binge frequency did not differ significantly from full syndrome cases. Results suggest that EDNOS represents a set of disorders associated with substantial psychological and physiological morbidity. Although certain EDNOS subtypes could be incorporated into existing Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) categories, others-such as purging disorder and non-fat-phobic AN-may be best conceptualized as distinct syndromes. © 2009 American Psychological Association.

Authors
Thomas, JJ; Vartanian, LR; Brownell, KD
MLA Citation
Thomas, JJ, Vartanian, LR, and Brownell, KD. "The Relationship Between Eating Disorder Not Otherwise Specified (EDNOS) and Officially Recognized Eating Disorders: Meta-Analysis and Implications for DSM." Psychological Bulletin 135.3 (2009): 407-433.
PMID
19379023
Source
scival
Published In
Psychological Bulletin
Volume
135
Issue
3
Publish Date
2009
Start Page
407
End Page
433
DOI
10.1037/a0015326

Food addiction: An examination of the diagnostic criteria for dependence

The evidence for food's addictive properties is steadily growing. In addition to clinical and evolutionary plausibility, the possibility of addiction to food is supported by animal model research and increasingly by research with humans. Much as classic drugs of abuse "hijack" the brain, accumulating evidence with food suggests a similar impact, but with weaker effects. Although neu-robiological evidence for food addiction is compelling, dependence as conceptualized with respect to alcohol and other drugs of abuse is fundamentally a behavioral disorder. Thus, we review the current state of food addiction research in the context of each of the diagnostic criterion for dependence (ie, tolerance, withdrawal, loss of control) and briefly explore other relevant addiction topics such as expectancies, reinforcement, and incentive salience. There is substantial evidence that some people lose control over their food consumption, suffer from repeated failed attempts to reduce their intake, and are unable to abstain from certain types of food or reduce consumption in the face of negative consequences. Although there is some evidence for other dependence criterion, further research is needed to examine tolerance and withdrawal to high-fat sweets, time spent in obtaining, using, and recovering from excess food consumption and the degree to which important activities are given up due to overconsumption. As science continues forward and both the public and elected leaders become aware that food may trigger an addictive process, this information will likely be used to inform policy. Thus, researchers need to carefully consider the implications of their work and the way in which the results may be interpreted.Copyright © 2009 American Society of Addiction Medicine.

Authors
Gearhardt, AN; Corbin, WR; Brownell, KD
MLA Citation
Gearhardt, AN, Corbin, WR, and Brownell, KD. "Food addiction: An examination of the diagnostic criteria for dependence." Journal of Addiction Medicine 3.1 (2009): 1-7.
Source
scival
Published In
Journal of Addiction Medicine
Volume
3
Issue
1
Publish Date
2009
Start Page
1
End Page
7
DOI
10.1097/ADM.0b013e318193c993

Innovative legal approaches to address obesity

Context: The law is a powerful public health tool with considerable potential to address the obesity issue. Scientific advances, gaps in the current regulatory environment, and new ways of conceptualizing rights and responsibilities offer a foundation for legal innovation. Methods: This article connects developments in public health and nutrition with legal advances to define promising avenues for preventing obesity through the application of the law. Findings: Two sets of approaches are defined: (1) direct application of the law to factors known to contribute to obesity and (2) original and innovative legal solutions that address the weak regulatory stance of government and the ineffectiveness of existing policies used to control obesity. Specific legal strategies are discussed for limiting children's food marketing, confronting the potential addictive properties of food, compelling industry speech, increasing government speech, regulating conduct, using tort litigation, applying nuisance law as a litigation strategy, and considering performance-based regulation as an alternative to typical regulatory actions. Finally, preemption is an overriding issue and can play both a facilitative and a hindering role in obesity policy. Conclusions: Legal solutions are immediately available to the government to address obesity and should be considered at the federal, state, and local levels. New and innovative legal solutions represent opportunities to take the law in creative directions and to link legal, nutrition, and public health communities in constructive ways. © 2009 Milbank Memorial Fund.

Authors
Pomeranz, JL; Teret, SP; Sugarman, SD; Rutkow, L; Brownell, KD
MLA Citation
Pomeranz, JL, Teret, SP, Sugarman, SD, Rutkow, L, and Brownell, KD. "Innovative legal approaches to address obesity." Milbank Quarterly 87.1 (2009): 185-213.
PMID
19298420
Source
scival
Published In
The Milbank Quarterly
Volume
87
Issue
1
Publish Date
2009
Start Page
185
End Page
213
DOI
10.1111/j.1468-0009.2009.00552.x

The perils of ignoring history: Big tobacco played dirty and millions died. how similar is big food

Context: In 1954 the tobacco industry paid to publish the "Frank Statement to Cigarette Smokers" in hundreds of U.S. newspapers. It stated that the public's health was the industry's concern above all others and promised a variety of good-faith changes. What followed were decades of deceit and actions that cost millions of lives. In the hope that the food history will be written differently, this article both highlights important lessons that can be learned from the tobacco experience and recommends actions for the food industry. Methods: A review and analysis of empirical and historical evidence pertaining to tobacco and food industry practices, messages, and strategies to influence public opinion, legislation and regulation, litigation, and the conduct of science. Findings: The tobacco industry had a playbook, a script, that emphasized personal responsibility, paying scientists who delivered research that instilled doubt, criticizing the "junk" science that found harms associated with smoking, making self-regulatory pledges, lobbying with massive resources to stifle government action, introducing "safer" products, and simultaneously manipulating and denying both the addictive nature of their products and their marketing to children. The script of the food industry is both similar to and different from the tobacco industry script. Conclusions: Food is obviously different from tobacco, and the food industry differs from tobacco companies in important ways, but there also are significant similarities in the actions that these industries have taken in response to concern that their products cause harm. Because obesity is now a major global problem, the world cannot afford a repeat of the tobacco history, in which industry talks about the moral high ground but does not occupy it. © 2009 Milbank Memorial Fund.

Authors
Brownell, KD; Warner, KE
MLA Citation
Brownell, KD, and Warner, KE. "The perils of ignoring history: Big tobacco played dirty and millions died. how similar is big food." Milbank Quarterly 87.1 (2009): 259-294.
PMID
19298423
Source
scival
Published In
The Milbank Quarterly
Volume
87
Issue
1
Publish Date
2009
Start Page
259
End Page
294
DOI
10.1111/j.1468-0009.2009.00555.x

Obesity metaphors: How beliefs about the causes of obesity affect support for public policy

Context: Relatively little is known about the factors shaping public attitudes toward obesity as a policy concern. This study examines whether individuals' beliefs about the causes of obesity affect their support for policies aimed at stemming obesity rates. This article identifies a unique role of metaphor-based beliefs, as distinct from conventional political attitudes, in explaining support for obesity policies. Methods: This article used the Yale Rudd Center Public Opinion on Obesity Survey, a nationally representative web sample surveyed from the Knowledge Networks panel in 2006/07 (N = 1,009). The study examines how respondents' demographic and health characteristics, political attitudes, and agreement with seven obesity metaphors affect support for sixteen policies to reduce obesity rates. Findings: Including obesity metaphors in regression models helps explain public support for policies to curb obesity beyond levels attributable solely to demographic, health, and political characteristics. The metaphors that people use to understand rising obesity rates are strong predictors of support for public policy, and their influence varies across different types of policy interventions. Conclusions: Over the last five years, the United States has begun to grapple with the implications of dramatically escalating rates of obesity. Individuals use metaphors to better understand increasing rates of obesity, and obesity metaphors are independent and powerful predictors of support for public policies to curb obesity. Metaphorical reasoning also offers a potential framework for using strategic issue framing to shift support for obesity policies. © 2009 Milbank Memorial Fund.

Authors
Barry, CL; Brescoll, VL; Brownell, KD; Schlesinger, M
MLA Citation
Barry, CL, Brescoll, VL, Brownell, KD, and Schlesinger, M. "Obesity metaphors: How beliefs about the causes of obesity affect support for public policy." Milbank Quarterly 87.1 (2009): 7-47.
PMID
19298414
Source
scival
Published In
The Milbank Quarterly
Volume
87
Issue
1
Publish Date
2009
Start Page
7
End Page
47
DOI
10.1111/j.1468-0009.2009.00546.x

A crisis in the marketplace: How food marketing contributes to childhood obesity and what can be done

Reducing food marketing to children has been proposed as one means for addressing the global crisis of childhood obesity, but significant social, legal, financial, and public perception barriers stand in the way. The scientific literature documents that food marketing to children is (a) massive; (b) expanding in number of venues (product placements, video games, the Internet, cell phones, etc.); (c) composed almost entirely of messages for nutrient-poor, calorie-dense foods; (d ) having harmful effects; and (e) increasingly global and hence difficult to regulate by individual countries. The food industry, governmental bodies, and advocacy groups have proposed a variety of plans for altering the marketing landscape. This article reviews existing knowledge of the impact of marketing and addresses the value of various legal, legislative, regulatory, and industry-based approaches to change. Copyright © 2009 by Annual Reviews. All rights reserved.

Authors
Harris, JL; Pomeranz, JL; Lobstein, T; Brownell, KD
MLA Citation
Harris, JL, Pomeranz, JL, Lobstein, T, and Brownell, KD. "A crisis in the marketplace: How food marketing contributes to childhood obesity and what can be done." Annual Review of Public Health 30 (2009): 211-225.
PMID
18976142
Source
scival
Published In
Annual Review of Public Health
Volume
30
Publish Date
2009
Start Page
211
End Page
225
DOI
10.1146/annurev.publhealth.031308.100304

MarketWatch: Availability and prices of foods across stores and neighborhoods: The case of New Haven, Connecticut

Two studies compared food availability and prices in large and small stores across neighborhoods of varying income levels in New Haven, Connecticut. The findings suggest that supermarket access in lower-income neighborhoods has improved since 1971, and average food prices are comparable across income areas. Despite this progress, stores in lower-income neighborhoods (compared to those in higher-income neighborhoods) stock fewer healthier varieties of foods and have fresh produce of much lower quality. Policies are needed not only to improve access to supermarkets, but also to ensure that stores in lower-income neighborhoods provide high-quality produce and healthier versions of popular foods. ©2008 Project HOPE-The People-to-People Health Foundation, Inc.

Authors
Andreyeva, T; Blumenthal, DM; Schwartz, MB; Long, MW; Brownell, KD
MLA Citation
Andreyeva, T, Blumenthal, DM, Schwartz, MB, Long, MW, and Brownell, KD. "MarketWatch: Availability and prices of foods across stores and neighborhoods: The case of New Haven, Connecticut." Health Affairs 27.5 (2008): 1381-1388.
PMID
18780928
Source
scival
Published In
Health Affairs
Volume
27
Issue
5
Publish Date
2008
Start Page
1381
End Page
1388
DOI
10.1377/hlthaff.27.5.1381

Authors' Response

Authors
Schwartz, MB; Vartanian, LR; Wharton, CR; Brownell, KD
MLA Citation
Schwartz, MB, Vartanian, LR, Wharton, CR, and Brownell, KD. "Authors' Response." Journal of the American Dietetic Association 108.10 (2008): 1619-1620.
Source
scival
Published In
Journal of the American Dietetic Association
Volume
108
Issue
10
Publish Date
2008
Start Page
1619
End Page
1620
DOI
10.1016/j.jada.2008.08.032

The Sydney Principles' for reducing the commercial promotion of foods and beverages to children

A set of seven principles (the 'Sydney Principles') was developed by an International Obesity Taskforce (IOTF) Working Group to guide action on changing food and beverage marketing practices that target children. The aim of the present communication is to present the Sydney Principles and report on feedback received from a global consultation (November 2006 to April 2007) on the Principles. The Principles state that actions to reduce marketing to children should: (i) support the rights of children; (ii) afford substantial protection to children; (iii) be statutory in nature; (iv) take a wide definition of commercial promotions; (v) guarantee commercial-free childhood settings; (vi) include cross-border media; and (vii) be evaluated, monitored and enforced. The draft principles were widely disseminated and 220 responses were received from professional and scientific associations, consumer bodies, industry bodies, health professionals and others. There was virtually universal agreement on the need to have a set of principles to guide action in this contentious area of marketing to children. Apart from industry opposition to the third principle calling for a statutory approach and several comments about the implementation challenges, there was strong support for each of the Sydney Principles. Feedback on two specific issues of contention related to the age range to which restrictions should apply (most nominating age 16 or 18 years) and the types of products to be included (31 % nominating all products, 24 % all food and beverages, and 45 % energy-dense, nutrient-poor foods and beverages). The Sydney Principles, which took a children's rights-based approach, should be used to benchmark action to reduce marketing to children. The age definition for a child and the types of products which should have marketing restrictions may better suit a risk-based approach at this stage. The Sydney Principles should guide the formation of an International Code on Food and Beverage Marketing to Children. © The Authors 2008.

Authors
Swinburn, B; Sacks, G; Lobstein, T; Rigby, N; Baur, LA; Brownell, KD; Gill, T; Seidell, J; Kumanyika, S
MLA Citation
Swinburn, B, Sacks, G, Lobstein, T, Rigby, N, Baur, LA, Brownell, KD, Gill, T, Seidell, J, and Kumanyika, S. "The Sydney Principles' for reducing the commercial promotion of foods and beverages to children." Public Health Nutrition 11.9 (2008): 881-886.
PMID
18510788
Source
scival
Published In
Public health nutrition
Volume
11
Issue
9
Publish Date
2008
Start Page
881
End Page
886
DOI
10.1017/S136898000800284X

Legal and public health considerations affecting the success, reach, and impact of menu-labeling laws

Because the rate of consumption of away-from-home meals has increased dramatically, the distinction between requiring nutrition information for packaged but not restaurant products is no longer reasonable. Public health necessitates that nutrition labels must be included with restaurant menus as a strategy to educate consumers and address the escalation of obesity.Menu- labeling laws are being considered at the local, state, and federal levels, but the restaurant industry opposes such action. We discuss the public health rationale and set forth the government's legal authority for the enactment of menu-labeling laws. We further aim to educate the public health community of the potential legal challenges to such laws, and we set forth methods for governments to survive these challenges by drafting laws according to current legal standards.

Authors
Pomeranz, JL; Brownell, KD
MLA Citation
Pomeranz, JL, and Brownell, KD. "Legal and public health considerations affecting the success, reach, and impact of menu-labeling laws." American Journal of Public Health 98.9 (2008): 1578-1583.
PMID
18633081
Source
scival
Published In
American journal of public health
Volume
98
Issue
9
Publish Date
2008
Start Page
1578
End Page
1583
DOI
10.2105/AJPH.2007.128488

Perceptions of weight discrimination: Prevalence and comparison to race and gender discrimination in America

Objective: Limited data are available on the prevalence and patterns of body weight discrimination from representative samples. This study examined experiences of weight/height discrimination in a nationally representative sample of US adults and compared their prevalence and patterns with discrimination experiences based on race and gender. Method and procedures: Data were from the National Survey of Midlife Development in the United States, a 1995-1996 community-based survey of English-speaking adults aged 25-74 (N=2290). Reported experiences of weight/height discrimination included a variety of institutional settings and interpersonal relationships. Multivariate regression analyses were used to predict weight/height discrimination controlling for sociodemographic characteristics and body weight status. Results: The prevalence of weight/height discrimination ranged from 5% among men to 10% among women, but these average percentages obscure the much higher risk of weight discrimination among heavier individuals (40% for adults with body mass index (BMI) of 35 and above). Younger individuals with a higher BMI had a particularly high risk of weight/height discrimination regardless of their race, education and weight status. Women were at greater risk for weight/height discrimination than men, especially women with a BMI of 30-35 who were three times more likely to report weight/height discrimination compared to male peers of a similar weight. Discussion: Weight/height discrimination is prevalent in American society and is relatively close to reported rates of racial discrimination, particularly among women. Both institutional forms of weight/height discrimination (for example, in employment settings) and interpersonal mistreatment due to weight/height (for example, being called names) were common, and in some cases were even more prevalent than discrimination due to gender and race. © 2008 Nature Publishing Group All rights reserved.

Authors
Puhl, RM; Andreyeva, T; Brownell, KD
MLA Citation
Puhl, RM, Andreyeva, T, and Brownell, KD. "Perceptions of weight discrimination: Prevalence and comparison to race and gender discrimination in America." International Journal of Obesity 32.6 (2008): 992-1000.
PMID
18317471
Source
scival
Published In
International Journal of Obesity
Volume
32
Issue
6
Publish Date
2008
Start Page
992
End Page
1000
DOI
10.1038/ijo.2008.22

Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006

Objective: Little is known about the prevalence and patterns of weight discrimination in the United States. This study examined the trends in perceived weight/height discrimination among a nationally representative sample of adults aged 35-74 years, comparing experiences of discrimination based on race, age, and gender. Methods and Procedures: Data were from the two waves of the National Survey of Midlife Developmentin the United States (MIDUS), a survey of community-based English-speaking adults initially in 1995-1996 and a follow-up in 2004- 2006. Reported experiences of weight/height discrimination included a variety of settings in major lifetime events and interpersonal relationships. Results: The prevalence of weight/height discrimination increased from 7% in 1995-1996 to 12% in 2004-2006, affecting all population groups but the elderly. This growth is unlikely to be explained by changes in obesity rates. Discussion: Weight/height discrimination is highly prevalent in American society and increasing at disturbing rates. Its prevalence is relatively close to reported rates of race and age discrimination, but virtually no legal or social sanctions against weight discrimination exist. © 2008 The Obesity Society.

Authors
Andreyeva, T; Puhl, RM; Brownell, KD
MLA Citation
Andreyeva, T, Puhl, RM, and Brownell, KD. "Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006." Obesity 16.5 (2008): 1129-1134.
PMID
18356847
Source
scival
Published In
Obesity (Silver Spring, Md.)
Volume
16
Issue
5
Publish Date
2008
Start Page
1129
End Page
1134
DOI
10.1038/oby.2008.35

Cognitive Processing About Classroom-Relevant Contexts: Teachers' Attention to and Utilization of Girls' Body Size, Ethnicity, Attractiveness, and Facial Affect

This study examines 2 aspects of cognitive processing in person perception-attention and decision making-in classroom-relevant contexts. Teachers completed 2 implicit, performance-based tasks that characterized attention to and utilization of 4 student characteristics of interest: ethnicity, facial affect, body size, and attractiveness. Stimuli were 24 full-body photos of girls that varied along the dimensions of interest. Teachers completed a similarity-ratings task and 4 preference-ratings tasks. Results showed that teachers attended to ethnicity and body size but did not utilize this information when selecting students across contexts. In contrast, teachers relied heavily on affect and attractiveness when making decisions. These results suggest that further investigating cognitive processing in person perception is important in understanding how teachers attend to and use multiple salient student attributes in real-world contexts. This study also illustrates the potential utility of adopting a method that places a premium on internal validity to investigate questions relevant to educational researchers. Future work should investigate how other student information, such as student background or personality, affects teachers' cognitive processing in different classroom-relevant contexts. © 2008 American Psychological Association.

Authors
Wang, SS; Treat, TA; Brownell, KD
MLA Citation
Wang, SS, Treat, TA, and Brownell, KD. "Cognitive Processing About Classroom-Relevant Contexts: Teachers' Attention to and Utilization of Girls' Body Size, Ethnicity, Attractiveness, and Facial Affect." Journal of Educational Psychology 100.2 (2008): 473-489.
Source
scival
Published In
Journal of Educational Psychology
Volume
100
Issue
2
Publish Date
2008
Start Page
473
End Page
489
DOI
10.1037/0022-0663.100.2.473

Toward optimal health: The influence of the environment on obesity

Authors
Godfrey, JR; Brownell, K
MLA Citation
Godfrey, JR, and Brownell, K. "Toward optimal health: The influence of the environment on obesity." Journal of Women's Health 17.3 (2008): 325-330.
PMID
18328015
Source
scival
Published In
Journal of Women's Health
Volume
17
Issue
3
Publish Date
2008
Start Page
325
End Page
330
DOI
10.1089/jwh.2007.0776

Examining the Nutritional Quality of Breakfast Cereals Marketed to Children

There are both public health and food industry initiatives aimed at increasing breakfast consumption among children, particularly the consumption of ready-to-eat cereals. The purpose of this study was to determine whether there were identifiable differences in nutritional quality between cereals that are primarily marketed to children and cereals that are not marketed to children. Of the 161 cereals identified between January and February 2006, 46% were classified as being marketed to children (eg, packaging contained a licensed character or contained an activity directed at children). Multivariate analyses of variance were used to compare children's cereals and nonchildren's cereals with respect to their nutritional content, focusing on nutrients required to be reported on the Nutrition Facts panel (including energy). Compared to nonchildren's cereals, children's cereals were denser in energy, sugar, and sodium, but were less dense in fiber and protein. The proportion of children's and nonchildren's cereals that did and did not meet national nutritional guidelines for foods served in schools were compared using χ2analysis. The majority of children's cereals (66%) failed to meet national nutrition standards, particularly with respect to sugar content. t tests were used to compare the nutritional quality of children's cereals with nutrient-content claims and health claims to those without such claims. Although the specific claims were generally justified by the nutritional content of the product, there were few differences with respect to the overall nutrition profile. Overall, there were important differences in nutritional quality between children's cereals and nonchildren's cereals. Dietary advice for children to increase consumption of ready-to-eat breakfast cereals should identify and recommend those cereals with the best nutrient profiles. © 2008 American Dietetic Association.

Authors
Schwartz, MB; Vartanian, LR; Wharton, CM; Brownell, KD
MLA Citation
Schwartz, MB, Vartanian, LR, Wharton, CM, and Brownell, KD. "Examining the Nutritional Quality of Breakfast Cereals Marketed to Children." Journal of the American Dietetic Association 108.4 (2008): 702-705.
PMID
18375229
Source
scival
Published In
Journal of the American Dietetic Association
Volume
108
Issue
4
Publish Date
2008
Start Page
702
End Page
705
DOI
10.1016/j.jada.2008.01.003

Weight stigmatization and bias reduction: Perspectives of overweight and obese adults

This study employed qualitative methods with a sample of overweight and obese adults to identify and describe their subjective experiences of weight bias. Participants (274 females and 44 males) completed an online battery of self-report questionnaires, including several open-ended questions about weight stigmatization. These questions asked them to describe their worst experiences of weight stigmatization, their perceptions of common weight-based stereotypes, their feelings about being overweight and their suggestions for strategies to reduce weight stigma in our culture. Participants reported experiencing weight stigma across a range of contexts and involving a variety of interpersonal sources. Close relationship partners (such as friends, parents and spouses) were the most common source of their worst stigmatizing encounters. Participants challenged common weight-based stereotypes (notably, that obese individuals are 'lazy') and reported that they would like the public to gain a better understanding of the difficulties of weight loss, the causes of obesity and the emotional consequences of being stigmatized. Education was reported as the most promising avenue for future stigma-reduction efforts. The experiences and opinions expressed were not significantly different for men versus women or overweight versus obese individuals. A minority of participants expressed beliefs suggestive of self-blame and internalization of weight-based stereotypes. These results indicate that while obese individuals experience weight bias across many domains, more stigma-reduction efforts should target stigmatizing encounters in close relationships, including parents, spouses and friends of obese persons. © The Author 2007. Published by Oxford University Press. All rights reserved.

Authors
Puhl, RM; Moss-Racusin, CA; Schwartz, MB; Brownell, KD
MLA Citation
Puhl, RM, Moss-Racusin, CA, Schwartz, MB, and Brownell, KD. "Weight stigmatization and bias reduction: Perspectives of overweight and obese adults." Health Education Research 23.2 (2008): 347-358.
PMID
17884836
Source
scival
Published In
Health Education Research
Volume
23
Issue
2
Publish Date
2008
Start Page
347
End Page
358
DOI
10.1093/her/cym052

Assessing the feasibility and impact of federal childhood obesity policies

Research on childhood obesity has primarily been conducted by experts in nutrition, psychology, and medicine. Only recently have public policy scholars devoted serious work to this burgeoning public health crisis. Here the authors advance that research by surveying national experts in health/nutrition and health policy on the public health impact and the political feasibility of fifty-one federal policy options for addressing childhood obesity. Policies that were viewed as politically infeasible but having a great impact on childhood obesity emphasized outright bans on certain activities. In contrast, education and information dissemination policies were viewed as having the potential to receive a favorable hearing from national policy makers but little potential public health impact. Both nutrition and policy experts believed that increasing funding for research would be beneficial and politically feasible. A central need for the field is to develop the means to make high-impact policies more politically feasible.

Authors
Brescoll, VL; Kersh, R; Brownell, KD
MLA Citation
Brescoll, VL, Kersh, R, and Brownell, KD. "Assessing the feasibility and impact of federal childhood obesity policies." Annals of the American Academy of Political and Social Science 615.1 (2008): 178-194.
Source
scival
Published In
Annals of the American Academy of Political and Social Science
Volume
615
Issue
1
Publish Date
2008
Start Page
178
End Page
194
DOI
10.1177/0002716207309189

Effects of soft drink consumption on nutrition and health: A systematic review and meta-analysis

In a meta-analysis of 88 studies, we examined the association between soft drink consumption and nutrition and health outcomes. We found clear associations of soft drink intake with increased energy intake and body weight. Soft drink intake also was associated with lower intakes of milk, calcium, and other nutrients and with an increased risk of several medical problems (e.g., diabetes). Study design significantly influenced results: larger effect sizes were observed in studies with stronger methods (longitudinal and experimental vs cross-sectional studies). Several other factors also moderated effect sizes (e.g., gender, age, beverage type). Finally, studies funded by the food industry reported significantly smaller effects than did non-industry-funded studies. Recommendations to reduce population soft drink consumption are strongly supported by the available science.

Authors
Vartanian, LR; Schwartz, MB; Brownell, KD
MLA Citation
Vartanian, LR, Schwartz, MB, and Brownell, KD. "Effects of soft drink consumption on nutrition and health: A systematic review and meta-analysis." American Journal of Public Health 97.4 (2007): 667-675.
PMID
17329656
Source
scival
Published In
American journal of public health
Volume
97
Issue
4
Publish Date
2007
Start Page
667
End Page
675
DOI
10.2105/AJPH.2005.083782

A pilot study of a weight management program with food provision in schizophrenia

Obesity is a serious medical problem that disproportionately affects people with severe mental illness. Behavioral strategies aimed at lifestyle modification have proven effective for weight loss in general population but have not been studied adequately among persons with schizophrenia. We have conducted a randomized controlled pilot trial of an established weight loss program, modified for this specific population, and supplemented with a novel food replacement program, as well as practical, community based teaching of shopping and preparing healthy food. The program not only arrested weight gain, and produced meaningful weight loss, but also weight loss continued 6 months after the intervention is completed. Cognitive impairment had no bearing to the extent a participant benefited from the program. As a conclusion, well designed simple behavioral programs can produce lasting weight loss for patients with schizophrenia and comorbid obesity, improve metabolic indices, and possibly decrease significant medical risks associated with obesity. © 2007.

Authors
Jean-Baptiste, M; Tek, C; Liskov, E; Chakunta, UR; Nicholls, S; Hassan, AQ; Brownell, KD; Wexler, BE
MLA Citation
Jean-Baptiste, M, Tek, C, Liskov, E, Chakunta, UR, Nicholls, S, Hassan, AQ, Brownell, KD, and Wexler, BE. "A pilot study of a weight management program with food provision in schizophrenia." Schizophrenia Research 96.1-3 (2007): 198-205.
PMID
17628437
Source
scival
Published In
Schizophrenia Research
Volume
96
Issue
1-3
Publish Date
2007
Start Page
198
End Page
205
DOI
10.1016/j.schres.2007.05.022

Actions necessary to prevent childhood obesity: Creating the climate for change

Childhood obesity has become a public health epidemic, and currently a battle exists over how to frame and address this problem. This paper explores how public policy approaches can be employed to address obesity. We present the argument that obesity should be viewed as the consequence of a "toxic environment" rather than the result of the population failing to take enough "personal responsibility." In order to make progress in decreasing the prevalence of obesity, we must shift our view of obesity away from the medical model (which focuses on the individual)to a public health model (which focuses on the population). At the same time, we must be sensitive to the problem of weight bias.Potential obstacles to taking a public policy approach are identified, as well as suggestions on how to overcome them. © 2007 American Society of Law, Medicine & Ethics, Inc.

Authors
Schwartz, MB; Brownell, KD
MLA Citation
Schwartz, MB, and Brownell, KD. "Actions necessary to prevent childhood obesity: Creating the climate for change." Journal of Law, Medicine and Ethics 35.1 (2007): 78-89.
PMID
17341218
Source
scival
Published In
The Journal of Law, Medicine & Ethics
Volume
35
Issue
1
Publish Date
2007
Start Page
78
End Page
89
DOI
10.1111/j.1748-720X.2007.00114.x

Conference coverage: Selected presentations from the Annual Scientific Meeeting of NAASO-The Obesity Society; October 20-24, 2006: Boston, Massachusetts

Authors
McDermott, AY; Shah, A; Brownell, K; Berkowitz, R; Inge, TH; Klein, S; Apovian, C; Goran, MI; Butte, NF; Messier, SP; Kirschenbaum, D; Rosenbaum, M; Hill, JO
MLA Citation
McDermott, AY, Shah, A, Brownell, K, Berkowitz, R, Inge, TH, Klein, S, Apovian, C, Goran, MI, Butte, NF, Messier, SP, Kirschenbaum, D, Rosenbaum, M, and Hill, JO. "Conference coverage: Selected presentations from the Annual Scientific Meeeting of NAASO-The Obesity Society; October 20-24, 2006: Boston, Massachusetts." MedGenMed Medscape General Medicine 9.3 (2007).
Source
scival
Published In
MedGenMed : Medscape general medicine
Volume
9
Issue
3
Publish Date
2007

Confronting and coping with weight stigma: An investigation of overweight and obese adults

Objective: This study examined experiences of weight stigmatization, sources of stigma, coping strategies, psychological functioning, and eating behaviors in a sample of 2671 overweight and obese adults. Research Methods and Procedures: The total sample was partitioned into two subsamples for investigation. Sample I was comprised of 2449 adult women, and Sample II was a matched sample of adult men and women (N = 222) that was disaggregated to investigate gender differences. Both samples completed an online battery of self-report questionnaires measuring frequency of weight stigmatization and coping responses to deal with bias, the most common sources of the bias, symptoms of depression, self-esteem, attitudes about weight and obesity, and binge eating behaviors. Results: Experiences of weight stigmatization, in many forms and across multiple occasions, was common in both samples. A variety of coping strategies were used in response. More frequent exposure to stigma was related to more attempts to cope and higher BMI. Physicians and family members were the most frequent sources of weight bias reported. No gender differences were observed in types or frequency of stigmatization. Frequency of stigmatization was not related to current psychological functioning, although coping responses were associated with emotional well-being. Discussion: These findings raise questions about the relationship between stigma and psychological functioning and have important implications for obesity treatment and stigma reduction intervention efforts, both of which are discussed. Copyright © 2006 NAASO.

Authors
Puhl, RM; Brownell, KD
MLA Citation
Puhl, RM, and Brownell, KD. "Confronting and coping with weight stigma: An investigation of overweight and obese adults." Obesity 14.10 (2006): 1802-1815.
PMID
17062811
Source
scival
Published In
Obesity (Silver Spring, Md.)
Volume
14
Issue
10
Publish Date
2006
Start Page
1802
End Page
1815
DOI
10.1038/oby.2006.208

Lessons from a small country about the global obesity crisis

Developed countries had high obesity rates before the problem was taken seriously and hence the genesis must be seen in retrospect. Developing countries offer a clear view of causal factors but also opportunities for prevention, which must focus on both food and physical activity environments. © 2006 Brownell and Yach; licensee BioMed Central Ltd.

Authors
Brownell, KD; Yach, D
MLA Citation
Brownell, KD, and Yach, D. "Lessons from a small country about the global obesity crisis." Globalization and Health 2 (2006).
Source
scival
Published In
Globalization and Health
Volume
2
Publish Date
2006
DOI
10.1186/1744-8603-2-11

Evaluating the effects of eating disorder memoirs on readers' eating attitudes and behaviors

Objective: More than 50 individuals have published eating disorder (ED) memoirs. The current study was the first to test whether memoirs affect readers' eating attitudes and behaviors, and whether they normalize and/or glamorize EDs. Method: Fifty female undergraduates read an ED or control memoir. Before and afterward, participants completed the 26-item Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI) Drive for Thinness subscale, a measure of perceived ED symptom prevalence, and an Implicit Association Test (IAT) measuring associations between anorexia and glamour/danger. Results: Participants in the ED condition did not demonstrate significant changes in the EAT-26, the EDI Drive for Thinness subscale, perceived symptom prevalence, or IAT associations compared with controls. Before reading, the EAT-26 and EDI Drive for Thinness subscale correlated positively with perceived symptom prevalence and strength of the IAT association between anorexia and glamour. Conclusion: ED memoirs appear to have little effect on undergraduates' eating attitudes and behaviors. Future research should investigate whether memoirs affect individuals with preexisting eating pathology, who may normalize and glamorize ED symptoms. © 2006 by Wiley Periodicals, Inc.

Authors
Thomas, JJ; Judge, AM; Brownell, KD; Vartanian, LR
MLA Citation
Thomas, JJ, Judge, AM, Brownell, KD, and Vartanian, LR. "Evaluating the effects of eating disorder memoirs on readers' eating attitudes and behaviors." International Journal of Eating Disorders 39.5 (2006): 418-425.
PMID
16570267
Source
scival
Published In
International Journal of Eating Disorders
Volume
39
Issue
5
Publish Date
2006
Start Page
418
End Page
425
DOI
10.1002/eat.20239

Erratum: Epidemiologic and economic consequences of the global epidemics of obesity and diabetes (Nature Medicine (2006) 12, (62-66))

Authors
Yach, D; Stuckler, D; Brownell, KD
MLA Citation
Yach, D, Stuckler, D, and Brownell, KD. "Erratum: Epidemiologic and economic consequences of the global epidemics of obesity and diabetes (Nature Medicine (2006) 12, (62-66))." Nature Medicine 12.3 (2006): 367--.
Source
scival
Published In
Nature Medicine
Volume
12
Issue
3
Publish Date
2006
Start Page
367-
DOI
10.1038/nm0306-367a

The influence of one's own body weight on implicit and explicit anti-fat bias

Objective: This study examined the influence of one's own body weight on the strength of implicit and explicit anti-fat bias. Research Methods and Procedure: Implicit and explicit anti-fat attitudes and obesity stereotypes were assessed among a large online sample (N = 4283) that included representation from across the weight spectrum (from underweight to extremely obese). Respondents also indicated their willingness to make a range of personal sacrifices in exchange for not being obese. Results: All weight groups exhibited significant anti-fat bias, but there was an inverse relation between one's own weight and the level of observed bias. Thinner people were more likely to automatically associate negative attributes (bad, lazy) with fat people, to prefer thin people to fat people, and to explicitly rate fat people as lazier and less motivated than thin people. However, when the lazy stereotype was contrasted with another negative attribute (anxious), obese and non-obese people exhibited equally strong implicit stereotyping. Finally, a substantial proportion of respondents indicated a willingness to endure aversive life events to avoid being obese. For example, 46% of the total sample indicated that they would rather give up 1 year of life than be obese, and 30% reported that they would rather be divorced than be obese. In each case, thinner people were more willing to sacrifice aspects of their health or life circumstances than were heavier people. Discussion: Although the strength of weight bias decreased as respondents' body weight increased, a significant degree of anti-fat bias was still evident among even the most obese group of respondents, highlighting the pervasiveness of this bias. Copyright © 2006 NAASO.

Authors
Schwartz, MB; Vartanian, LR; Nosek, BA; Brownell, KD
MLA Citation
Schwartz, MB, Vartanian, LR, Nosek, BA, and Brownell, KD. "The influence of one's own body weight on implicit and explicit anti-fat bias." Obesity 14.3 (2006): 440-447.
PMID
16648615
Source
scival
Published In
Obesity (Silver Spring, Md.)
Volume
14
Issue
3
Publish Date
2006
Start Page
440
End Page
447
DOI
10.1038/oby.2006.58

Can television change anti-fat attitudes and behavior?

This work investigated negative attitudes toward overweight people and whether anti-fat attitudes and behavior could be reduced by media-based empathy and classical conditioning interventions. Participants were first primed by an empathy-evoking video of obese persons or a non-weight-related control video. Next, they viewed either a video portraying obese persons positively (e.g., as competent) or negatively (e.g., as clumsy). Participants completed outcome measures of implicit and explicit weight-related attitudes and participated in a covert behavioral task (competence ratings of thin and overweight job applicants). Results confirm strong implicit and explicit anti-fat bias across conditions, yet participants rated overweight job applicants more highly in most domains while disfavoring overweight candidates on a personal level. Overall, bias persisted despite video interventions, although surprisingly the negative (stereotypic) video was associated with somewhat reduced bias. Relationships among implicit bias, explicit bias, individual-difference variables, and awareness of obesity as a social problem are explored and discussed. Copyright © 2006 by Bellwether Publishing, Ltd. All rights reserved.

Authors
Gapinski, KD; Schwartz, MB; Brownell, KD
MLA Citation
Gapinski, KD, Schwartz, MB, and Brownell, KD. "Can television change anti-fat attitudes and behavior?." Journal of Applied Biobehavioral Research 11.1 (2006): 1-28.
Source
scival
Published In
Journal of Applied Biobehavioral Research
Volume
11
Issue
1
Publish Date
2006
Start Page
1
End Page
28

Epidemiologic and economic consequences of the global epidemics of obesity and diabetes

Authors
Yach, D; Stuckler, D; Brownell, KD
MLA Citation
Yach, D, Stuckler, D, and Brownell, KD. "Epidemiologic and economic consequences of the global epidemics of obesity and diabetes." Nature Medicine 12.1 (2006): 62-66.
PMID
16397571
Source
scival
Published In
Nature Medicine
Volume
12
Issue
1
Publish Date
2006
Start Page
62
End Page
66
DOI
10.1038/nm0106-62

Does a "Toxic" Environment Make Obesity Inevitable?

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Does a "Toxic" Environment Make Obesity Inevitable?." Obesity Management 1.2 (April 2005): 52-55.
Source
crossref
Published In
Obesity Management
Volume
1
Issue
2
Publish Date
2005
Start Page
52
End Page
55
DOI
10.1089/obe.2005.1.52

The battle of the bulge

Think America is overweight? Take a look at the rest of the world. Obesity has become a global pandemic that afflicts young and old, rich and poor alike.

Authors
Brownell, KD; Yach, D
MLA Citation
Brownell, KD, and Yach, D. "The battle of the bulge." Foreign Policy 151 (2005): 26-27.
Source
scival
Published In
Foreign Policy
Issue
151
Publish Date
2005
Start Page
26
End Page
27

Impact of perceived consensus on stereotypes about obese people: A new approach for reducing bias

In 3 experiments, the authors tested the effect of perceived social consensus on attitudes toward obese people. Participants completed self-report measures of attitudes toward obese people prior to and after manipulated consensus feedback depicting attitudes of others. In Study 1 (N = 60), participants decreased negative and increased positive stereotypes after learning that others held more favorable attitudes toward obese people. In Study 2 (N = 55), participants improved attitudes when they learned about favorable attitudes of obese people from an in-group versus an out-group source. In Study 3 (N = 200), a consensus approach was compared with other stigma reduction methods. Social consensus feedback influenced participants' attitudes and beliefs about causes of obesity. Providing information about the uncontrollable causes of obesity and supposed scientific prevalence of traits also improved attitudes. Copyright 2005 by the American Psychological Association.

Authors
Puhl, RM; Schwartz, MB; Brownell, KD
MLA Citation
Puhl, RM, Schwartz, MB, and Brownell, KD. "Impact of perceived consensus on stereotypes about obese people: A new approach for reducing bias." Health Psychology 24.5 (2005): 517-525.
PMID
16162046
Source
scival
Published In
Health Psychology
Volume
24
Issue
5
Publish Date
2005
Start Page
517
End Page
525
DOI
10.1037/0278-6133.24.5.517

The chronicling of obesity: Growing awareness of its social, economic, and political contexts

Authors
Brownell, KD
MLA Citation
Brownell, KD. "The chronicling of obesity: Growing awareness of its social, economic, and political contexts." Journal of Health Politics, Policy and Law 30.5 (2005): 955-964.
PMID
16477793
Source
scival
Published In
Journal of Health Politics, Policy and Law
Volume
30
Issue
5
Publish Date
2005
Start Page
955
End Page
964
DOI
10.1215/03616878-30-5-955

Childhood obesity

The issues related to prevent childhood obesity are discussed by the Institute of Medicine (IOM). Obesity is one of the problems brought on by poor diet and lack of physical activity. Mandatory immunization required safety restraints in cars and restrictions on tobacco and alcohol promotion begin the list. Each citizen must decide whether the toll taken by poor diet and inactivity warrants a similar protective philosophy, but in so doing must consider the high cost that will be visited on America's children by failing to act.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Childhood obesity." Issues in Science and Technology 21.4 (2005): 13-14.
Source
scival
Published In
Issues in science and technology
Volume
21
Issue
4
Publish Date
2005
Start Page
13
End Page
14

Public policy and obesity: The need to marry science with advocacy

Obesity is an epidemic that likely will worsen if strong, broad-reaching changes are not made to the current environment. Although treatment of the individual traditionally has been the focus of the obesity field, prevention using a public health model will be essential for making progress. There are encouraging signs that nations are taking the obesity problem seriously, that there is growing recognition that prevention must be the priority, and that a full-scale effort must be made to protect children. One important area of research is to understand what makes local victories possible, say a school system banning soft drinks and snack foods, or a neighborhood creating ways for citizens to be more physically active, and then to help make such changes spread to other communities. Public policy changes long have been used to combat infectious and chronic diseases and will be vital in the attempt to reduce the toll of poor diet, physical inactivity, and obesity.

Authors
Wang, SS; Brownell, KD
MLA Citation
Wang, SS, and Brownell, KD. "Public policy and obesity: The need to marry science with advocacy." Psychiatric Clinics of North America 28.1 (2005): 235-252.
PMID
15733621
Source
scival
Published In
Psychiatric Clinics of North America
Volume
28
Issue
1
Publish Date
2005
Start Page
235
End Page
252
DOI
10.1016/j.psc.2004.09.001

Obesity and managed care: A role for activism and advocacy?

The Director of the Yale Center for Eating and Weight Disorders discusses the papers by Porter et al and Jeffrey and colleagues, arguing that managed care plans can-and should-take a greater role in preventing obesity.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Obesity and managed care: A role for activism and advocacy?." American Journal of Managed Care 10.6 (2004): 353-354.
PMID
15209478
Source
scival
Published In
American Journal of Managed Care
Volume
10
Issue
6
Publish Date
2004
Start Page
353
End Page
354

The influence of the stigma of obesity on overweight individuals

OBJECTIVE: To investigate the internalization of anti-fat bias among overweight individuals across a variety of attitudes and stereotypes. DESIGN: Two studies were conducted using the Implicit Association Test (IAT), a performance-based measure of bias, to examine beliefs among overweight individuals about 'fat people' vs 'thin people'. Study two also contained explicit measures of attitudes about obese people. SUBJECTS: Study 1 participants were 68 overweight patients at a treatment research clinic (60 women, 8 men; mean Body Mass Index (BMI) of 37.1 ± 3.9 kg/m2). Study 2 involved 48 overweight participants (33 women, 15 men) with a BMI of 34.5 ± 4.0 kg/ m2. RESULTS: Participants exhibited significant anti-fat bias on the IAT across several attributes and stereotypes. They also endorsed the explicit belief that fat people are lazier than thin people. CONCLUSION: Unlike other minority group members, overweight individuals do not appear to hold more favorable attitudes toward ingroup members. This ingroup devaluation has implications for changing the stigma of obesity and for understanding the psychosocial and even medical impact of obesity on those affected.

Authors
Wang, SS; Brownell, KD; Wadden, TA
MLA Citation
Wang, SS, Brownell, KD, and Wadden, TA. "The influence of the stigma of obesity on overweight individuals." International Journal of Obesity 28.10 (2004): 1333-1337.
PMID
15278101
Source
scival
Published In
International Journal of Obesity
Volume
28
Issue
10
Publish Date
2004
Start Page
1333
End Page
1337
DOI
10.1038/sj.ijo.0802730

Are stress eaters at risk for the metabolic syndrome?

Stress eating is a health behavior that has been overlooked in much of health psychology research. It is largely unknown why some tend to eat during or after stressful periods, whereas others tend to lose their appetite and lose weight. Furthermore, it is unknown if such transient changes in food intake or macronutrient composition during stress have clinically significant consequences in terms of weight and metabolic health. The Brown University Medical Student Study examined students during a baseline control period as well as during two examination periods. This design enabled an examination of weight changes in self-proclaimed stress eaters vs stress-less eaters over time. Stress eaters tended to gain more weight and demonstrated increases in nocturnal levels of insulin, cortisol, and blood levels of total/HDL cholesterol ratio, during exam periods, controlling for the baseline control period. These data show prospectively that stress eating may indeed have short-term consequences on metabolic health. Future research will need to determine whether this confers a greater risk of disease over time. © 2004 New York Academy of Sciences.

Authors
Epel, E; Jimenez, S; Brownell, K; Stroud, L; Stoney, C; Niaura, R
MLA Citation
Epel, E, Jimenez, S, Brownell, K, Stroud, L, Stoney, C, and Niaura, R. "Are stress eaters at risk for the metabolic syndrome?." Annals of the New York Academy of Sciences 1032 (2004): 208-210.
PMID
15677412
Source
scival
Published In
Annals of the New York Academy of Sciences
Volume
1032
Publish Date
2004
Start Page
208
End Page
210
DOI
10.1196/annals.1314.022

Fast Food and Obesity in Children

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Fast Food and Obesity in Children." Pediatrics 113.1 I (2004): 132--.
PMID
14702462
Source
scival
Published In
Pediatrics
Volume
113
Issue
1 I
Publish Date
2004
Start Page
132-
DOI
10.1542/peds.113.1.132

Obesity and body image

Modern western culture emphasizes thinness, denigrates excess weight, and stigmatizes obese individuals, making it likely that obese people internalize these messages and feel badly about the physical presence that brands them. There is clear evidence that obesity is linked with poor body image, but not all obese persons suffer from this problem or are equally vulnerable. Risk factors identified thus far are degree of overweight, being female, and binge eating, with some evidence of risk increasing with early age of onset of obesity, race, and several additional factors. Treatments do exist for improving body image in overweight individuals. Key questions are how to identify those in need of body image intervention, how such programs can be integrated with weight loss treatments, and ultimately, how body image distress can be prevented. © 2003 Elsevier B.V. All rights reserved.

Authors
Schwartz, MB; Brownell, KD
MLA Citation
Schwartz, MB, and Brownell, KD. "Obesity and body image." Body Image 1.1 (2004): 43-56.
Source
scival
Published In
Body Image
Volume
1
Issue
1
Publish Date
2004
Start Page
43
End Page
56
DOI
10.1016/S1740-1445(03)00007-X

"Before and After" diet advertisements escalate weight stigma

The stigma-producing effects of "before and after" diet advertisements on a healthy weight sample were examined. Subjects (n=59) were exposed to a presentation containing either a "before and after" diet ad, or solely the "before" or "after" picture embedded in a different ad. Subjects were then given measures to assess negative attitudes and endorsement of stereotypes about overweight people. Across all subjects, strong implicit anti-fat bias was present. Subjects in the Before and After condition indicated that weight is more easily controllable than did subjects in either the Before Picture Only or the After Picture Only conditions. There were two moderating variables for this effect. Subjects who reported greater life satisfaction endorsed fewer anti-fat stereotypes, and those who enjoyed an emotionally close relationship with an overweight person were less biased. These results suggest that "before and after" diet ads enhance weight stigma and perpetuate damaging stereotypes. © 2004, Editrice Kurtis.

Authors
Geier, AB; Schwartz, MB; Brownell, KD
MLA Citation
Geier, AB, Schwartz, MB, and Brownell, KD. ""Before and After" diet advertisements escalate weight stigma." Eating and Weight Disorders 8.4 (2003): 282-288.
PMID
15018377
Source
scival
Published In
Eating and weight disorders : EWD
Volume
8
Issue
4
Publish Date
2003
Start Page
282
End Page
288
DOI
10.1007/BF03325027

Portrayals of Overweight and Obese Individuals on Commercial Television

Objectives. This study examined the distribution and individual characteristics of body types on prime-time television. Methods. Five episodes of each of the 10 top-rated prime-time fictional programs on 6 broadcast networks during the 1999-2000 season were quantitatively analyzed. Results. Of 1018 major television characters, 14% of females and 24% of males were overweight or obese, less than half their percentages in the general population. Overweight and obese females were less likely to be considered attractive, to interact with romantic partners, or to display physical affection. Overweight and obese males were less likely to interact with romantic partners and friends or to talk about dating and were more likely to be shown eating. Conclusions. Overweight and obese television characters are associated with specific negative characteristics.

Authors
Greenberg, BS; Eastin, M; Hofschire, L; Lachlan, K; Brownell, KD
MLA Citation
Greenberg, BS, Eastin, M, Hofschire, L, Lachlan, K, and Brownell, KD. "Portrayals of Overweight and Obese Individuals on Commercial Television." American Journal of Public Health 93.8 (2003): 1342-1348.
PMID
12893625
Source
scival
Published In
American Journal of Public Health
Volume
93
Issue
8
Publish Date
2003
Start Page
1342
End Page
1348

Psychosocial origins of obesity stigma: Toward changing a powerful and pervasive bias

Widespread bias and discrimination based on weight have been documented in key areas of living, including education, employment, and health care. This paper examines the social and psychological origins of this bias through a review and critique of theoretical and empirical literatures, and proposes how the field might best advance in the area of reducing stigma. Explanations for the development and reduction of weight stigma are examined with different theoretical approaches, including attribution theory and a social consensus model. Individual and sociocultural contributors to bias suggested by these approaches are high-lighted. New directions are discussed in both the understanding and prevention of weight bias.

Authors
Puhl, RM; Brownell, KD
MLA Citation
Puhl, RM, and Brownell, KD. "Psychosocial origins of obesity stigma: Toward changing a powerful and pervasive bias." Obesity Reviews 4.4 (2003): 213-227.
PMID
14649372
Source
scival
Published In
Obesity Reviews
Volume
4
Issue
4
Publish Date
2003
Start Page
213
End Page
227
DOI
10.1046/j.1467-789X.2003.00122.x

Trick, treat, or toy: Children are just as likely to choose toys as candy on Halloween

This study investigated whether children would choose toys over candy when offered both on Halloween. Seven households gave trick-or-treaters a choice between comparably sized toys and candies.The subjects (N = 284) were between 3 and 14 years of age. Children were just as likely to choose toys as candy. There were no gender differences. The implication of this study is that children will not be disappointed by toy treats on Halloween. In practice, nutrition professionals should encourage adults to create holiday traditions that do not rely on unhealthful foods.

Authors
Schwartz, MB; Chen, EY; Brownell, KD
MLA Citation
Schwartz, MB, Chen, EY, and Brownell, KD. "Trick, treat, or toy: Children are just as likely to choose toys as candy on Halloween." Journal of Nutrition Education and Behavior 35.4 (2003): 207-209.
PMID
12859885
Source
scival
Published In
Journal of Nutrition Education and Behavior
Volume
35
Issue
4
Publish Date
2003
Start Page
207
End Page
209

Sociotropy and bulimic symptoms in clinical and nonclinical samples

Objective: The purpose of this study is to examine the relation between sociotropy and bulimic symptoms. Studies of interpersonal functioning among individuals with bulimia nervosa consistently reveal issues of social dependency, need for approval, and fear of rejection. These themes are conceptually related to sociotropy, a cognitive-personality factor that has been implicated in the development and maintenance of depression. Individuals high in sociotropy are keenly invested in attaining others' approval and avoiding social rejection. Methods: The relationship between sociotropy and bulimic symptoms was examined in two samples of women: undergraduate women and community women seeking treatment at a private eating disorder facility. Results: In both samples, sociotropy was significantly associated with bulimic symptoms beyond the shared relation with depressed mood. Discussion: Findings are discussed in terms of the maintenance and treatment of bulimia nervosa. © 2003 by Wiley Periodicals, Inc.

Authors
Hayaki, J; Friedman, MA; Whisman, MA; Delinsky, SS; Brownell, KD
MLA Citation
Hayaki, J, Friedman, MA, Whisman, MA, Delinsky, SS, and Brownell, KD. "Sociotropy and bulimic symptoms in clinical and nonclinical samples." International Journal of Eating Disorders 34.1 (2003): 172-176.
PMID
12772183
Source
scival
Published In
International Journal of Eating Disorders
Volume
34
Issue
1
Publish Date
2003
Start Page
172
End Page
176
DOI
10.1002/eat.10172

Body objectification and "fat talk": Effects on emotion, motivation, and cognitive performance

To evaluate the effects of self-objectification on mood, motivation, and cognitive performance, 80 women either tried on a swimsuit (high objectification) or a sweater (low objectification). In addition, in order to investigate whether "fat talk" exacerbates the negative effects of self-objectification, half of each group overheard a confederate make self-disparaging body comments or neutral comments. Self-objectification, either as an individual difference disposition (trait) or as a situationally induced state, was associated with increased negative feelings, decreased intrinsic motivation, lower self-efficacy, and diminished cognitive functioning. The "fat talk" prime had mixed effects; potential reasons are discussed in detail. Exposure to fat talk was associated with an increase in negative emotion for women in sweaters, but a decrease in negative emotion for women in swimsuits. Fat talk was also associated with improved motivation and cognitive functioning for women low in trait self-objectification but diminished motivation and performance for women high in trait self-objectification.

Authors
Gapinski, KD; Brownell, KD; LaFrance, M
MLA Citation
Gapinski, KD, Brownell, KD, and LaFrance, M. "Body objectification and "fat talk": Effects on emotion, motivation, and cognitive performance." Sex Roles 48.9-10 (2003): 377-388.
Source
scival
Published In
Sex Roles
Volume
48
Issue
9-10
Publish Date
2003
Start Page
377
End Page
388
DOI
10.1023/A:1023516209973

Ways of coping with obesity stigma: Review and conceptual analysis

There is clear documentation of bias and discrimination aimed at overweight persons, but less is known about methods individuals use to cope with weight stigma. This paper provides an analysis of such methods, integrating work on weight stigma with what is known from other relevant areas (e.g., race and gender bias). Multiple means of coping have been studied, ranging from attempts to change the stigmatizing condition (losing weight) to taking pride in the condition and mobilizing social action to prevent discrimination. The most promising areas for future research, methodological challenges, and the importance of individual difference and situational factors as moderating variables are discussed. © 2003 Elsevier Science Ltd. All rights reserved.

Authors
Puhl, R; Brownell, KD
MLA Citation
Puhl, R, and Brownell, KD. "Ways of coping with obesity stigma: Review and conceptual analysis." Eating Behaviors 4.1 (2003): 53-78.
Source
scival
Published In
Eating Behaviors
Volume
4
Issue
1
Publish Date
2003
Start Page
53
End Page
78
DOI
10.1016/S1471-0153(02)00096-X

Predicting adolescent eating and activity behaviors: The role of social norms and personal agency

Guided by the theory of planned behavior, this 2-week longitudinal study examined health behaviors in a sample of 279 adolescents. Social norms and perceived behavioral control (PBC) were tested as predictors of self-reported intentions and behaviors in 2 domains, eating and physical activity. Differentiating, as opposed to aggregating, parent and peer norms provided unique information. For PBC, the authors distinguished global causality beliefs from self-related agency beliefs and intraself (effort, ability) from extraself (parents, teachers) means. Intraself agency beliefs strongly predicted healthy intentions, whereas intraself causality beliefs had a negative influence. Patterns differed somewhat across behaviors and gender. Results highlight theoretical issues and provide potential targets for research on health promotion programs for youth.

Authors
Baker, CW; Little, TD; Brownell, KD
MLA Citation
Baker, CW, Little, TD, and Brownell, KD. "Predicting adolescent eating and activity behaviors: The role of social norms and personal agency." Health Psychology 22.2 (2003): 189-198.
PMID
12683739
Source
scival
Published In
Health Psychology
Volume
22
Issue
2
Publish Date
2003
Start Page
189
End Page
198
DOI
10.1037/0278-6133.22.2.189

Demonstrations of implicit anti-fat bias: The impact of providing causal information and evoking empathy

Three studies investigated implicit biases, and their modifiability, against overweight persons. In Study 1 (N = 144), the authors demonstrated strong implicit anti-fat attitudes and stereotypes using the Implicit Association Test, despite no explicit anti-fat bias. When participants were informed that obesity is caused predominantly by overeating and lack of exercise, higher implicit bias relative to controls was produced; informing participants that obesity is mainly due to genetic factors did not result in lower bias. In Studies 2A (N = 90) and 2B (N = 63), participants read stories of discrimination against obese persons to evoke empathy. This did not lead to lower bias compared with controls but did produce diminished implicit bias among overweight participants, suggesting an in-group bias.

Authors
Teachman, BA; Gapinski, KD; Brownell, KD; Rawlins, M; Jeyaram, S
MLA Citation
Teachman, BA, Gapinski, KD, Brownell, KD, Rawlins, M, and Jeyaram, S. "Demonstrations of implicit anti-fat bias: The impact of providing causal information and evoking empathy." Health Psychology 22.1 (2003): 68-78.
PMID
12558204
Source
scival
Published In
Health Psychology
Volume
22
Issue
1
Publish Date
2003
Start Page
68
End Page
78
DOI
10.1037/0278-6133.22.1.68

Weight Bias among Health Professionals Specializing in Obesity

Purpose: To determine the level of anti-fat bias in health professionals specializing in obesity and identify personal characteristics that correlate with both implicit and explicit bias. Research Methods and Procedures: The Implicit Associations Test (IAT) and a self-report questionnaire assessing explicit attitudes, personal experiences with obesity, and demographic characteristics was administered to clinicians and researchers attending the opening session of an international obesity conference (N = 389). The IAT was used to assess overall implicit weight bias (associating "obese people" and "thin people" with "good" vs. "bad") and three ranges of stereotypes: lazy-motivated, smart-stupid, and valuable-worthless. The questionnaire assessed explicit bias on the same dimensions, along with personal and professional experiences with obesity. Results: Health professionals exhibited a significant prothin, anti-fat implicit bias on the IAT. In addition, the subjects significantly endorsed the implicit stereotypes of lazy, stupid, and worthless using the IAT. Level of bias was associated with several personal characteristics. Characteristics significantly predictive of lower levels of implicit anti-fat bias include being male, older, having a positive emotional outlook on life, weighing more, having friends who are obese, and indicating an understanding of the experience of obesity. Discussion: Even professionals whose careers emphasize research or the clinical management of obesity show very strong weight bias, indicating pervasive and powerful stigma. Understanding the extent of anti-fat bias and the personal characteristics associated with it will aid in developing intervention strategies to ameliorate these damaging attitudes. Copyright © 2003 NAASO.

Authors
Schwartz, MB; Chambliss, HO; Brownell, KD; Blair, SN; Billington, C
MLA Citation
Schwartz, MB, Chambliss, HO, Brownell, KD, Blair, SN, and Billington, C. "Weight Bias among Health Professionals Specializing in Obesity." Obesity Research 11.9 (2003): 1033-1039.
PMID
12972672
Source
scival
Published In
Obesity Research
Volume
11
Issue
9
Publish Date
2003
Start Page
1033
End Page
1039

The scales of justice: Should food manufacturers bear any responsibility for causing obesity?

Authors
III, JFB; Brownell, KD; Burita, M
MLA Citation
III, JFB, Brownell, KD, and Burita, M. "The scales of justice: Should food manufacturers bear any responsibility for causing obesity?." Medical Crossfire 4.10 (2002): 21-24.
Source
scival
Published In
Medical Crossfire
Volume
4
Issue
10
Publish Date
2002
Start Page
21
End Page
24

Obesity: Responding to the global epidemic

Obesity has reached epidemic proportions in the United States and other developed nations. In the United States, 27% of adults are obese and an additional 34% are overweight. Research in the past decade has shown that genetic influences clearly predispose some individuals to obesity. The marked increase in prevalence, however, appears to be attributable to a toxic environment that implicitly discourages physical activity while explicitly encouraging the consumption of supersized portions of high-fat, high-sugar foods. Management of the obesity epidemic will require a two-pronged approach. First, better treatments, including behavioral, pharmacologic, and surgical interventions, are needed for individuals who are already obese. The second and potentially more promising approach is to prevent the development of obesity by tackling the toxic environment. This will require bold public policy initiatives such as regulating food advertising directed at children. The authors call not for the adoption of a specific policy initiative, but instead propose that policy research, based on viewing obesity as a public health problem, become a central focus of research.

Authors
Wadden, TA; Brownell, KD; Foster, GD
MLA Citation
Wadden, TA, Brownell, KD, and Foster, GD. "Obesity: Responding to the global epidemic." Journal of Consulting and Clinical Psychology 70.3 (2002): 510-525.
PMID
12090366
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
70
Issue
3
Publish Date
2002
Start Page
510
End Page
525
DOI
10.1037//0022-006X.70.3.510

Comparison of price change and health message interventions in promoting healthy food choices

This study examines the feasibility and effectiveness of an environmental intervention for improving diet by comparing the impact of health messages, lowered prices, and their combination on the purchase of healthy food items in a restaurant. Price decreases alone, rather than a combination of price decreases and health messages, were associated with a higher level of increased purchases of some healthy food items as compared with control items over a 4-month period. Price decreases may be a more powerful means than health messages of increasing consumption of healthy foods. Health messages may have paradoxical effects if foods labeled as healthy are assumed to taste bad.

Authors
Horgen, KB; Brownell, KD
MLA Citation
Horgen, KB, and Brownell, KD. "Comparison of price change and health message interventions in promoting healthy food choices." Health Psychology 21.5 (2002): 505-512.
PMID
12211518
Source
scival
Published In
Health Psychology
Volume
21
Issue
5
Publish Date
2002
Start Page
505
End Page
512
DOI
10.1037//0278-6133.21.5.505

Emotional expression and body dissatisfaction.

OBJECTIVE: The purpose of this study was to examine the relation between emotional expression and body dissatisfaction in a sample of young women. METHOD: Participants were 141 female undergraduates. They were assessed for emotional expression, body dissatisfaction, nonassertiveness, and depressive symptoms. The unique relation between emotional expression and body dissatisfaction was analyzed using hierarchical multiple regression. RESULTS: Emotional expression was related inversely to body dissatisfaction. This association was significant after controlling for body mass index, nonassertiveness, and depressive symptoms. DISCUSSION: This is the first study to examine the link between emotional expression and body dissatisfaction. Findings are discussed in terms of possible strategies for modifying shape- and weight-related concerns in women. Copyright 2002 by John Wiley & Sons, Inc.

Authors
Hayaki, J; Friedman, MA; Brownell, KD
MLA Citation
Hayaki, J, Friedman, MA, and Brownell, KD. "Emotional expression and body dissatisfaction." The International journal of eating disorders 31.1 (2002): 57-62.
PMID
11835298
Source
scival
Published In
The International journal of eating disorders
Volume
31
Issue
1
Publish Date
2002
Start Page
57
End Page
62

Shame and severity of bulimic symptoms

Initial research suggests that self-conscious affect such as shame may perpetuate bulimic symptoms among individuals suffering from bulimia nervosa (BN). This investigation reports findings from two studies that examine the relation of shame to bulimic symptoms. In the first study, the relation of shame to bulimic symptoms was examined among 137 female college undergraduates. Shame accounted for a significant portion of variance in bulimic symptoms after controlling for age, weight status, guilt, and depressed mood. A second study examined the severity of shame in 30 bulimic patients compared to 28 eating-disordered patients with subclinical symptoms. Although patients with more severe bulimic symptoms exhibited higher levels of shame, this relation was not independent of the shared relation with depression and guilt. Findings are discussed in terms of the role of shame in bulimic symptoms. © 2001 Elsevier Science Ltd. All rights reserved.

Authors
Hayaki, J; Friedman, MA; Brownell, KD
MLA Citation
Hayaki, J, Friedman, MA, and Brownell, KD. "Shame and severity of bulimic symptoms." Eating Behaviors 3.1 (2002): 73-83.
Source
scival
Published In
Eating Behaviors
Volume
3
Issue
1
Publish Date
2002
Start Page
73
End Page
83
DOI
10.1016/S1471-0153(01)00046-0

Bias, discrimination, and obesity

This article reviews information on discriminatory attitudes and behaviors against obese individuals, integrates this to show whether systematic discrimination occurs and why, and discusses needed work in the field. Clear and consistent stigmatization, and in some cases discrimination, can be documented in three important areas of living: employment, education, and health care. Among the findings are that 28% of teachers in one study said that becoming obese is the worst thing that can happen to a person; 24% of nurses said that they are "repulsed" by obese persons; and, controlling for income and grades, parents provide less college support for their overweight than for their thin children. There are also suggestions but not yet documentation of discrimination occurring in adoption proceedings, jury selection, housing, and other areas. Given the vast numbers of people potentially affected, it is important to consider the research-related, educational, and social policy implications of these findings.

Authors
Puhl, R; Brownell, KD
MLA Citation
Puhl, R, and Brownell, KD. "Bias, discrimination, and obesity." Obesity Research 9.12 (2001): 788-805.
PMID
11743063
Source
scival
Published In
Obesity Research
Volume
9
Issue
12
Publish Date
2001
Start Page
788
End Page
805

Stress may add bite to appetite in women: A laboratory study of stress-induced cortisol and eating behavior

To date, there are few known predictors of stress-induced eating. The purpose of this study was to identify whether physiological and psychological variables are related to eating after stress. Specifically, we hypothesized that high cortisol reactivity in response to stress may lead to eating after stress, given the relations between cortisol with both psychological stress and mechanisms affecting hunger. To test this, we exposed fifty-nine healthy pre-menopausal women to both a stress session and a control session on different days. High cortisol reactors consumed more calories on the stress day compared to low reactors, but ate similar amounts on the control day. In terms of taste preferences, high reactors ate significantly more sweet food across days. Increases in negative mood in response to the stressors were also significantly related to greater food consumption. These results suggest that psychophysiological response to stress may influence subsequent eating behavior. Over time, these alterations could impact both weight and health. (C) 2000 Elsevier Science Ltd.

Authors
Epel, E; Lapidus, R; McEwen, B; Brownell, K
MLA Citation
Epel, E, Lapidus, R, McEwen, B, and Brownell, K. "Stress may add bite to appetite in women: A laboratory study of stress-induced cortisol and eating behavior." Psychoneuroendocrinology 26.1 (2001): 37-49.
PMID
11070333
Source
scival
Published In
Psychoneuroendocrinology
Volume
26
Issue
1
Publish Date
2001
Start Page
37
End Page
49
DOI
10.1016/S0306-4530(00)00035-4

Implicit anti-fat bias among health professionals: Is anyone immune?

OBJECTIVE: To investigate whether negative implicit attitudes and beliefs toward overweight persons exist among health professionals who specialize in obesity treatment, and to compare these findings to the implicit anti-fat bias evident in the general population. DESIGN: Health care professionals completed a series of implicit and explicit attitude and belief measures. Results were compared to measures obtained from a general population sample. SUBJECTS: A total of 84 health professionals who treat obesity (71% male, mean age 48 y, mean body mass index (BMI) 25.39). MEASUREMENTS: Participants completed an attitude- and a belief-based Implicit Association Test. This reaction time measure of automatic memory-based associations asked participants to classify words into the following target category pair. 'fat people' vs 'thin people'. Simultaneously, the tasks required categorization of words into one of the following descriptor category pairs: good vs bad (attitude measure) or motivated vs lazy (stereotype measure). Participants also reported explicit attitudes and beliefs about fat and thin persons. RESULTS: Clear evidence for implicit anti-fat bias was found for both the attitude and stereotype measures. As expected, this bias was strong but was lower than bias in the general population. Also as predicted, only minimal evidence for an explicit anti-fat bias was found. Implicit and explicit measures of the lazy stereotype were positively related although the attitude measures were not. CONCLUSION: Even health care specialists have strong negative associations toward obese persons, indicating the pervasiveness of the stigma toward obesity. Notwithstanding, there appears to be a buffering factor, perhaps related to their experience in caring for obese patients, which reduces the bias.

Authors
Teachman, BA; Brownell, KD
MLA Citation
Teachman, BA, and Brownell, KD. "Implicit anti-fat bias among health professionals: Is anyone immune?." International Journal of Obesity 25.10 (2001): 1525-1531.
PMID
11673776
Source
scival
Published In
International Journal of Obesity
Volume
25
Issue
10
Publish Date
2001
Start Page
1525
End Page
1531
DOI
10.1038/sj.ijo.0801745

“Fearful cognitions associated with eating pathology” psychometric properties of a new scale

Authors
Teachman, B; Brownell, KD
MLA Citation
Teachman, B, and Brownell, KD. "“Fearful cognitions associated with eating pathology” psychometric properties of a new scale." Eating Disorders 8.4 (December 2000): 283-297.
Source
crossref
Published In
Eating Disorders
Volume
8
Issue
4
Publish Date
2000
Start Page
283
End Page
297
DOI
10.1080/10640260008251237

Small taxes on soft drinks and snack foods to promote health

Health officials often wish to sponsor nutrition and other health promotion programs but are hampered by lack of funding. One source of funding is suggested by the fact that 18 states and 1 major city levy special taxes on soft drinks, candy, chewing gum, or snack foods. The tax rates may be too small to affect sales, but in some jurisdictions, the revenues generated are substantial. Nationally, about $1 billion is raised annually from these taxes. The authors propose that state and local governments levy taxes on foods of low nutritional value and use the revenues to fund health promotion programs.

Authors
Jacobson, MF; Brownell, KD
MLA Citation
Jacobson, MF, and Brownell, KD. "Small taxes on soft drinks and snack foods to promote health." American Journal of Public Health 90.6 (2000): 854-857.
PMID
10846500
Source
scival
Published In
American Journal of Public Health
Volume
90
Issue
6
Publish Date
2000
Start Page
854
End Page
857

Stress and body shape: Stress-induced cortisol secretion is consistently greater among women with central fat

Objective: Excessive central fat puts one at greater risk of disease. In animal studies, stress-induced cortisol secretion has been shown to increase central fat. The objective of this study was to assess whether women with central fat distribution (as indicated by a high waist-to-hip ratio [WHR]), across a range of body mass indexes, display consistently heightened cortisol reactivity to repeated laboratory stressors. Methods: Fifty nine healthy premenopausal women, 30 with a high WHR and 29 with a low WHR, were exposed to consecutive laboratory sessions over 4 days (three stress sessions and one rest session). During these sessions, cortisol and psychological responses were assessed. Results: Women with a high WHR evaluated the laboratory challenges as more threatening, performed more poorly on them, and reported more chronic stress. These women secreted significantly more cortisol during the first stress session than women with a low WHR. Furthermore, lean women with a high WHR lacked habituation to stress in that they continued to secrete significantly more cortisol in response to now familiar challenges (days 2 and 3) than lean women with a low WHR. Conclusions: Central fat distribution is related to greater psychological vulnerability to stress and cortisol reactivity. This may be especially true among lean women, who did not habituate to repeated stress. The current cross-sectional findings support the hypothesis that stress-induced cortisol secretion may contribute to central fat and demonstrate a link between psychological stress and risk for disease.

Authors
Epel, ES; McEwen, B; Seeman, T; Matthews, K; Castellazzo, G; Brownell, KD; Bell, J; Ickovics, JR
MLA Citation
Epel, ES, McEwen, B, Seeman, T, Matthews, K, Castellazzo, G, Brownell, KD, Bell, J, and Ickovics, JR. "Stress and body shape: Stress-induced cortisol secretion is consistently greater among women with central fat." Psychosomatic Medicine 62.5 (2000): 623-632.
PMID
11020091
Source
scival
Published In
Psychosomatic Medicine
Volume
62
Issue
5
Publish Date
2000
Start Page
623
End Page
632

Body mass index, eating attitudes, and symptoms of depression and anxiety in pregnancy and the postpartum period

Objective: This report describes associations between body mass index (BMI; kg/m2), eating attitudes, and affective symptoms across pregnancy and the postpartum period in a sample of 64 women. Methods: As part of a larger study women were recruited during pregnancy and followed prospectively to 14 months postpartum. Measures included self-reported prepregnancy and 4-month postpartum BMI as well as pregnancy, 4-month, and 14-month postpartum eating attitudes (EAT), depressive symptoms (CES-D), and anxiety symptoms (STAI). Results: During pregnancy symptoms of depression or anxiety were not significantly correlated with concurrent eating attitudes or measures of BMI. However, at 14 months postpartum, measures of eating attitudes and both depression and anxiety symptoms were associated. Measures of BMI were associated with depressive and anxiety symptoms at both 4 and 14 months postpartum. Four-month eating attitudes and BMI predicted 14-month postpartum depressive symptoms, beyond pregnancy, and 4-month postpartum measures of affective symptoms. Results suggested that overweight women were at risk for elevated anxiety at 4 months and depressive symptoms at both 4 and 14 months postpartum. Conclusions: These results provide evidence for a significant, albeit moderate, relationship between BMI, eating attitudes, and symptoms of depression and anxiety in the postpartum period that are not present during pregnancy.

Authors
Carter, AS; Baker, CW; Brownell, KD
MLA Citation
Carter, AS, Baker, CW, and Brownell, KD. "Body mass index, eating attitudes, and symptoms of depression and anxiety in pregnancy and the postpartum period." Psychosomatic Medicine 62.2 (2000): 264-270.
PMID
10772407
Source
scival
Published In
Psychosomatic Medicine
Volume
62
Issue
2
Publish Date
2000
Start Page
264
End Page
270

Studying intergenerational transmission of eating attitudes and behaviors: Methodological and conceptual questions

Associations between parent and child attitudes and behaviors related to eating and weight were examined among college-age men and women and their mothers and fathers (ns = 44, 47, 87, and 66, respectively). Parent attitudes and behaviors were assessed from the perspective of the parent and the student, and 2 pathways of influence were examined: modeling and direct criticism. In general, students' attitudes and behaviors were more strongly related to perceptions of their parents rather than to parents' own self-reports. There was more support for perceived direct criticism as a pathway of influence, particularly for daughters. Perceived criticism about eating and appearance had large associations with student attitudes and behaviors. Weight loss behavior was related to perceived criticism among daughters and to perceived paternal eating attitudes among sons. Results highlight important methodological and conceptual questions for intergenerational research.

Authors
Baker, CW; Whisman, MA; Brownell, KD
MLA Citation
Baker, CW, Whisman, MA, and Brownell, KD. "Studying intergenerational transmission of eating attitudes and behaviors: Methodological and conceptual questions." Health Psychology 19.4 (2000): 376-381.
PMID
10907656
Source
scival
Published In
Health Psychology
Volume
19
Issue
4
Publish Date
2000
Start Page
376
End Page
381
DOI
10.1037//0278-6133.19.4.376

Marital status, marital satisfaction, and body image dissatisfaction.

OBJECTIVE: This study examined whether married individuals have comparable body image disturbance to nonmarried individuals and whether the quality of a marital relationship is significantly related to body image disturbance in a sample of dieters. METHOD: Measures of marital status, marital satisfaction, and body dissatisfaction were administered to a sample of 16,377 subjects who had tried to lose weight at least once within the previous 3 years. RESULTS: Marital status was not associated with increased body dissatisfaction. Marital satisfaction was significantly related to body dissatisfaction when controlling for age, body mass index, self-esteem, and gender. DISCUSSION: Body dissatisfaction occurs at comparable levels among married and single individuals and the study of marital functioning among eating-disordered individuals represents a large gap in the literature.

Authors
Friedman, MA; Dixon, AE; Brownell, KD; Whisman, MA; Wilfley, DE
MLA Citation
Friedman, MA, Dixon, AE, Brownell, KD, Whisman, MA, and Wilfley, DE. "Marital status, marital satisfaction, and body image dissatisfaction." The International journal of eating disorders 26.1 (July 1999): 81-85.
PMID
10349587
Source
epmc
Published In
International Journal of Eating Disorders
Volume
26
Issue
1
Publish Date
1999
Start Page
81
End Page
85
DOI
10.1002/(sici)1098-108x(199907)26:1<81::aid-eat10>3.0.co;2-v

Lesbians, bisexual women, and body image: an investigation of gender roles and social group affiliation.

OBJECTIVE: This study examined the effects of considering oneself to be masculine, feminine, or androgynous in appearance, of having friends who share one's gender and sexual orientation, and of affiliating with three subcommunities within the lesbian society on various aspects of body image. METHOD: Self-report measures were obtained from 188 lesbian and bisexual females. RESULTS: Feminine women reported lower body satisfaction than did androgynous or masculine identified subjects. Those whose friends shared their sexual orientation and gender had more positive body images than those whose friends shared only gender. In contrast, community affiliation was unrelated to body satisfaction. DISCUSSION: Within-group differences among lesbians may be central to understanding body image in this group.

Authors
Ludwig, MR; Brownell, KD
MLA Citation
Ludwig, MR, and Brownell, KD. "Lesbians, bisexual women, and body image: an investigation of gender roles and social group affiliation." The International journal of eating disorders 25.1 (January 1999): 89-97.
PMID
9924657
Source
epmc
Published In
International Journal of Eating Disorders
Volume
25
Issue
1
Publish Date
1999
Start Page
89
End Page
97
DOI
10.1002/(sici)1098-108x(199901)25:1<89::aid-eat11>3.0.co;2-t

Marital status, marital satisfaction, and body image dissatisfaction

Objective: This study examined whether married individuals have comparable body image disturbance to nonmarried individuals and whether the quality of a marital relationship is significantly related to body image disturbance in a sample of dieters. Method: Measures of marital status, marital satisfaction, and body dissatisfaction were administered to a sample of 16,377 subjects who had tried to lose weight at least once within the previous 3 years. Results: Marital status was not associated with increased body dissatisfaction. Marital satisfaction was significantly related to body dissatisfaction when controlling for age, body mass index, self-esteem, and gender. Discussion: Body dissatisfaction occurs at comparable levels among married and single individuals and the study of marital functioning among eating-disordered individuals represents a large gap in the literature.

Authors
Friedman, MA; Dixon, AE; Brownell, KD; Whisman, MA; Wilfley, DE
MLA Citation
Friedman, MA, Dixon, AE, Brownell, KD, Whisman, MA, and Wilfley, DE. "Marital status, marital satisfaction, and body image dissatisfaction." International Journal of Eating Disorders 26.1 (1999): 81-85.
Source
scival
Published In
International Journal of Eating Disorders
Volume
26
Issue
1
Publish Date
1999
Start Page
81
End Page
85
DOI
10.1002/(SICI)1098-108X(199907)26:1<81::AID-EAT10>3.0.CO;2-V

The central role of lifestyle change in long-term weight management

Lifestyle change - most notably, modification of eating behavior, physical activity, and psychologic factors like attitudes, goals, and emotions - is the central determinant of whether people will lose weight and maintain the loss. Even when medical intervention appears to be the primary treatment, as with pharmacotherapy, behavior plays the determining role in successful weight loss. For example, the likelihood that a patient will take his or her prescribed medication is influenced by thoughts, attitudes, behaviors, and social environment. The patient who is dissatisfied with the moderate weight loss produced by most treatments, and hence is prone to relapse, is affected by the same factors. Methods are available to help people develop the self-management skills necessary to produce long-term lifestyle change (1-3). As individuals internalize a new set of attitudes and behaviors, resisting old habits and acquiring new ones become easier. Only then will there be any reasonable chance of long-term weight-loss success.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "The central role of lifestyle change in long-term weight management." Clinical Cornerstone 2.3 (1999): 43-48.
PMID
10696284
Source
scival
Published In
Clinical Cornerstone
Volume
2
Issue
3
Publish Date
1999
Start Page
43
End Page
48
DOI
10.1016/S1098-3597(99)90004-2

Eating attitudes and behaviors in pregnancy and postpartum: Global stability versus specific transitions

Global changes in eating attitudes were examined prospectively across pregnancy and 4 months postpartum in a sample of 90 women. In addition, specific changes in dieting behavior and weight/shape satisfaction were assessed at 4 months postpartum for concurrent and retrospective time points. Measures included the Eating Attitudes Test (EAT) and weight/shape satisfaction in pregnancy and at 4 months postpartum, as well as prepregnancy, pregnancy, and postpartum weight loss efforts. While global EAT scores were stable across time, dieting scores (Factor I) increased between pregnancy and postpartum. Weight/shape satisfaction was higher in pregnancy, and satisfaction was related to EAT scores at 4 months postpartum but not during pregnancy. Prepregnancy dieters and nondieters were best discriminated by higher weights, elevated pregnancy dieting scores, and lower postpartum weight/shape satisfaction. Results emphasize the importance of looking beyond changes in global eating attitudes and behaviors to more specific eating concerns or behaviors. Lastly, the results have implications for identifying women at risk for eating- and weight-related concerns during this period of rapid physical change.

Authors
Baker, CW; Carter, AS; Cohen, LR; Brownell, KD
MLA Citation
Baker, CW, Carter, AS, Cohen, LR, and Brownell, KD. "Eating attitudes and behaviors in pregnancy and postpartum: Global stability versus specific transitions." Annals of Behavioral Medicine 21.2 (1999): 143-148.
PMID
10499135
Source
scival
Published In
Annals of Behavioral Medicine
Volume
21
Issue
2
Publish Date
1999
Start Page
143
End Page
148

Lesbians, bisexual women, and body image: An investigation of gender roles and social group affiliation

Objective: This study examined the effects of considering oneself to be masculine, feminine, or androgynous in appearance, of having friends who share one's gender and sexual orientation, and of affiliating with three subcommunities within the lesbian society on various aspects of body image. Method: Self-report measures were obtained from 188 lesbian and bisexual females. Results: Feminine women reported lower body satisfaction than did androgynous or masculine identified subjects. Those whose friends shared their sexual orientation and gender had more positive body images than those whose friends shared only gender. In contrast, community affiliation was unrelated to body satisfaction. Discussion: Within-group differences among lesbians may be central to understanding body image in this group.

Authors
Ludwig, MR; Brownell, KD
MLA Citation
Ludwig, MR, and Brownell, KD. "Lesbians, bisexual women, and body image: An investigation of gender roles and social group affiliation." International Journal of Eating Disorders 25.1 (1999): 89-97.
Source
scival
Published In
International Journal of Eating Disorders
Volume
25
Issue
1
Publish Date
1999
Start Page
89
End Page
97
DOI
10.1002/(SICI)1098-108X(199901)25:1<89::AID-EAT11>3.0.CO;2-T

Eating disturbances in white and minority female dieters.

OBJECTIVE: This study examined disordered eating, attitudes about weight and appearance, self-esteem, weight loss, and reasons for weight regain in a sample of white, black, Asian, and Hispanic female dieters. METHOD: In this cross-sectional descriptive study, we scrutinized survey responses of a large number of households subscribing to Consumer Reports magazine. Females (N = 9,971) between 21 and 65 years old (M = 42.9, SD = 10.4) with a mean body mass index (BMI) of 27.2 (SD = 6.2) were selected for comparisons. RESULTS: Ethnic groups were different in terms of age, BMI, household income, and marital status. Therefore, these variables were used as covariates in the analyses. More black women were overweight and purged compared to the other groups. Asian women valued the beneficial role of exercise in weight control more, while black women were more inclined to attribute weight gain to cravings and slow metabolism. The groups did not differ in terms of binge eating, attitudes about weight and appearance, self-esteem, the number of attempts to lose weight, and the reasons for their failures. CONCLUSIONS: This study suggests that unhealthy eating attitudes and practices may be similar for women who diet, irrespective of ethnic background. However, the generalizability of these findings is limited by the inherent sampling bias.

Authors
le Grange, D; Stone, AA; Brownell, KD
MLA Citation
le Grange, D, Stone, AA, and Brownell, KD. "Eating disturbances in white and minority female dieters." The International journal of eating disorders 24.4 (December 1998): 395-403.
PMID
9813764
Source
epmc
Published In
International Journal of Eating Disorders
Volume
24
Issue
4
Publish Date
1998
Start Page
395
End Page
403
DOI
10.1002/(sici)1098-108x(199812)24:4<395::aid-eat6>3.0.co;2-a

Weight loss, psychological, and nutritional patterns in competitive female bodybuilders

Authors
Andersen, RE; Brownell, KD; Morgan, GD; Bartlett, SJ
MLA Citation
Andersen, RE, Brownell, KD, Morgan, GD, and Bartlett, SJ. "Weight loss, psychological, and nutritional patterns in competitive female bodybuilders." Eating Disorders 6.2 (June 1998): 159-167.
Source
crossref
Published In
Eating Disorders
Volume
6
Issue
2
Publish Date
1998
Start Page
159
End Page
167
DOI
10.1080/10640269808251251

Binge eating in an obese community sample.

OBJECTIVE: The present study sought to examine the validity and utility of diagnostic criteria for binge-eating disorder (BED) by replicating and extending a study reported by de Zwaan and colleagues (International Journal of Eating Disorders, 15, 43-52, 1994). METHOD: Four groups of obese individuals were selected from a large community-based sample of men and women: 33 women and 20 men with BED, 79 women and 40 men with subthreshold BED, 21 women and 39 men who reported recurrent overeating, and 80 female and 80 male normal controls. The groups were compared on measures of body image concern, dieting behavior, and associated psychological distress. RESULTS: Individuals with BED were distinguishable from overeaters and normal controls on a number of psychological and behavioral variables. Few differences were found between subthreshold and full-syndrome BED, raising questions about the diagnostic validity of the frequency threshold. Men with BED did not differ from women with BED above and beyond the gender-related differences observed across all four groups. DISCUSSION: Our findings support the view of BED as a distinct syndrome.

Authors
Striegel-Moore, RH; Wilson, GT; Wilfley, DE; Elder, KA; Brownell, KD
MLA Citation
Striegel-Moore, RH, Wilson, GT, Wilfley, DE, Elder, KA, and Brownell, KD. "Binge eating in an obese community sample." The International journal of eating disorders 23.1 (January 1998): 27-37.
PMID
9429916
Source
epmc
Published In
International Journal of Eating Disorders
Volume
23
Issue
1
Publish Date
1998
Start Page
27
End Page
37
DOI
10.1002/(sici)1098-108x(199801)23:1<27::aid-eat4>3.0.co;2-3

Diet, exercise and behavioural intervention: The nonpharmacological approach

Behaviour is an important factor in both the aetiology and treatment of obesity. Successful long-term weight management ultimately depends on the ability of patients to change their behaviour patterns, particularly with regard to diet and exercise. Many patients find such changes extremely difficult to initiate and maintain. The failure to properly address behavioural modification is part of the reason why so many weight loss programmes cannot produce long-term weight loss, even though initial weight loss is often achieved with relative ease. Four examples of lifestyle changes are discussed in this paper: exercise; relapse prevention; the concept of a reasonable weight; and attribution theory. Behavioural therapy should be an integral part of a multifaceted approach for managing obesity and associated conditions, such as type II (non-insulin-dependent) diabetes.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Diet, exercise and behavioural intervention: The nonpharmacological approach." European Journal of Clinical Investigation, Supplement 28.2 (1998): 19-22.
PMID
9777323
Source
scival
Published In
European Journal of Clinical Investigation, Supplement
Volume
28
Issue
2
Publish Date
1998
Start Page
19
End Page
22

Differential relation of psychological functioning with the history and experience of weight cycling

Two measures of weight cycling and indexes of psychological functioning were examined in a large sample of dieters. History of weight cycling was assessed to include number of dieting attempts, total lifetime weight lost and regained, and number of weight cycles over 20 lb (9.1 kg). Experience of weight cycling measured perception of being a yo-yo dieter and perceived success at maintaining past weight losses. Experience was more strongly related than history to all psychological measures. Further, when controlling for the effects of age, body mass index, and experience, the relation between history and the psychological variables was nonsignificant. This finding suggests that an individual's perception of being a weight cycler may be more related to psychological problems than the actual number of pounds lost and regained over time.

Authors
Friedman, MA; Schwartz, MB; Brownell, KD
MLA Citation
Friedman, MA, Schwartz, MB, and Brownell, KD. "Differential relation of psychological functioning with the history and experience of weight cycling." Journal of Consulting and Clinical Psychology 66.4 (1998): 646-650.
PMID
9735581
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
66
Issue
4
Publish Date
1998
Start Page
646
End Page
650
DOI
10.1037//0022-006X.66.4.646

Obesity management: A comprehensive plan

The emerging concept of obesity is one of chronic disease requiring chronic care. Many healthcare professionals are not trained with this new concept and are faced with learning new weight management techniques that are likely to be more effective in the long term. Successful treatment must include an understanding of the biological, social, and psychological factors that may affect an individual's ability to manage his or her weight. It can be helpful for professionals and patients to eliminate the age-old concept of an ideal weight. Research now shows that even small amounts of weight loss, if maintained, can significantly improve health. With this in mind, the 10% or 15% weight loss commonly associated with pharmacotherapy or lifestyle modification programs can be viewed as a success. Lifestyle changes are essential to weight loss and maintenance, but programs vary widely in quality. The best lifestyle modification programs will be comprehensive and based in science. They will place more emphasis on the benefits of physical activity and will be able to deal with the myriad of psychological stresses commonly responsible for relapse. In addition, good programs should have specific techniques in place to deal with special situations such as binge eating. Since it is likely that reimbursement for the medical management of obesity will continue to grow, physicians must decide what level of service they are able to offer. For some, it will not be practical to provide comprehensive care. For whatever level is chosen, resources must exist to assure that each patient receives quality weight management assistance.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Obesity management: A comprehensive plan." American Journal of Managed Care 4.3 SUPPL. (1998): S126-S132.
Source
scival
Published In
American Journal of Managed Care
Volume
4
Issue
3 SUPPL.
Publish Date
1998
Start Page
S126
End Page
S132

Beliefs about weight gain and attitudes toward relapse in a sample of women and men with obesity

Objective: The purpose of this study was to examine beliefs regarding reasons for weight gain, likely responses to weight loss relapse, notions of reasonable weight loss, and correlations between beliefs and attitudes in a large non-clinical sample of men and women with obesity. Research Methods and Procedures: Participants were 3,394 white women (n=1,674) and men (n=1,720) with obesity who had responded to a survey about body image and eating behaviors conducted by Consumer Reports magazine. Results: Women and men indicated that the most important reasons for their weight gain were lack of exercise and enjoying eating; the least important reason was a need to avoid social or sexual situations. Both groups reported that their most likely response to relapse is to start watching food intake, whereas their least likely response is to ask a friend, spouse, or family member for help. Women rated depression, stress, low self-esteem, and need to avoid situations as more important reasons for their weight gain than did men, and women were more likely to feel terrible and regain as a response to relapse. There was no relationship between an individual's beliefs about weight gain, responses to relapse, or notions of reasonable weight loss. Discussion: Implications of these findings for the treatment of obesity are discussed. Copyright © 1998 NAASO.

Authors
Cachelin, FM; Striegel-Moore, RH; Brownell, KD
MLA Citation
Cachelin, FM, Striegel-Moore, RH, and Brownell, KD. "Beliefs about weight gain and attitudes toward relapse in a sample of women and men with obesity." Obesity Research 6.3 (1998): 231-237.
PMID
9618128
Source
scival
Published In
Obesity Research
Volume
6
Issue
3
Publish Date
1998
Start Page
231
End Page
237

Physical activity, genetic, and nutritional considerations in childhood weight management

Juvenile obesity is a serious, increasingly prevalent problem in technologically developed societies. Almost one-quarter of U.S. children are now obese, a dramatic increase of over 20% in the past decade. It is intriguing that the increase in prevalence has been occurring while overall fat consumption has been declining. Body mass and composition are influenced by genetic factors, but the actual heritability of juvenile obesity is not known. A low physical activity (PA) is characteristic of obese children and adolescents, and it may be one cause of juvenile obesity. There is little evidence, however, that overall energy expenditure is low among the obese. There is a strong association between the prevalence of obesity and the extent of TV viewing. Enhanced PA can reduce body fat and blood pressure and improve lipoprotein profile in obese individuals. Its effect on body composition, however, is slower than with low-calorie diets. The three main dietary approaches are: protein sparing modified fast, balanced hypocaloric diets, and comprehensive behavioral lifestyle programs. To achieve long- standing control of overweight, one should combine changes in eating and activity patterns, using behavior modification techniques. However, the onus is also on society to reduce incentives for a sedentary lifestyle and over- consumption of food. To address the key issues related to childhood weight management, the American College of Sports Medicine convened a Scientific Roundtable in Indianapolis.

Authors
Bar-Or, O; Foreyt, J; Bouchard, C; Brownell, KD; Dietz, WH; Ravussin, E; Salbe, AD; Schwenger, S; Jeor, SS; Torun, B
MLA Citation
Bar-Or, O, Foreyt, J, Bouchard, C, Brownell, KD, Dietz, WH, Ravussin, E, Salbe, AD, Schwenger, S, Jeor, SS, and Torun, B. "Physical activity, genetic, and nutritional considerations in childhood weight management." Medicine and Science in Sports and Exercise 30.1 (1998): 2-10.
PMID
9475638
Source
scival
Published In
Medicine and Science in Sports and Exercise
Volume
30
Issue
1
Publish Date
1998
Start Page
2
End Page
10
DOI
10.1097/00005768-199801000-00002

Motivations for running and eating attitudes in obligatory versus nonobligatory runners

Objective: This study examined the association between motivations to run and eating disturbances in a sample of obligatory and nonobligatory runners. Method: 240 males and 84 females were evaluated for running habits, motivations for running, and eating and weight concerns. 26.2% of the men and 25% of the women were classified as obligatory runners. Results: Obligatory runners were more motivated to run by negative factors such as guilt for stopping, scored significantly higher on the Eating Attitudes Test (EAT), and had lower weights. These effects were strongest in women. Discussion: The results suggest that female obligatory runners may be at increased risk for eating disorders.

Authors
Slay, HA; Hayaki, J; Napolitano, MA; Brownell, KD
MLA Citation
Slay, HA, Hayaki, J, Napolitano, MA, and Brownell, KD. "Motivations for running and eating attitudes in obligatory versus nonobligatory runners." International Journal of Eating Disorders 23.3 (1998): 267-275.
PMID
9547661
Source
scival
Published In
International Journal of Eating Disorders
Volume
23
Issue
3
Publish Date
1998
Start Page
267
End Page
275
DOI
10.1002/(SICI)1098-108X(199804)23:3<267::AID-EAT4>3.0.CO;2-H

Dietary fat consumption in a cohort of American adults, 1985-1991: Covariates, secular trends, and compliance with guidelines

Purpose. To examine compliance with the guideline for dietary fat (i.e., 30% of total daily calories) and covariates of fat intake in a cohort of adults using both 24-hour recall and food frequency questionnaire (FFQ). Design. Prospective, observational cohort study over 5 years. Setting. Community-based sample in Reno, Nevada. Subjects. Equal numbers of male and female, lean and overweight adults (n = 508), recruited from 1985 to 1986, of whom 348 completed all relevant surveys. Measures. Subjects underwent repeated anthropometric measures and completed extensive surveys on diet, weight cycling, lifestyle, and physical activity. Results. Mean fat intake by 24-hour recall declined from 36.9% to 33.6% of calories between years 1 and 5 (p < .001), while calorie intake increased (p = .2). As measured by FFQ at year 2, mean fat intake was 39.1% of calories, and only 11.8% of subjects were in compliance with the guideline for dietary fat intake. Fat intake by FFQ at year 2 was statistically higher than by 24-hour recall in year 1 for lean women (p = .02) and lean men (p = .02), but not for the overweight of either gender, and was significantly higher than the year 5 24-hour recall for all categories of gender and weight (p < .001). Calorie intake, gender, and body mass index were significant in regression models that explained less than 10% of total variability in fat intake (r2 = .08; p < .01). Conclusions. Compliance with the nationally recommended level of dietary fat intake was poor in this cohort, especially as measured by FFQ. Variability in fat intake was largely unexplained by host characteristics, including education. Further study is required to corroborate secular trends in population fat intake, elucidate the determinants of such intake, and identify cost-effective strategies for reducing the consumption of dietary fat.

Authors
Katz, DL; Brunner, RL; Jeor, STS; Scott, B; Jekel, JF; Brownell, KD
MLA Citation
Katz, DL, Brunner, RL, Jeor, STS, Scott, B, Jekel, JF, and Brownell, KD. "Dietary fat consumption in a cohort of American adults, 1985-1991: Covariates, secular trends, and compliance with guidelines." American Journal of Health Promotion 12.6 (1998): 382-390.
PMID
10182090
Source
scival
Published In
American journal of health promotion : AJHP
Volume
12
Issue
6
Publish Date
1998
Start Page
382
End Page
390

Eating disturbances in white and minority female dieters

Objective: This study examined disordered eating, attitudes about weight and appearance, self-esteem, weight loss, and reasons for weight regain in a sample of white, black, Asian, and Hispanic female dieters. Method: In this cross-sectional descriptive study, we scrutinized survey responses of a large number of households subscribing to Consumer Reports magazine. Females (N = 9,971) between 21 and 65 years old (M = 42.9, SD=10.4) with a mean body mass index (BMI) of 27.2 (SD = 6.2) were selected for comparisons. Results: Ethnic groups were different in terms of age, BMI, household income, and marital status. Therefore, these variables were used as covariates in the analyses. More black women were overweight and purged compared to the other groups. Asian women valued the beneficial role of exercise in weight control more, while black women were more inclined to attribute weight gain to cravings and slow metabolism. The groups did not differ in terms of binge eating, attitudes about weight and appearance, self-esteem, the number of attempts to lose weight, and the reasons for their failures. Conclusions: This study suggests that unhealthy eating attitudes and practices may be similar for women who diet, irrespective of ethnic background. However, the generalizability of these findings is limited by the inherent sampling bias.

Authors
Grange, DL; Stone, AA; Brownell, KD
MLA Citation
Grange, DL, Stone, AA, and Brownell, KD. "Eating disturbances in white and minority female dieters." International Journal of Eating Disorders 24.4 (1998): 395-403.
Source
scival
Published In
International Journal of Eating Disorders
Volume
24
Issue
4
Publish Date
1998
Start Page
395
End Page
403
DOI
10.1002/(SICI)1098-108X(199812)24:4<395::AID-EAT6>3.0.CO;2-A

The clinical and economic aspects of obesity management: A managed care perspective

Authors
Kushner, RF; Brownell, KD; Wolf, AM; Burton, WN
MLA Citation
Kushner, RF, Brownell, KD, Wolf, AM, and Burton, WN. "The clinical and economic aspects of obesity management: A managed care perspective." American Journal of Managed Care 4.3 SUPPL. (1998): S151-S154.
Source
scival
Published In
American Journal of Managed Care
Volume
4
Issue
3 SUPPL.
Publish Date
1998
Start Page
S151
End Page
S154

Sex differences in the relationship of body fat distribution with psychosocial variables.

OBJECTIVE: This study tested the hypothesis that the relationship of psychosocial variables to body fat distribution would differ in men and women and would vary according to gender differences in natural patterns of fat distribution. METHOD: Body fat distribution and psychological functioning were examined in 5,930 male and 7,598 female dieters. RESULTS: Upper body size and shape were more strongly related to psychological functioning in men and lower body size and shape were more important in women. DISCUSSION: To better understand the association of weight with psychosocial status, patterns of body fat distribution should be considered.

Authors
Hoffman, JM; Brownell, KD
MLA Citation
Hoffman, JM, and Brownell, KD. "Sex differences in the relationship of body fat distribution with psychosocial variables." The International journal of eating disorders 22.2 (September 1997): 139-145.
PMID
9261651
Source
epmc
Published In
International Journal of Eating Disorders
Volume
22
Issue
2
Publish Date
1997
Start Page
139
End Page
145
DOI
10.1002/(sici)1098-108x(199709)22:2<139::aid-eat4>3.0.co;2-g

Relationship of weight, body dissatisfaction, and self-esteem in African American and white female dieters.

OBJECTIVE: The present study examined the relationship among weight, body dissatisfaction, and self-esteem in a large group of African American and white female dieters who were generally overweight and of middle to high socioeconomic status. METHOD: Subjects were participants in a survey of dieting practices undertaken by Consumer Reports magazine. Major outcome measures included the Rosenberg Self-Esteem Scale and an assessment of shape and weight attitudes. RESULTS: No significant differences between African American and white women were found for body dissatisfaction, self-esteem, discrepancies between actual and ideal weight and shape, or the relationship between self-esteem and body dissatisfaction. Body mass index contributed less to body satisfaction scores in African American than in white women. DISCUSSION: This study provides a comparison of African American and white women in the upper social classes, and raises the possibility that previous findings of less body concern in African American women reflect class rather than race effects.

Authors
Caldwell, MB; Brownell, KD; Wilfley, DE
MLA Citation
Caldwell, MB, Brownell, KD, and Wilfley, DE. "Relationship of weight, body dissatisfaction, and self-esteem in African American and white female dieters." The International journal of eating disorders 22.2 (September 1997): 127-130.
PMID
9261649
Source
epmc
Published In
International Journal of Eating Disorders
Volume
22
Issue
2
Publish Date
1997
Start Page
127
End Page
130
DOI
10.1002/(sici)1098-108x(199709)22:2<127::aid-eat2>3.0.co;2-h

Adult obesity and functioning in the family of origin.

OBJECTIVE: This study investigated the relationship between eating and weight behaviors and functioning in individuals' families of origin. METHOD: Subjects were 237 women and 242 men enrolled in the RENO (Relationship of Energy, Nutrition, and Obesity) Diet-Heart Study, a prospective 5-year study of the effects of weight fluctuation on cardiovascular disease risk factors in normal weight and obese adults. Variables of primary interest included subjects' body mass index (BMI), age of onset of obesity, eating attitudes, lack of control while eating, and family functioning. RESULTS: In men, higher family cohesion was related to healthier eating attitudes and better control over eating, controlling for age, BMI, and adaptability, whereas higher adaptability (changing rules and poor leadership) was related to earlier onset of obesity and more disturbed eating attitudes. Cohesion and adaptability were not related to body weight or eating variables in women. DISCUSSION: The lower societal pressure on men to be thin may increase the importance of family factors in influencing their shape and weight.

Authors
Johnson, B; Brownell, KD; St Jeor, ST; Brunner, RL; Worby, M
MLA Citation
Johnson, B, Brownell, KD, St Jeor, ST, Brunner, RL, and Worby, M. "Adult obesity and functioning in the family of origin." The International journal of eating disorders 22.2 (September 1997): 213-218.
PMID
9261661
Source
epmc
Published In
International Journal of Eating Disorders
Volume
22
Issue
2
Publish Date
1997
Start Page
213
End Page
218
DOI
10.1002/(sici)1098-108x(199709)22:2<213::aid-eat14>3.0.co;2-1

Comparison of men and women with binge eating disorder.

OBJECTIVE: This study examined gender differences in individuals with binge eating disorder (BED) on eating-related psychopathology and general psychological functioning. METHOD: Subjects were age-matched men (n = 21) and women (n = 21) with BED who were administered the Eating Disorders Examination (EDE), the Structured Clinical Interview for DSM-III-R (SCID) and SCID II, and who completed the Emotional Eating Scale (EES) and other questionnaires regarding psychological functioning. RESULTS: Men and women did not differ on measures of eating disturbance, shape and weight concerns, interpersonal problems, or self-esteem, but more men than women met criteria for at least one Axis I diagnosis and had a lifetime diagnosis of substance dependence. Women were more likely to report eating in response to negative emotions, particularly anxiety, anger and frustration, and depression. DISCUSSION: Results from our study suggest that while men and women presenting for treatment for BED are very similar, males may have more Axis I psychiatric disturbance and less emotional eating than their female counterparts. These findings are discussed in terms of the role of gender in BED and possible treatment implications are explored.

Authors
Tanofsky, MB; Wilfley, DE; Spurrell, EB; Welch, R; Brownell, KD
MLA Citation
Tanofsky, MB, Wilfley, DE, Spurrell, EB, Welch, R, and Brownell, KD. "Comparison of men and women with binge eating disorder." The International journal of eating disorders 21.1 (January 1997): 49-54.
PMID
8986517
Source
epmc
Published In
International Journal of Eating Disorders
Volume
21
Issue
1
Publish Date
1997
Start Page
49
End Page
54
DOI
10.1002/(sici)1098-108x(199701)21:1<49::aid-eat6>3.0.co;2-3

Age of onset for binge eating: are there different pathways to binge eating?

OBJECTIVE: In examining individuals with binge eating disorder (BED), we aimed to determine whether their binge eating preceded their first diet or their first diet preceded their binge eating, the age of their first diet, the age of their first binge, and the age when they met DSM-IV criteria for BED. Additionally, we aimed to identify psychological factors that may distinguish the two groups. METHODS: Eighty-seven individuals with BED (19 men and 68 women) were administered the Eating Disorders Examination, the Structured Clinical Interview for DSM-III-R, and several other measures of psychological functioning and psychiatric disturbance. RESULTS: Forty-five percent of the subjects reported that dieting preceded their first binge episode (dietfirst) and 55% reported that binge eating preceded their first diet (bingefirst). There were no significant differences in current eating disturbance, body mass index (BMI), or age for these two groups, but they differed on the age of the first episode of binge eating and the age when binging met BED criteria. The group reporting having binged first had a younger age of onset of binge eating and a younger age at which binge eating met diagnostic criteria than the dietfirst group. The bingefirst group also had a history of more psychiatric problems and were more likely to have an Axis II personality disorder. DISCUSSION: Age of onset of the first binge and BED is markedly different depending on whether an individual began dieting or binging first. These findings suggest that there may be important etiological differences between individuals who binge first and those who diet first. Moreover, individuals who binge first may be at greater risk for psychiatric disturbance.

Authors
Spurrell, EB; Wilfley, DE; Tanofsky, MB; Brownell, KD
MLA Citation
Spurrell, EB, Wilfley, DE, Tanofsky, MB, and Brownell, KD. "Age of onset for binge eating: are there different pathways to binge eating?." The International journal of eating disorders 21.1 (January 1997): 55-65.
PMID
8986518
Source
epmc
Published In
International Journal of Eating Disorders
Volume
21
Issue
1
Publish Date
1997
Start Page
55
End Page
65
DOI
10.1002/(sici)1098-108x(199701)21:1<55::aid-eat7>3.0.co;2-2

A classification system to evaluate weight maintainers, gainers, and losers

Objectives: To study natural weight changes and to develop a weight classification system that can identify weight maintainers, gainers, and losers. Design/outcome: A prospective, observational study in which weight changes over five annual measurements were evaluated. In the weight classification system used, changes greater than 5 lb defined weight maintenance, gain, or loss. Subjects/settings: Subjects were healthy, normal- weight and overweight, men and women (mean age=44.1±14.1 years) in the Relationships of Energy, Nutrition, and Obesity to Cardiovascular Disease Risk Study. Prospective data for 385 of the original 508 subjects for whom actual weights were available for each of the 5 years (1985 to 1990) were used to classify and characterize subjects by weight-change categories. Statistical analyses: Cross-tabulations (with χ 2tests) and hierarchical log-linear analyses (with partial χ 2tests) to examine the relationships of categorical variables; analyses of variance (with F tests) for continuous measures. Results: Over the 4-year interval, 46% of subjects were classified as maintainers, 34% as gainers, and 20% as losers. Over shorter 1-year epochs, more subjects were maintainers (62%) and fewer subjects were gainers (22%) or losers (16%). Maintainers had fewer and smaller magnitudes of weight fluctuations and showed fewer deleterious changes in health risk factors than gainers. Applications: Weight changes of greater than ±5 lb can classify a person as a weight maintainer, gainer, or loser. Although annual weight changes were used in this study, a weight change of more than 5 lb between any two points in time may suggest nonmaintenance of weight or weight instability that needs further evaluation.

Authors
Jeor, STS; Brunner, RL; Harrington, ME; Scott, BJ; Daugherty, SA; Cutter, GR; Brownell, KD; Dyer, AR; Foreyt, JP
MLA Citation
Jeor, STS, Brunner, RL, Harrington, ME, Scott, BJ, Daugherty, SA, Cutter, GR, Brownell, KD, Dyer, AR, and Foreyt, JP. "A classification system to evaluate weight maintainers, gainers, and losers." Journal of the American Dietetic Association 97.5 (1997): 481-488.
PMID
9145085
Source
scival
Published In
Journal of the American Dietetic Association
Volume
97
Issue
5
Publish Date
1997
Start Page
481
End Page
488

Binge eating in an obese community sample

Objective: The present study sought to examine the validity and utility of diagnostic criteria for binge-eating disorder (BED) by replicating and extending a study reported by de Zwaan and colleagues (International Journal of Eating Disorders 15, 43-52, 1994). Method: Four groups of obese individuals were selected from a large community-based sample of men and women: 33 women and 20 men with BED, 79 women and 40 men with subthreshold BED, 21 women and 39 men who reported recurrent overeating, and 80 female and 80 male normal controls. The groups were compared on measures of body image concern, dieting behavior, and associated psychological distress. Results: Individuals with BED were distinguishable from overeaters and normal controls on a number of psychological and behavioral variables. Few differences were found between subthreshold and full-syndrome BED, raising questions about the diagnostic validity of the frequency threshold Men with BED did not differ from women with BED above and beyond the gender-related differences observed across all four groups. Discussion: Our findings support the view of BED as a distinct syndrome.

Authors
Striegel-Moore, RH; Wilson, GT; Wilfley, DE; Elder, KA; Brownell, KD
MLA Citation
Striegel-Moore, RH, Wilson, GT, Wilfley, DE, Elder, KA, and Brownell, KD. "Binge eating in an obese community sample." International Journal of Eating Disorders 23.1 (1997): 27-37.
Source
scival
Published In
International Journal of Eating Disorders
Volume
23
Issue
1
Publish Date
1997
Start Page
27
End Page
37
DOI
10.1002/(SICI)1098-108X(199801)23:1<27::AID-EAT4>3.0.CO;2-3

Comparison of men and women with binge eating disorder

Objective: This study examined gender differences in individuals with binge eating disorder (BED) on eating-related psychopathology and general psychological functioning. Method: Subjects were age-matched men (n = 21) and women (n = 21) with BED who were administered the Eating Disorders Examination (EDE), the Structured Clinical Interview for DSM-III-R (SCID) and SCID II, and who completed the Emotional Eating Scale (EES) and other questionnaires regarding psychological functioning. Results: Men and women did not differ on measures of eating disturbance, shape and weight concerns, interpersonal problems, or self-esteem, but more men than women met criteria for at least one Axis I diagnosis and had a lifetime diagnosis of substance dependence. Women were more likely to report eating in response to negative emotions, particularly anxiety, anger and frustration, and depression. Discussion: Results from our study suggest that while men and women presenting for treatment for BED are very similar, males may have more Axis I psychiatric disturbance and less emotional eating than their female counterparts. These findings are discussed in terms of the role of gender in BED and possible treatment implications are explored.

Authors
Tanofsky, MB; Wilfley, DE; Spurrell, EB; Welch, R; Brownell, KD
MLA Citation
Tanofsky, MB, Wilfley, DE, Spurrell, EB, Welch, R, and Brownell, KD. "Comparison of men and women with binge eating disorder." International Journal of Eating Disorders 21.1 (1997): 49-54.
Source
scival
Published In
International Journal of Eating Disorders
Volume
21
Issue
1
Publish Date
1997
Start Page
49
End Page
54
DOI
10.1002/(SICI)1098-108X(199701)21:1<49::AID-EAT6>3.0.CO;2-3

Age of onset for binge eating: Are there different pathways to binge eating?

Objective: In examining individuals with binge eating disorder (BED), we aimed to determine whether their binge eating preceded their first diet or their first diet preceded their binge eating, the age of their first diet, the age of their first binge, and the age when they met DSM-IV criteria for BED. Additionally, we aimed to identify psychological factors that may distinguish the two groups. Method: Eighty-seven individuals with BED (19 men and 68 women) were administered the Eating Disorders Examination, the Structured Clinical Interview for DSM-III-R, and several other measures of psychological functioning and psychiatric disturbance. Results: Forty-five percent of the subjects reported that dieting preceded their first binge episode (dietfirst) and 55% reported that binge eating preceded their first diet (bingefirst). There were no significant differences in current eating disturbance, body mass index (BMI), or age for these two groups, but they differed on the age of the first episode of binge eating and the age when hinging met BED criteria. The group reporting having hinged first had a younger age of onset of binge eating and a younger age at which binge eating met diagnostic: criteria than the dietfirst group. The bingefirst group also had a history of more psychiatric problems and were more likely to have an Axis II personality disorder. Discussion: Age of onset of the first binge and BED is markedly different depending on whether an individual began dieting or binging first. These findings suggest that there may be important etiological differences between individuals who binge first and those who diet first. Moreover, individuals who binge first may be at greater risk for psychiatric disturbance.

Authors
Spurrell, EB; Wilfley, DE; Tanofsky, MB; Brownell, KD
MLA Citation
Spurrell, EB, Wilfley, DE, Tanofsky, MB, and Brownell, KD. "Age of onset for binge eating: Are there different pathways to binge eating?." International Journal of Eating Disorders 21.1 (1997): 55-65.
Source
scival
Published In
International Journal of Eating Disorders
Volume
21
Issue
1
Publish Date
1997
Start Page
55
End Page
65
DOI
10.1002/(SICI)1098-108X(199701)21:1<55::AID-EAT7>3.0.CO;2-2

Sex differences in the relationship of body fat distribution with psychosocial variables

Objective: This study tested the hypothesis that the relationship of psychosocial variables to body fat distribution would differ in men and women and would vary according to gender differences in natural patterns of fat distribution. Method: Body fat distribution and psychological functioning were examined in 5,930 male and 7,598 female dieters. Results: Upper body size and shape were more strongly related to psychological functioning in men and lower body size and shape were more important in women. Discussion: To better understand the association of weight with psychosocial status, patterns of body fat distribution should be considered.

Authors
Hoffman, JM; Brownell, KD
MLA Citation
Hoffman, JM, and Brownell, KD. "Sex differences in the relationship of body fat distribution with psychosocial variables." International Journal of Eating Disorders 22.2 (1997): 139-145.
Source
scival
Published In
International Journal of Eating Disorders
Volume
22
Issue
2
Publish Date
1997
Start Page
139
End Page
145
DOI
10.1002/(SICI)1098-108X(199709)22:2<139::AID-EAT4>3.0.CO;2-G

Relationship of weight, body dissatisfaction, and self-esteem in african american and white female dieters

Objective: The present study examined the relationship among weight, body dissatisfaction, and self-esteem in a large group of African American and white female dieters who were generally overweight and of middle to high socioeconomic status. Method: Subjects were participants in a survey of dieting practices undertaken by Consumer Reports magazine. Major outcome measures included the Rosenberg Self-Esteem Scale and an assessment of shape and weight attitudes. Results: No significant differences between African American and white women were found for body dissatisfaction, self-esteem, discrepancies between actual and ideal weight and shape, or the relationship between self-esteem and body dissatisfaction. Body mass index contributed less to body satisfaction scores in African American than in white women. Discussion: This study provides a comparison of African American and white women in the upper social classes, and raises the possibility that previous findings of less body concern in African American women reflect class rather than race effects.

Authors
Caldwell, MB; Brownell, KD; Wilfley, DE
MLA Citation
Caldwell, MB, Brownell, KD, and Wilfley, DE. "Relationship of weight, body dissatisfaction, and self-esteem in african american and white female dieters." International Journal of Eating Disorders 22.2 (1997): 127-130.
Source
scival
Published In
International Journal of Eating Disorders
Volume
22
Issue
2
Publish Date
1997
Start Page
127
End Page
130
DOI
10.1002/(SICI)1098-108X(199709)22:2<127::AID-EAT2>3.0.CO;2-H

Adult obesity and functioning in the family of origin

Objective: This study investigated the relationship between eating and weight behaviors and functioning in individuals' families of origin. Method: Subjects were 237 women and 242 men enrolled in the RENO (Relationship of Energy, Nutrition, and Obesity) Diet-Heart Study, a prospective 5-year study of the effects of weight fluctuation on cardiovascular disease risk factors in normal weight and obese adults. Variables of primary interest included subjects' body mass index (BMI), age of onset of obesity, eating attitudes, lack of control while eating, and family functioning. Results: In men, higher family cohesion was related to healthier eating attitudes and better control over eating, controlling for age, BMI, and adaptability, whereas higher adaptability (changing rules and poor leadership) was related to earlier onset of obesity and more disturbed eating attitudes. Cohesion and adaptability were not related to body weight or eating variables in women. Discussion: The lower societal pressure on men to be thin may increase the importance of family factors in influencing their shape and weight.

Authors
Johnson, B; Brownell, KD; Jeor, STS; Brunner, RL; Worby, M
MLA Citation
Johnson, B, Brownell, KD, Jeor, STS, Brunner, RL, and Worby, M. "Adult obesity and functioning in the family of origin." International Journal of Eating Disorders 22.2 (1997): 213-218.
Source
scival
Published In
International Journal of Eating Disorders
Volume
22
Issue
2
Publish Date
1997
Start Page
213
End Page
218
DOI
10.1002/(SICI)1098-108X(199709)22:2<213::AID-EAT14>3.0.CO;2-1

Body shape ideals across gender, sexual orientation, socioeconomic status, race, and age in personal advertisements.

OBJECTIVE: To assess body shape ideals across gender, sexual orientation, race, socio-economic status, and age, METHOD: An analysis of personal advertisements was conducted across seven different publications which targeted the groups of interest. RESULTS: Women advertised body weight much less often than men, and lesbians reported body shape descriptors significantly less often than heterosexual women. Gay men and African-American men described their body shape significantly more often than did other groups. However, their reported body mass indices (BMI) were significantly different-African-American men reported a higher BMI, and gay men a lower BMI, than Euro-American heterosexual men. DISCUSSION: Race and sexual orientation may influence the importance of size of body shape ideals for men. For women, however, their advertised weights conformed to the thin ideal across all groups surveyed. Gender roles affecting body shape ideals and mate attraction are discussed.

Authors
Epel, ES; Spanakos, A; Kasl-Godley, J; Brownell, KD
MLA Citation
Epel, ES, Spanakos, A, Kasl-Godley, J, and Brownell, KD. "Body shape ideals across gender, sexual orientation, socioeconomic status, race, and age in personal advertisements." The International journal of eating disorders 19.3 (April 1996): 265-273.
PMID
8704725
Source
epmc
Published In
International Journal of Eating Disorders
Volume
19
Issue
3
Publish Date
1996
Start Page
265
End Page
273
DOI
10.1002/(sici)1098-108x(199604)19:3<265::aid-eat5>3.0.co;2-k

Confronting a rising tide of eating disorders and obesity: Treatment vs. prevention and policy

Eating disorders and obesity are rising in prevalence and are problems of considerable public health significance. Prevailing treatments have a limited impact on public health because the disorders do not yield easily to intervention and because the treatments are costly and available to few. Shifting from a medical to a public health model argues for increased focus on both prevention and public policy. Research on prevention is in its early stages but must be aggressively pursued. Even less is known about policy, but recommendations are made to after policy so that consumption of healthful foods increases, consumption of unhealthful foods decreases, and levels of physical activity are enhanced.

Authors
Battle, EK; Brownell, KD
MLA Citation
Battle, EK, and Brownell, KD. "Confronting a rising tide of eating disorders and obesity: Treatment vs. prevention and policy." Addictive Behaviors 21.6 (1996): 755-765.
PMID
8904941
Source
scival
Published In
Addictive Behaviors
Volume
21
Issue
6
Publish Date
1996
Start Page
755
End Page
765
DOI
10.1016/0306-4603(96)00034-2

Methodological issues in weight cycling

Recent studies have suggested that weight changes may be related to disease risk independent of weight status. A critical step in testing this assertion is the measurement of weight change and so-called "weight cycling". However intuitive the concept of weight cycling may appear, research in this area is hampered by complex methodological issues. This article discusses various measures of nominal weight cycling, including the standard deviation, coefficient of variation, regression techniques, and cycles. A cycle is a sequence of a gain followed by a loss or vice versa. The various measures are compared in seven hypothetical cases created to illustrate their strengths and weaknesses. Superior performance of the cycles measure over the coefficient of variation, number of fluctuations, and simple regression methods is argued. The linkage of the cycles measure with the statistical theory of runs also provides a basis for testing the significance of weight fluctuations or other variables that may cycle, such as blood lipids, etc. The cycles measure and runs test provide a viable definition for identifying weight cycling and a tool for evaluating the critical amount of weight gained and/or lost in relationship to risk. © 1996 The Society of Behavioral Medicine.

Authors
Cutter, G; Jeor, S; Brunner, R; Wolfe, P; Foreyt, J; Dyer, A; Brownell, KD
MLA Citation
Cutter, G, Jeor, S, Brunner, R, Wolfe, P, Foreyt, J, Dyer, A, and Brownell, KD. "Methodological issues in weight cycling." Annals of Behavioral Medicine 18.4 (1996): 280-289.
Source
scival
Published In
Annals of Behavioral Medicine
Volume
18
Issue
4
Publish Date
1996
Start Page
280
End Page
289
DOI
10.1007/BF02895290

Behaviour change in practice: Group approaches

Preliminary research in the treatment of obesity suggests that group interventions may be at least as effective as individual interventions, presumably due to the social support created among individuals in the group. Given that a cost-effectiveness analysis may favor groups, further research is necessary on how the benefits of group process can be maximized.

Authors
Hayaki, J; Brownell, KD
MLA Citation
Hayaki, J, and Brownell, KD. "Behaviour change in practice: Group approaches." International Journal of Obesity 20.SUPPL. 1 (1996): S27-S30.
PMID
8646262
Source
scival
Published In
International Journal of Obesity
Volume
20
Issue
SUPPL. 1
Publish Date
1996
Start Page
S27
End Page
S30

Body shape ideals across gender, sexual orientation, socioeconomic status, race, and age in personal advertisements

Objective: To assess body shape ideals across gender, sexual orientation, race, socioeconomic status, and age. Method: An analysis of personal advertisements was conducted across seven different publications which targeted the groups of interest. Results: Women advertised body weight much less often than men, and lesbians reported body shape descriptors significantly less often than heterosexual women. Gay men and African- American men described their body shape significantly more often than did other groups. However, their reported body mass indices (BMI) were significantly different-African-American men reported a higher BMI, and gay men a lower BMI, than Euro-American heterosexual men. Discussion: Race and sexual orientation may influence the importance of size of body shape ideals for men. For women, however, their advertised weights conformed to the thin ideal across all groups surveyed. Gender roles affecting body shape ideals and mate attraction are discussed.

Authors
Epel, ES; Spanakos, A; Kasl-Godley, J; Brownell, KD
MLA Citation
Epel, ES, Spanakos, A, Kasl-Godley, J, and Brownell, KD. "Body shape ideals across gender, sexual orientation, socioeconomic status, race, and age in personal advertisements." International Journal of Eating Disorders 19.3 (1996): 265-273.
Source
scival
Published In
International Journal of Eating Disorders
Volume
19
Issue
3
Publish Date
1996
Start Page
265
End Page
273
DOI
10.1002/(SICI)1098-108X(199604)19:3<265::AID-EAT5>3.0.CO;2-K

Who are the weight maintainers?

To characterize people who maintain weight over long periods of time, normal weight and obese adults (n = 385) were studied over five annual visits. Subjects were classified using a +/- 5 lb change between the first and the fifth year visits to determine overall maintenance (M), with gain (G) or loss (L) being any change outside this range. This MGL status was cross-tabulated with a Fluctuation Index which counted the number of successive year-to-year weight changes of more than +/- 5 lbs (F0 through F4). True maintainers were defined as those having all weight changes within +/- 5 lbs during the 5-year period (M and F0). Nineteen percent (n = 73) of the subjects were classified as True Maintainers and included three times as many normal weight as obese subjects. Obese subjects comprised only 25% of the True Maintainer group but 60% of the Non-Maintainer group. Age had no association with Maintainer status. Standard measures of weight variability were lowest among True Maintainers and highest in Non-Maintainers. In addition, True Maintainers had lower BMI, Percent Body Fat, and Waist-Hip Ratios than Non-Maintainers. Subjects classified as Non-Maintainers were more likely to engage in dieting, by a variety of measures, than True Maintainers--this was particularly true among obese subjects. Finally, changes in total cholesterol, LDL and HDL cholesterol, and systolic and diastolic blood pressure were not reliably associated with Maintainer status, although the ordering of the group means suggested that True Maintainers had slightly healthier levels of "risk" variables. Overall, the results suggest that True Maintainers comprise a potentially important and interesting group of individuals who need further study.

Authors
Jeor, STS; Brunner, RL; Harrington, ME; Scott, BJ; Cutter, GR; Brownell, KD; Dyer, AR; Foreyt, JP
MLA Citation
Jeor, STS, Brunner, RL, Harrington, ME, Scott, BJ, Cutter, GR, Brownell, KD, Dyer, AR, and Foreyt, JP. "Who are the weight maintainers?." Obesity research 3 Suppl 2 (1995): 249s-259s.
PMID
8581784
Source
scival
Published In
Obesity research
Volume
3 Suppl 2
Publish Date
1995
Start Page
249s
End Page
259s

Dietary intake of female collegiate heavyweight rowers

The purpose of this study was to evaluate the adequacy of dietary intake in 16 female heavyweight rowers during the sprint racing phase of the season. Caloric intake for the rowers was 2,633 kcal/day, lower than expected given the training regimen of these athletes. On average, rowers consumed below optimal levels of carbohydrate. Protein intake was satisfactory but fat intake was higher than recommended. For the majority of rowers, micronutrient intake met the RDA. However, calcium, zinc, B6, and B12 fell short of meeting two-thirds of the RDA for a significant percentage of rowers. The preevent meal consumed both 15 hr and 2 hr before the event provided less carbohydrate and fluid but more fat than desirable. Female heavyweight rowers would benefit from nutritional counseling that provides strategies for increasing complex carbohydrates, calcium, zinc, B6, and B12 while reducing dietary fat. Adequate fluid intake is also essential.

Authors
Steen, SN; Mayer, K; Brownell, KD; Wadden, TA
MLA Citation
Steen, SN, Mayer, K, Brownell, KD, and Wadden, TA. "Dietary intake of female collegiate heavyweight rowers." International Journal of Sport Nutrition 5.3 (1995): 225-231.
PMID
8547940
Source
scival
Published In
International Journal of Sport Nutrition
Volume
5
Issue
3
Publish Date
1995
Start Page
225
End Page
231

Psychological correlates of obesity: Moving to the next research generation

Studies comparing obese and nonobese persons have generally failed to find differences in global aspects of psychological functioning (e.g., depression, anxiety). The resulting conclusion, that obesity does not carry risk for psychological problems, is inimical to clinical impression, reports from over-weight individuals, and a consistent literature showing strong cultural bias and negative attitudes toward obese persons. The often-cited notion that obesity has no psychological consequences may be an inevitable byproduct of the manner in which the first generation of studies in the field has been conducted. The authors propose a second generation of studies that begins with a risk factor model to identify the individuals who will suffer from their obesity and the areas of functioning most affected. Recommendations are also made for a third generation of studies that will establish causal pathways linking obesity to specific areas of distress.

Authors
Friedman, MA; Brownell, KD
MLA Citation
Friedman, MA, and Brownell, KD. "Psychological correlates of obesity: Moving to the next research generation." Psychological Bulletin 117.1 (1995): 3-20.
PMID
7870862
Source
scival
Published In
Psychological Bulletin
Volume
117
Issue
1
Publish Date
1995
Start Page
3
End Page
20

Adherence to dietary regimens 1: An overview of research

In recent government reports, scientists have highlighted the link between diet and health and have concluded that dietary changes could reduce risks for some major chronic illnesses tie, cancer and cardiovascular disease). As a result, the feasibility of lasting dietary change has become a central concern. Despite mixed findings from dietary adherence studies, there is evidence that meaningful dietary modification and adherence are possible, although not easily accomplished. Psychological, cultural, environmental, and behavioral factors exert an influence on whether individuals try to change their eating habits. Given the complex interaction between these factors, it is not surprising that education alone rarely produces lasting change. To develop comprehensive approaches to dietary management, practitioners must integrate theoretical and empirical information across a number of fields. In addition to focusing on individual behavior change, the authors suggest, those concerned with the nation's health should give serious consideration to the possibility of changes at the policy level.

Authors
Brownell, KD; Cohen, LR
MLA Citation
Brownell, KD, and Cohen, LR. "Adherence to dietary regimens 1: An overview of research." Behavioral Medicine 20.4 (1995): 149-154.
PMID
7620226
Source
scival
Published In
Behavioral Medicine
Volume
20
Issue
4
Publish Date
1995
Start Page
149
End Page
154

Adherence to dietary regimens 2: Components of effective interventions

Authors
Brownell, KD; Cohen, LR
MLA Citation
Brownell, KD, and Cohen, LR. "Adherence to dietary regimens 2: Components of effective interventions." Behavioral Medicine 20.4 (1995): 155-164.
PMID
7620227
Source
scival
Published In
Behavioral Medicine
Volume
20
Issue
4
Publish Date
1995
Start Page
155
End Page
164

Psychological correlates of weight fluctuation

This investigation attempted to determine psychological correlates of weight fluctuation in a sample of 497 normal weight and obese adults who were enrolled in a prospective, natural history study. Subjects were stratified by gender, obesity, and age and classified as weight maintainers, gainers, or losers based on their changes in weight over a 1-year period. Subjects were further classified as either weight fluctuators or nonfluctuators based on historical self-report. Nonfluctuators reported significantly higher general well-being, greater eating self-efficacy, and lower stress than weight fluctuators, regardless of body weight. Weight maintainers had more favorable eating serf-efficacy related to negative affect than weight gainers. Results suggest that weight fluctuation is strongly associated with negative psychological attributes in both normal weight and obese individuals. Future research should focus on the assessment and treatment of weight fluctuation and on weight maintenance, irrespective of weight status.

Authors
Foreyt, JP; Brunner, RL; Goodrick, GK; Cutter, G; Brownell, KD; Jeor, STS
MLA Citation
Foreyt, JP, Brunner, RL, Goodrick, GK, Cutter, G, Brownell, KD, and Jeor, STS. "Psychological correlates of weight fluctuation." International Journal of Eating Disorders 17.3 (1995): 263-275.
PMID
7773263
Source
scival
Published In
International Journal of Eating Disorders
Volume
17
Issue
3
Publish Date
1995
Start Page
263
End Page
275

Weight loss, psychological, and nutritional patterns in competitive male body builders

There has been increasing interest in the effects of chronic dieting and of repeated cycles of weight loss and regain in athletes. The purpose of this investigation was to examine the eating and weight loss practices, nutrition, and psychological factors in 45 male body builders competing in a drug-free competition. Subjects completed a questionnaire on the morning of a body building competition to assess the weight loss and dietary history, psychological distress, reports of binge eating, and vitamin and mineral supplement usage. The subjects reported high levels of dieting, weight loss, and weight regain. The mean weight loss reported in the competitive season was 6.8 kg; the mean weight gain reported was 6.2 kg. Eighty-five percent reported gaining weight while 46% reported episodes of binge eating after competitions. Most (81.5%) reported being preoccupied with food sometimes, often, or always. Between 30 and 50% reported psychological distress when preparing for competition (anxiety, short temper, anger). A similar number (30-50%) reported using amino acid, protein, and vitamin supplements. It appears that severe dieting practices are common in the sport of competitive body building. The potential physiological, psychological, and health implications of these practices, combined with the growing popularity of body building, are of sufficient importance to warrant further attention by investigators and the body building community.

Authors
Andersen, RE; Barlett, SJ; Morgan, GD; Brownell, KD
MLA Citation
Andersen, RE, Barlett, SJ, Morgan, GD, and Brownell, KD. "Weight loss, psychological, and nutritional patterns in competitive male body builders." International Journal of Eating Disorders 18.1 (1995): 49-57.
PMID
7670443
Source
scival
Published In
International Journal of Eating Disorders
Volume
18
Issue
1
Publish Date
1995
Start Page
49
End Page
57

Exercise and obesity treatment: Psychological aspects

Exercise is clearly beneficial as a means for losing weight and keeping it off. Given recent studies showing its association with maintenance, it would be difficult to argue that any factor is more important than exercise. For an exercise program to be helpful for obese persons, the challenges of exercise adherence must be considered, as must the mechanisms linking exercise to weight control. Both argue for whatever activity an individual will undertake that will produce the psychological effects that promote weight control.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Exercise and obesity treatment: Psychological aspects." International Journal of Obesity 19.SUPPL. 4 (1995): S122-S125.
PMID
8581087
Source
scival
Published In
International Journal of Obesity
Volume
19
Issue
SUPPL. 4
Publish Date
1995
Start Page
S122
End Page
S125

Matching Individuals to Weight Loss Treatments: A Survey of Obesity Experts

For identification of factors for matching individuals to treatments, experts in the field of obesity were surveyed about the indications and contraindications for 11 common approaches to weight loss. The experts provided 170 client characteristics as possible matching factors, yet only 5 factors were matched to specific programs by 50% or more of the respondents. The results are discussed with regard to potential variables for studies on matching individuals to treatments, working hypotheses to be tested, and the value of matching information for clinical decision making.

Authors
Schwartz, MB; Brownell, KD
MLA Citation
Schwartz, MB, and Brownell, KD. "Matching Individuals to Weight Loss Treatments: A Survey of Obesity Experts." Journal of Consulting and Clinical Psychology 63.1 (1995): 149-153.
PMID
7896981
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
63
Issue
1
Publish Date
1995
Start Page
149
End Page
153
DOI
10.1037/0022-006X.63.1.149

Distorting reality for children: Body size proportions of Barbie and Ken dolls

Using hip measurements as a constant, calculations were made to determine the changes necessary for a young, healthy adult woman and man to attain the same body proportions as Barbie and Ken dolls, respectively. Among the changes necessary were for the female to increase 24 in. in height, 5 in. in the chest, and 3.2 in. in neck length, while decreasing 6 in. in the waist, and for the male to increase 20 in. in height, 11 in. in the chest, and 7.9 in. in neck circumference. Like adults, children are exposed to highly unrealistic ideals for shape and weight.

Authors
Brownell, KD; Napolitano, MA
MLA Citation
Brownell, KD, and Napolitano, MA. "Distorting reality for children: Body size proportions of Barbie and Ken dolls." International Journal of Eating Disorders 18.3 (1995): 295-298.
PMID
8556027
Source
scival
Published In
International Journal of Eating Disorders
Volume
18
Issue
3
Publish Date
1995
Start Page
295
End Page
298

The stress-eating paradox: Multiple daily measurements in adult males and females

Authors
Stone, AA; Brownell, KD
MLA Citation
Stone, AA, and Brownell, KD. "The stress-eating paradox: Multiple daily measurements in adult males and females." Psychology & Health 9.6 (November 1994): 425-436.
Source
crossref
Published In
Psychology and Health
Volume
9
Issue
6
Publish Date
1994
Start Page
425
End Page
436
DOI
10.1080/08870449408407469

Dieting and Disordered Eating Correlates of Weight Fluctuation in Normal And Obese Adults

Authors
Brunner, RL; St. Jeor, ST; Scott, BJ; Miller, GD; Carmody, TP; Brownell, KD; Foreyt, J
MLA Citation
Brunner, RL, St. Jeor, ST, Scott, BJ, Miller, GD, Carmody, TP, Brownell, KD, and Foreyt, J. "Dieting and Disordered Eating Correlates of Weight Fluctuation in Normal And Obese Adults." Eating Disorders 2.4 (January 1994): 341-356.
Source
crossref
Published In
Eating Disorders
Volume
2
Issue
4
Publish Date
1994
Start Page
341
End Page
356
DOI
10.1080/10640269408249132

Medical, metabolic, and psychological effects of weight cycling

This article reviews studies on the effects of weight cycling and weight variability on metabolism, psychological status, morbidity, and mortality. Repeated bouts of weight loss and regain, known as weight cycling or yo-yo dieting, are highly prevalent, occur in males and females, and are common in both overweight and nonoverweight individuals. While there has been no consistent demonstration that, as was first thought, weight cycling makes subsequent weight loss more difficult or regain more rapid, it is possible that this does occur under some conditions or in particular individuals. There are stronger and more consistent links between body weight variability and negative health outcomes, particularly all-cause mortality and mortality from coronary heart disease. Weight cycling may also have negative psychological and behavioral consequences; studies have reported increased risk for psychopathology, life dissatisfaction, and binge eating. The bulk of epidemiologic research shows an association of weight variability with morbidity and mortality, although the mechanisms are not clear at present. There is a clear need for further research on the effects of weight cycling on behavior, metabolism, and health. Understanding and promoting weight maintenance is an important priority.

Authors
Brownell, KD; Rodin, J
MLA Citation
Brownell, KD, and Rodin, J. "Medical, metabolic, and psychological effects of weight cycling." Archives of Internal Medicine 154.12 (1994): 1325-1330.
PMID
8002684
Source
scival
Published In
Archives of Internal Medicine
Volume
154
Issue
12
Publish Date
1994
Start Page
1325
End Page
1330
DOI
10.1001/archinte.154.12.1325

The dieting maelstrom: Is it possible and advisable to lose weight?

An impassioned debate over the virtues and dangers of dieting is polarizing the field and diverts attention from key issues. Dieting clearly has costs and, for some, has the potential for benefit. The primary challenges are (a) to identify individuals who will be helped or harmed by dieting, (b) to reduce the frequency and severity of dieting in those for whom the costs exceed the benefits, (c) to better understand the physiological and psychological reasons why some people can lose and others cannot, and (d) to develop safe and effective means for weight loss and its maintenance and to target these methods to individuals who stand to benefit.

Authors
Brownell, KD; Rodin, J
MLA Citation
Brownell, KD, and Rodin, J. "The dieting maelstrom: Is it possible and advisable to lose weight?." American Psychologist 49.9 (1994): 781-791.
PMID
7978665
Source
scival
Published In
American Psychologist
Volume
49
Issue
9
Publish Date
1994
Start Page
781
End Page
791

The social self, body dissatisfaction, and binge eating in obese females.

We examined the relationship of the social self to body dissatisfaction and to binge eating in two clinical samples of obese females. In the first study, with 32 nonbingeing obese females, social self measures of Public Self-Consciousness and Social Anxiety were positively correlated with body dissatisfaction. Self-esteem was negatively correlated with body dissatisfaction. In the second study, 11 obese binge eaters were compared with 11 matched nonbingeing obese females. Binge eaters were characterized by significantly higher levels of social anxiety and body dissatisfaction than the obese nonbingeing controls. These findings support the hypothesized links of social self concerns to body dissatisfaction and to binge eating in obese females.

Authors
Grilo, CM; Wilfley, DE; Jones, A; Brownell, KD; Rodin, J
MLA Citation
Grilo, CM, Wilfley, DE, Jones, A, Brownell, KD, and Rodin, J. "The social self, body dissatisfaction, and binge eating in obese females." Obesity research. 2.1 (1994): 24-27.
PMID
16353605
Source
scival
Published In
Obesity research
Volume
2
Issue
1
Publish Date
1994
Start Page
24
End Page
27

Teasing, body image, and self-esteem in a clinical sample of obese women

This study examined the relationship of physical-appearance-related teasing history to body image and self-esteem in a clinical sample of adult obese females. The frequency of being teased about weight and size while growing up was negatively correlated with evaluation of one's appearance and positively correlated with body dissatisfaction during adulthood. Self-esteem was unrelated to teasing history but covaried significantly with body image measures. Subjects with early-onset obesity reported greater body dissatisfaction than did subjects with adult-onset obesity. The findings suggest that being teased about weight/size while growing up may represent a risk factor for the development of negative body image and that self-esteem and body image covary. © 1994.

Authors
Grilo, CM; Wilfley, DE; Brownell, KD; Rodin, J
MLA Citation
Grilo, CM, Wilfley, DE, Brownell, KD, and Rodin, J. "Teasing, body image, and self-esteem in a clinical sample of obese women." Addictive Behaviors 19.4 (1994): 443-450.
PMID
7992678
Source
scival
Published In
Addictive Behaviors
Volume
19
Issue
4
Publish Date
1994
Start Page
443
End Page
450
DOI
10.1016/0306-4603(94)90066-3

Body weight change, all-cause mortality, and cause-specific mortality in the multiple risk factor intervention trial

Objective: To evaluate the relation between weight variability and death in high-risk, middle-aged men participating in the Multiple Risk Factor Intervention Trial (MRFIT). Design: Cohort study with 3.8 years of follow- up. Setting: Multicenter, collaborative, primary prevention trial conducted at 22 clinical centers in the United States. Participants: Men (n = 10 529) who were 35 to 57 years old at baseline and who were in the upper 10% to 15% of risk for coronary heart disease because of smoking, high blood pressure, and elevated cholesterol level. Participants were seen at least annually for 6 to 7 years for medical evaluations in study clinical centers. Measurements: Death from cardiovascular disease (228 deaths) and from all causes (380 deaths). Results: The primary measure of weight variability was the intrapersonal standard deviation of weight (ISD), which was calculated from measured weights obtained at clinic visits during a 6- to 7-year period. All- cause death rates per 1000 person-years of follow-up across ISD quartiles were 8.28, 8.25, 10.57, and 11.07 from the first to fourth quartiles, respectively. After adjusting for baseline risk factors associated with weight change, the relative risk for all-cause mortality in the fourth compared with the first quartile was 1.64 (95% CI, 1.21 to 2.23). Cardiovascular death and ISD showed a similar pattern. The association between weight change and death was not observed in the heaviest men. Conclusion: Greater weight variability was associated with a greater risk for cardiovascular disease and all-cause mortality in some types of high-risk men.

Authors
Blair, SN; Shaten, J; Brownell, K; Collins, G; Lissner, L
MLA Citation
Blair, SN, Shaten, J, Brownell, K, Collins, G, and Lissner, L. "Body weight change, all-cause mortality, and cause-specific mortality in the multiple risk factor intervention trial." Annals of Internal Medicine 119.7 II (1993): 749-757.
PMID
8363210
Source
scival
Published In
Annals of Internal Medicine
Volume
119
Issue
7 II
Publish Date
1993
Start Page
749
End Page
757

Whether Obesity Should Be Treated

Antidieting sentiment is strengthened in part by the assumption that all diets fail, which in turn is based on data from university-based treatment programs. A small percentage of overweight people attempt to lose weight in these programs, and they differ in important ways from overweight people in general. They are heavier, more likely to be binge eaters, and have higher levels of psychopathology-all negative prognostic factors for treatment. Generalizing from the treatment of this group to all programs is highly questionable. Hence, little is known about the effectiveness of approaches used by most people. There is a pressing need for research on this topic, and a need for treatments that address the specific needs of those who seek clinical treatments.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Whether Obesity Should Be Treated." Health Psychology 12.5 (1993): 339-341.
PMID
8223356
Source
scival
Published In
Health Psychology
Volume
12
Issue
5
Publish Date
1993
Start Page
339
End Page
341

Eating, weight, and dieting disturbances in male and female lightweight and heavyweight rowers

Rowers compete in a sport that allows comparison of male and female athletes and where some (lightweight) but not others (heavyweights) must meet specific weight criteria. Eating attitudes, dieting patterns, weight fluctuation, and methods of weight loss were evaluated in 162 rowers: 82 heavyweights (56 females, 26 males) and 80 lightweights (17 females, 63 males). Females displayed more disturbed eating practices and weight control methods than did males. Lightweights did not have more disturbed eating practices than heavyweights, but employed more extreme weight loss methods. Male rowers were more affected by weight restriction than were female rowers. Lightweight males showed greater weight fluctuation during the season and gained more weight during the offseason than did lightweight females and heavyweight males and females. These results indicate that rowing can join the growing list of sports where eating and weight disturbances may be present. Male athletes may be more vulnerable to these problems than previously recognized.

Authors
Sykora, C; Grilo, CM; Wilfley, DE; Brownell, KD
MLA Citation
Sykora, C, Grilo, CM, Wilfley, DE, and Brownell, KD. "Eating, weight, and dieting disturbances in male and female lightweight and heavyweight rowers." International Journal of Eating Disorders 14.2 (1993): 203-211.
PMID
8401553
Source
scival
Published In
International Journal of Eating Disorders
Volume
14
Issue
2
Publish Date
1993
Start Page
203
End Page
211

Obesity: Workshop III

Authors
Jeor, STS; Brownell, KD; Atkinson, RL; Bouchard, C; Dwyer, J; Foreyt, JP; Heber, D; Kris-Etherton, P; Stern, JS; Willett, W; Wilson, GT; Wood, PD
MLA Citation
Jeor, STS, Brownell, KD, Atkinson, RL, Bouchard, C, Dwyer, J, Foreyt, JP, Heber, D, Kris-Etherton, P, Stern, JS, Willett, W, Wilson, GT, and Wood, PD. "Obesity: Workshop III." Circulation 88.3 (1993): 1391-1396.
PMID
8353906
Source
scival
Published In
Circulation
Volume
88
Issue
3
Publish Date
1993
Start Page
1391
End Page
1396

Weight reduction diets and health promotion

Obesity is an important health problem. Despite record rates of is secondary to the development of criteria to match patients to dieting and the availability of numerous programs, the problem is not abating. This article discusses the popularity of fad diets, the safety and effectiveness of commonly used approaches to weight loss and the health effects of weight change. We propose an approach in which the search for a best treatment is secondary to the development of criteria to match patients to different treatments. This approach provides an opportunity for the health professional to take advantage of the multiple weight reduction resources in the community.

Authors
Lissner, L; Steen, SN; Brownell, KD
MLA Citation
Lissner, L, Steen, SN, and Brownell, KD. "Weight reduction diets and health promotion." American Journal of Preventive Medicine 8.3 (1992): 154-158.
PMID
1633002
Source
scival
Published In
American Journal of Preventive Medicine
Volume
8
Issue
3
Publish Date
1992
Start Page
154
End Page
158

Etiology and Treatment of Obesity: Understanding a Serious, Prevalent, and Refractory Disorder

Obesity remains a leading public health problem because of its complications, prevalence, and resistance to change, despite record rates of dieting. Risk factors exist at both population and individual levels, thus obesity has diverse etiologies and consequences. Dieting is often grounded in the notion that the body can be molded at will and that the rewards justify the effort, creating a drive for unrealistic goals. This article argues for establishing a "reasonable weight," which may differ from health and aesthetic ideals. Intervention is less a matter of finding a "best" treatment but of finding the approach with "best fit" for the individual. Advances in treatment are most likely when research is driven by theory on the etiology of weight gain, the relapse process, and methods for permanent behavior change. This article integrates information on etiology, social beliefs about body weight, theory, and treatment into a comprehensive and compassionate model for intervention.

Authors
Brownell, KD; Wadden, TA
MLA Citation
Brownell, KD, and Wadden, TA. "Etiology and Treatment of Obesity: Understanding a Serious, Prevalent, and Refractory Disorder." Journal of Consulting and Clinical Psychology 60.4 (1992): 505-517.
PMID
1506499
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
60
Issue
4
Publish Date
1992
Start Page
505
End Page
517
DOI
10.1037//0022-006X.60.4.505

Relation of level of exercise, age, and weight-cycling history to weight and eating concerns in male and female runners.

We examined the association between level of exercise and degree of weight preoccupation in a large sample of male and female runners, as well as risk factors posited to influence weight and eating concerns in the general population. Subjects were 2,459 males and 1,786 females who had completed a questionnaire on weight and eating concerns in a national running magazine. Eight percent of the males and 24% of the females had symptomatic scores on the Eating Attitudes Test (EAT). Exercise level, defined as weekly running mileage, was positively associated with excessive weight and eating concerns in males but not in females. Both sexes with a history of weight cycling were more likely to have symptomatic EAT scores than those with no such history. These results highlight the importance of studying these concerns in males as well as females and of examining the role of exercise level and weight-cycling history in the development of serious weight preoccupations.

Authors
Kiernan, M; Rodin, J; Brownell, KD; Wilmore, JH; Crandall, C
MLA Citation
Kiernan, M, Rodin, J, Brownell, KD, Wilmore, JH, and Crandall, C. "Relation of level of exercise, age, and weight-cycling history to weight and eating concerns in male and female runners." Health Psychology 11.6 (1992): 418-421.
PMID
1286662
Source
scival
Published In
Health Psychology
Volume
11
Issue
6
Publish Date
1992
Start Page
418
End Page
421
DOI
10.1037//0278-6133.11.6.418

Early-onset repeated dieting reduces food intake and body weight but not adiposity in dietary-obese female rats

As dieting behavior and attempts at weight loss are becoming increasingly common in adolescent girls, we wished to determine whether early-onset repeated dieting influenced the development of obesity and its metabolic correlates. Female rats were fed a high-fat diet and subjected to six cycles of dieting and regain, beginning in the peripubertal period. Although dieted rats weighed less than nondieted high-fat fed controls at the completion of the sixth cycle, body composition analysis revealed that the two groups were equally obese. Cumulative caloric intake was less in dieted rats, suggesting that the pattern of consumption promoted by dieting helped to establish the obesity. Resting metabolic rate did not differ between the two groups. These data suggest that although early-onset repeated dieting may result in reduced body weight the eventual level of adiposity may be unknowingly elevated, potentially leading to long-term health risks. © 1991.

Authors
Stein, LJ; Stellar, E; West, DB; Greenwood, MRC; Foster, GD; Feurer, I; Brown, J; Mullen, JL; Brownell, KD
MLA Citation
Stein, LJ, Stellar, E, West, DB, Greenwood, MRC, Foster, GD, Feurer, I, Brown, J, Mullen, JL, and Brownell, KD. "Early-onset repeated dieting reduces food intake and body weight but not adiposity in dietary-obese female rats." Physiology and Behavior 51.1 (1992): 1-6.
PMID
1741433
Source
scival
Published In
Physiology & Behavior
Volume
51
Issue
1
Publish Date
1992
Start Page
1
End Page
6

Variability of body weight and health outcomes in the Framingham population

Background. Fluctuation in body weight is a common phenomenon, due in part to the high prevalence of dieting. In this study we examined the associations between variability in body weight and health end points in subjects participating in the Framingham Heart Study, which involves follow-up examinations every two years after entry. Methods. The degree of variability of body weight was expressed as the coefficient of variation of each subject's measured body-mass-index values at the first eight biennial examinations during the study and on their recalled weight at 25 years of age. Using the 32-year follow-up data, we analyzed total mortality, mortality from coronary heart disease, and morbidity due to coronary heart disease and cancer in relation to intraindividual variation in body weight, including only end points that occurred after the 10th biennial examination. We used age-adjusted proportional-hazards regression for the data analysis. Results. Subjects with highly variable body weights had increased total mortality (P = 0.005 for men, P = 0.01 for women), mortality from coronary heart disease (P = 0.009 for men, P = 0.009 for women), and morbidity due to coronary heart disease (P = 0.0009 for men, P = 0.006 for women). Using a multivariate analysis that also controlled for obesity, trends in weight over time, and five indicators of cardiovascular risk, we found that the positive associations between fluctuations in body weight and end points related to mortality and coronary heart disease could not be attributed to these potential confounding factors. The relative risks of these end points in subjects whose weight varied substantially, as compared with those whose weight was relatively stable, ranged from 1.27 to 1.93. Conclusions. Fluctuations in body weight may have negative health consequences, independent of obesity and the trend of body weight over time.

Authors
Lissner, L; Odell, PM; D'Agostino, RB; III, JS; Kreger, BE; Belanger, AJ; Brownell, KD
MLA Citation
Lissner, L, Odell, PM, D'Agostino, RB, III, JS, Kreger, BE, Belanger, AJ, and Brownell, KD. "Variability of body weight and health outcomes in the Framingham population." New England Journal of Medicine 324.26 (1991): 1839-1844.
PMID
2041550
Source
scival
Published In
New England Journal of Medicine
Volume
324
Issue
26
Publish Date
1991
Start Page
1839
End Page
1844

Variability of body weight and health outcomes [2]

Authors
Dellinger, EP; Drexler, LJ; MacDonald, SD; Pierce, WE; Brownell, KD; Lissner, L; D'Agostino, RB
MLA Citation
Dellinger, EP, Drexler, LJ, MacDonald, SD, Pierce, WE, Brownell, KD, Lissner, L, and D'Agostino, RB. "Variability of body weight and health outcomes [2]." New England Journal of Medicine 325.24 (1991): 1745-1746.
PMID
1944478
Source
scival
Published In
New England Journal of Medicine
Volume
325
Issue
24
Publish Date
1991
Start Page
1745
End Page
1746

The heterogeneity of obesity: fitting treatments to individuals

Body weight is regulated by a complex interaction of biological, behavioral, and cultural factors. The population as a whole is at risk for obesity because of increased intake of dietary fat, the consumption of calories in fewer meals per day, striking accessibility to palatable foods, and decreased physical activity. This risk may become a reality in individuals with certain biological predispositions (genetic tendency, low metabolic rate, increased fat cell number), specific eating patterns, and susceptibility to the extreme cultural pressure to be lean. These factors must be considered in establishing goals for treatment, which fall into medical and psychosocial categories. This includes defining a "reasonable" as opposed to "ideal" weight. A three-stage process is proposed for identifying the best treatment for an individual. This involves a classification decision, a stepped care decision, and then a matching decision. Criteria are provided for a comprehensive assessment of the overweight individual, and treatment options are reviewed for programs of varying intensity, cost, and risk. © 1991 Association for Advancement of Behavior Therapy. All right reserved.

Authors
Brownell, KD; Wadden, TA
MLA Citation
Brownell, KD, and Wadden, TA. "The heterogeneity of obesity: fitting treatments to individuals." Behavior Therapy 22.2 (1991): 153-177.
Source
scival
Published In
Behavior Therapy
Volume
22
Issue
2
Publish Date
1991
Start Page
153
End Page
177
DOI
10.1016/S0005-7894(05)80174-1

Dieting and the search for the perfect body: Where physiology and culture collide

Modern society breeds a search for the perfect body. Today's aesthetic ideal is extremely thin, and now, superimposed on this, is the need to be physically fit. People seek the ideal, not only because of expected health benefits, but because of what the ideal symbolizes in our culture (self-control, success, acceptance). Two assumptions are widespread with regard to body weight and shape. One is that the body is infinitely malleable, and that with the right combination of diet and exercise, every person can reach the ideal. The second is that vast rewards await the person who attains the ideal. Research has shown that biological variables, particularly genetics, are influential in the regulation of body weight and shape. Hence, there are limits to how much a person can change. This places culture in conflict with physiology. In addition, the rewards of being attractive are less than most would expect. There are serious consequences of seeking the ideal and falling short, some psychological and others physiological (e.g., increased health risk for weight cycling). Clinical and research efforts are necessary to help individuals establish reasonable weight and shape goals, and to educate the public accordingly. © 1991 Association for Advancement of Behavior Therapy. All rights reserved.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Dieting and the search for the perfect body: Where physiology and culture collide." Behavior Therapy 22.1 (1991): 1-12.
Source
scival
Published In
Behavior Therapy
Volume
22
Issue
1
Publish Date
1991
Start Page
1
End Page
12
DOI
10.1016/S0005-7894(05)80239-4

Personal responsibility and control over our bodies: when expectation exceeds reality.

Good health has become more than a means to personal goals such as greater attractiveness and increased longevity. It symbolizes self-control, hard work, ambition, and success in life. Inherent in this symbolism is the concept that the individual controls behavior, which in turn controls health. Although control over one's life plays an important role in both physical and mental health, the concept of personal control also infers responsibility. Positive attributes are accorded to people who are healthy, but those who fall ill, or those with less than the perfect body, are blamed and are thought to be self-indulgent, lazy, or even irresponsible and immoral. There is a tendency to overstate the impact of personal behavior on health. However, biological realities shape the degree to which health is under the control of the individual. The positive effects of behavior change must be balanced with the limits imposed by biology.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Personal responsibility and control over our bodies: when expectation exceeds reality." Health Psychology 10.5 (1991): 303-310.
PMID
1935864
Source
scival
Published In
Health Psychology
Volume
10
Issue
5
Publish Date
1991
Start Page
303
End Page
310
DOI
10.1037//0278-6133.10.5.303

Exercise decreases fat selection in female rats during weight cycling

Weight cycling (weight loss and regain) increases fat intake in rats allowed to self-select a diet from protein, carbohydrate, and fat sources. This study reports the effects of exercise on macronutrient self-selection. Female Sprague-Dawley rats (5 mo old) self-selected their diet. After 3 wk, rats were assigned to one of the following three groups: ad libitum fed sedentary (Con), sedentary food restricted to 40% Con intake (R-Sed), or treadmill exercised (20 m/min, 1 h/day, 6 day/wk) food restricted to 40% Con intake (R-Ex). Food restriction was for 3 wk followed by 5 wk of refeeding. This was repeated for a second cycle. During restriction, body weight decreased by 30% in R-Sed and by 33% in R-Ex. Although refeeding resulted in greater weight regain in R-Ex than in R-Sed, fat regain was greater in R-Sed. By week 3 of refeeding, total caloric consumption did not differ. However, fat selection increased in R-Sed (56% kcal) vs. R-Ex (30%) and Con (35%). Fat selection in R-Sed increased further during cycle 2 (73% kcal). Resting oxygen consumption decreased during food restriction in R-Sed and R-Ex. After refeeding, resting metabolic rate in R-Ex was significantly greater than in R-Sed. In conclusion, weight cycling increases dietary fat selection and adiposity. Exercise mitigates this effect.

Authors
Gerardo-Gettens, T; Miller, GD; Horwitz, BA; McDonald, RB; Brownell, KD; Greenwood, MRC; Rodin, J; Stern, JS
MLA Citation
Gerardo-Gettens, T, Miller, GD, Horwitz, BA, McDonald, RB, Brownell, KD, Greenwood, MRC, Rodin, J, and Stern, JS. "Exercise decreases fat selection in female rats during weight cycling." American Journal of Physiology - Regulatory Integrative and Comparative Physiology 260.3 29-3 (1991): R518-R524.
PMID
2001001
Source
scival
Published In
American Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume
260
Issue
3 29-3
Publish Date
1991
Start Page
R518
End Page
R524

Patterns of weight loss and regain in wrestlers: Has the tradition changed?

To assess current weight loss practices in wrestlers, 63 college wrestlers and 368 high school wrestlers completed a questionnaire that examined the frequency and magnitude of weight loss, weight control methods, emotions associated with weight loss, dieting patterns, and preoccupation with food. Clear patterns emerged showing frequent, rapid, and large weight loss and regain cycles. Of the college wrestlers, 41% reported weight fluctuations of 5.0-9.1 kg each week of the season. For the high school wrestlers, 23% lost 2.7-4.5 kg weekly. In the college cohort, 35% lost 0.5-4.5 kg over 100 times in their life, and 22% had lost 5.0-9.1 kg between 21 and 50 times in their life. Of the high school wrestlers, 42% had already lost 5.0-9.1 kg 1-5 times in their life. A variety of aggressive methods were used to lose weight including dehydration, food restriction, fasting, and, for a few, vomiting, laxatives, and diuretics. 'Making weight' was associated with fatigue, anger, and anxiety. Thirty to forty percent of the wrestlers, at both the high school and college level, reported being preoccupied with food and eating out of control after a match. The tradition of 'making weight' still appears to be integral to wrestling. The potential physiological, psychological, and health consequences of these practices merit further attention.

Authors
Steen, SN; Brownell, KD
MLA Citation
Steen, SN, and Brownell, KD. "Patterns of weight loss and regain in wrestlers: Has the tradition changed?." Medicine and Science in Sports and Exercise 22.6 (1990): 762-768.
PMID
2287253
Source
scival
Published In
Medicine and Science in Sports and Exercise
Volume
22
Issue
6
Publish Date
1990
Start Page
762
End Page
768

Age and sex differences in health habits and beliefs of schoolchildren.

All children in Grades 3 through 12 of one school system completed a survey about health habits and beliefs including smoking and eating habits, perceptions of exercise, weight, and parental involvement in health. The surveys were factor-analyzed within grade and sex, and the overall factors that emerged were Smoking Habits, Family Discussion of Health, Family Thinking About Health, Nutritional Habits, and Health Locus of Control. Analysis of variance of each factor revealed that girls generally reported healthier food habits than did boys. However, girls reported more smoking and less exercise. There are also changes in habits and belief with age; junior high school is a particularly important time for the development of several habits. The findings are discussed in relation to theories of child development and the implications for the content and timing of future health education intervention programs with children.

Authors
Cohen, RY; Brownell, KD; Felix, MR
MLA Citation
Cohen, RY, Brownell, KD, and Felix, MR. "Age and sex differences in health habits and beliefs of schoolchildren." Health Psychology 9.2 (1990): 208-224.
PMID
2331979
Source
scival
Published In
Health Psychology
Volume
9
Issue
2
Publish Date
1990
Start Page
208
End Page
224
DOI
10.1037//0278-6133.9.2.208

Weight cycling: The experience of human dieters

Authors
Blackburn, GL; Wilson, GT; Kanders, BS; Stein, LJ; Lavin, PT; Adler, J; Brownell, KD
MLA Citation
Blackburn, GL, Wilson, GT, Kanders, BS, Stein, LJ, Lavin, PT, Adler, J, and Brownell, KD. "Weight cycling: The experience of human dieters." American Journal of Clinical Nutrition 49.5 SUPPL. (1989): 1105-1109.
PMID
2718940
Source
scival
Published In
American Journal of Clinical Nutrition
Volume
49
Issue
5 SUPPL.
Publish Date
1989
Start Page
1105
End Page
1109

The role of parents and older peers in school-based cardiovascular prevention programs: implications for program development.

This article describes a set of studies which compare the effectiveness of innovative interventions led by older peers and which included a parent component with teacher-led interventions for nutrition, blood pressure, and smoking prevention. Information about the agreement between parents' and children's (grades six through eight) perception of the children's health behavior and family interaction was also found, by surveying parents and children in 1051 households. Both teacher-led and older peer-led interventions were successful in increasing behavioral capabilities for nutrition and blood pressure, measured one year after the interventions. Results of the parent-child survey showed reasonable agreement between parents and children for reports of the child's exercise, dieting, and fast food consumption, but poorer agreement for smoking and perceptions of family interaction. Results are discussed in relation to the planning of future programs designed to address the importance of peer and parental role models.

Authors
Cohen, RY; Felix, MR; Brownell, KD
MLA Citation
Cohen, RY, Felix, MR, and Brownell, KD. "The role of parents and older peers in school-based cardiovascular prevention programs: implications for program development." Health Education Quarterly 16.2 (1989): 245-253.
PMID
2732066
Source
scival
Published In
Health Education Quarterly
Volume
16
Issue
2
Publish Date
1989
Start Page
245
End Page
253

Metabolic effects of repeated weight loss and regain in adolescent wrestlers.

This study examined resting metabolic rate in adolescent wrestlers to test the hypothesis that repeated cycles of weight loss and regain would be associated with reduced energy requirements. Energy restriction lowers resting metabolic rate in normal-weight and obese persons. Repeated cycles of weight loss and regain can increase food efficiency, defined as the degree of weight change per unit of food intake, in animals. Many wrestlers lose weight repeatedly as they "cut weight" for matches. This cycle of weight loss and regain may affect their resting metabolism. Twenty-seven wrestlers were classified as cyclers or non-cyclers based on their weight loss history. Resting metabolic rate was measured using indirect calorimetry and body composition was evaluated using six skinfolds. Cyclers and noncyclers did not differ in age, weight, height, surface area, lean body mass, or percent body fat. Cyclers had a significantly lower mean resting metabolic rate than noncyclers (154.6 vs 177.2 kJ/m2/h) (4.6 vs 5.5 kJ per kilogram of lean body mass per hour). There was a 14% difference between the cyclers and the noncyclers in resting energy expenditure (6631.8 vs 7702.8 kJ/d). Weight cycling in wrestlers appears to be associated with a lowered resting metabolic rate.

Authors
Steen, SN; Oppliger, RA; Brownell, KD
MLA Citation
Steen, SN, Oppliger, RA, and Brownell, KD. "Metabolic effects of repeated weight loss and regain in adolescent wrestlers." JAMA 260.1 (July 1988): 47-50.
PMID
3214488
Source
epmc
Published In
JAMA : the journal of the American Medical Association
Volume
260
Issue
1
Publish Date
1988
Start Page
47
End Page
50
DOI
10.1001/jama.1988.03410010055034

Metabolic effects of repeated weight loss and regain in adolescent wrestlers

This study examined resting metabolic rate in adolescent wrestlers to test the hypothesis that repeated cycles of weight loss and regain would be associated with reduced energy requirements. Energy restriction lowers resting metabolic rate in normal-weight and obese persons. Repeated cycles of weight loss and regain can increase food efficiency, defined as the degree of weight change per unit of food intake, in animals. Many wrestlers lose weight repeatedly as they 'cut weight' for matches. This cycle of weight loss and regain may affect their resting metabolism. Twenty-seven wrestlers were classified as cyclers or noncyclers based on their weight loss history. Resting metabolic rate was measured using indirect calorimetry and body composition was evaluated using six skinfolds. Cyclers and noncyclers did not differ in age, weight, height, surface area, lean body mass, or percent body fat. Cyclers had a significantly lower mean resting metabolic rate than noncyclers (154.6 vs 177.2 kJ/m2/h) (4.6 vs 5.5 kJ per kilogram of lean body mass per hour). There was a 14% difference between the cyclers and the noncyclers in resting energy expenditure (6631.8 vs 7702.8 kJ/d). Weight cycling in wrestlers appears to be associated with a lowered resting metabolic rate.

Authors
Steen, SN; Oppliger, RA; Brownell, KD
MLA Citation
Steen, SN, Oppliger, RA, and Brownell, KD. "Metabolic effects of repeated weight loss and regain in adolescent wrestlers." Journal of the American Medical Association 260.1 (1988): 47-50.
Source
scival
Published In
Journal of the American Medical Association
Volume
260
Issue
1
Publish Date
1988
Start Page
47
End Page
50

Obesity and weight control: The good and bad of dieting

There may be different “obesities” with different etiologies, characteristics and indications for treatment. The dangers of dieting must be balanced against the potential benefits, and if dieting is undertaken, a comprehensive program based on new principles offers the best hope for success. © Williams & Wilkins 1987. All Rights Reserved.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Obesity and weight control: The good and bad of dieting." Nutrition Today 22.3 (January 1, 1987): 4-9.
Source
scopus
Published In
Nutrition Today
Volume
22
Issue
3
Publish Date
1987
Start Page
4
End Page
9

Modern methods for weight control: The physiology and psychology of dieting

Authors
Brownell, KD; Steen, SN
MLA Citation
Brownell, KD, and Steen, SN. "Modern methods for weight control: The physiology and psychology of dieting." Physician and Sportsmedicine 15.12 (1987): 122-137.
Source
scival
Published In
Physician and Sportsmedicine
Volume
15
Issue
12
Publish Date
1987
Start Page
122
End Page
137

Competitions to facilitate health promotion: Review and conceptual analysis

Authors
Brownell, KD; Felix, MRJ
MLA Citation
Brownell, KD, and Felix, MRJ. "Competitions to facilitate health promotion: Review and conceptual analysis." American Journal of Health Promotion 2.1 (1987): 28-36.
Source
scival
Published In
American Journal of Health Promotion
Volume
2
Issue
1
Publish Date
1987
Start Page
28
End Page
36

Improving long-term weight loss: Pushing the limits of treatment

This paper adopts an aggressive stance on short-term and long-term weight losses produced by treatment of obesity. For many years the behavior therapy field has settled for small weight losses. This has resulted in part from a focus on "maintenance," which implies something worth maintaining. Complacency has occurred because of the contest mentality underlying the design of parametric studies which compare behavior therapy to various alternatives and find behavior therapy to be the "treatment of choice." It is not surprising that behavior therapy emerges the victor in these contests, given that the comparison groups are pseudotreatments such as nondirective group therapy rather than the widely used forms of dieting (e.g., Weight Watchers, Overeaters Anonymous, self-imposed diets). There is renewed cause for hope, however. The most recent generation of behavioral programs can produce substantial weight losses, apparently because programs are both longer and better. This paper proposes specific methods for testing the limits of treatment for obesity, in hopes that greater initial losses will be accompanied by more effective approaches to maintenance. In addition, we propose that more attention be focused on matching individuals to treatments, so that professionals serve a dual role of providing their treatment to those who are best suited and referring others elsewhere. © 1987 Association for Advancement of Behavior Therapy. All rights reserved.

Authors
Brownell, KD; Jeffery, RW
MLA Citation
Brownell, KD, and Jeffery, RW. "Improving long-term weight loss: Pushing the limits of treatment." Behavior Therapy 18.4 (1987): 353-374.
Source
scival
Published In
Behavior Therapy
Volume
18
Issue
4
Publish Date
1987
Start Page
353
End Page
374
DOI
10.1016/S0005-7894(87)80004-7

Weight regulation practices in athletes: Analysis of metabolic and health effects

Athletes engage in a number of dietary and weight control practices which may influence metabolism, health, and performance. This paper reviews the literature on these factors with special emphasis on athletes who show large, frequent, and rapid fluctuations in weight (wrestlers) and athletes who maintain low weight and low percent body fat (e.g., distance runners, gymnasts, and figure skaters). A theory is presented which relates these weight patterns and the accompanying dietary habits to changes in body composition, metabolism, metabolic activity of adipose tissue, and the distribution of body fat. Changes in these physiological variables may be manifested in enhanced food efficiency (weight as a function of caloric intake) as the body seeks to protect and replenish its energy stores. This may explain the surprisingly low caloric intakes of some athletes. The health status of the athlete is a concern in this regard because there may be changes in fat distribution, risk factors for cardiovascular disease, and hormonal factors associated with reproductive functioning in both females and males. Amenorrhea in female athletes may be mediated at least in part by regional fat distribution; depletion of femoral fat depots (lactational energy reserves) may be the stimulus for cessation or disruption of menses.

Authors
Brownell, KD; Steen, SN; Wilmore, JH
MLA Citation
Brownell, KD, Steen, SN, and Wilmore, JH. "Weight regulation practices in athletes: Analysis of metabolic and health effects." Medicine and Science in Sports and Exercise 19.6 (1987): 546-556.
PMID
3323766
Source
scival
Published In
Medicine and Science in Sports and Exercise
Volume
19
Issue
6
Publish Date
1987
Start Page
546
End Page
556

Experimentation with smokeless tobacco and cigarettes by children and adolescents: Relationship to beliefs, peer use, and parental use

Experimentation with both cigarettes and smokeless tobacco by children in grades 3-12 in a school district in Pennsylvania was related to peer experimentation, parental use, and personal beliefs about the harm of the product for both males and females. Experimentation with both products had begun as early as the third grade and increased with age, with a major increase in experimentation during junior high school. Nearly half the males in grades 7-12 did not believe smokeless tobacco was harmful.

Authors
Cohen, RY; Sattler, J; Felix, MRJ; Brownell, KD
MLA Citation
Cohen, RY, Sattler, J, Felix, MRJ, and Brownell, KD. "Experimentation with smokeless tobacco and cigarettes by children and adolescents: Relationship to beliefs, peer use, and parental use." American Journal of Public Health 77.11 (1987): 1454-1456.
PMID
3661802
Source
scival
Published In
American Journal of Public Health
Volume
77
Issue
11
Publish Date
1987
Start Page
1454
End Page
1456

Understanding and Preventing Relapse

This article examines relapse by integrating knowledge from the addictive disorders of alcoholism, smoking, and obesity. Commonalities across these areas suggest at least three basic stages of behavior change: motivation and commitment, initial change, and maintenance. A distinction is made between lapse and relapse, with lapse referring to the process (slips or mistakes) that may or may not lead to an outcome (relapse). The natural history of relapse is discussed, as are the consequences of relapse for patients and the professionals who treat them. Information on determinants and predictors of relapse is evaluated, with the emphasis on the interaction of individual, environmental, and physiological factors. Methods of preventing relapse are proposed and are targeted to the three stages of change. Specific research needs in these areas are discussed. © 1986 American Psychological Association.

Authors
Brownell, KD; Marlatt, GA; Lichtenstein, E; Wilson, GT
MLA Citation
Brownell, KD, Marlatt, GA, Lichtenstein, E, and Wilson, GT. "Understanding and Preventing Relapse." American Psychologist 41.7 (1986): 765-782.
PMID
3527003
Source
scival
Published In
American Psychologist
Volume
41
Issue
7
Publish Date
1986
Start Page
765
End Page
782
DOI
10.1037/0003-066X.41.7.765

Interventions to prevent relapse.

Authors
Brownell, KD; Glynn, TJ; Glasgow, R; Lando, H; Rand, C; Gottlieb, A; Pinney, JM
MLA Citation
Brownell, KD, Glynn, TJ, Glasgow, R, Lando, H, Rand, C, Gottlieb, A, and Pinney, JM. "Interventions to prevent relapse." Health Psychology 5 Suppl (1986): 53-68.
PMID
3582325
Source
scival
Published In
Health Psychology
Volume
5 Suppl
Publish Date
1986
Start Page
53
End Page
68

The effects of repeated cycles of weight loss and regain in rats

This study examined the metabolic effects of weight cycling, i.e., repeated periods of weight loss followed by regain. There were three groups of adult, male Sprague-Dawley rats: (1) Chow Controls (a normal weight control group fed chow throughout); (2) Obese Controls (animals fed a high-fat diet throughout); and (3) Obese Cycling (obese animals cycled through two bouts of caloric restriction and refeeding). The cycled animals showed significant increases in food efficiency (weight gain/kcal food intake) in the second restriction and refeeding periods compared to the first, i.e., weight loss occurred at half the rate and regain at three times the rate in the second cycle. Several physiological changes were associated with this cycling effect. At the end of the experiment, cycled animals had a four-fold increase in food efficiency compared to obese animals of the same weight who had not cycled. These data suggest that frequent dieting may make subsequent weight loss more difficult. The possible metabolic and health consequences of "yo-yo" dieting are discussed. © 1986.

Authors
Brownell, KD; Greenwood, MRC; Stellar, E; Shrager, EE
MLA Citation
Brownell, KD, Greenwood, MRC, Stellar, E, and Shrager, EE. "The effects of repeated cycles of weight loss and regain in rats." Physiology and Behavior 38.4 (1986): 459-464.
PMID
3823159
Source
scival
Published In
Physiology & Behavior
Volume
38
Issue
4
Publish Date
1986
Start Page
459
End Page
464

Public health approaches to obesity and its management.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Public health approaches to obesity and its management." Annual review of public health 7 (1986): 521-533.
PMID
3718654
Source
scival
Published In
Annual review of public health
Volume
7
Publish Date
1986
Start Page
521
End Page
533

Peer-Led Program for the Treatment and Prevention of Obesity in the Schools

A total of 89 overweight children in Grades 2-5 in one experimental and one control school participated in a 12-week weight reduction program conducted primarily by older children trained as peer counselors. Children in the experimental school lost 0.15 kg and reduced their percentage overweight by 5.3%, whereas those in the control school gained 1.3 kg and increased their percentage overweight by 0.3%. Program children also showed positive changes in self-concept as compared with a control group and displayed improvements in food selection. Changes in weight, self-concept, and food selection were only partially maintained at 18-week follow-up, however, pointing to the need for an ongoing program of weight loss maintenance. © 1985 American Psychological Association.

Authors
Foster, GD; Wadden, TA; Brownell, KD
MLA Citation
Foster, GD, Wadden, TA, and Brownell, KD. "Peer-Led Program for the Treatment and Prevention of Obesity in the Schools." Journal of Consulting and Clinical Psychology 53.4 (1985): 538-540.
PMID
4031211
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
53
Issue
4
Publish Date
1985
Start Page
538
End Page
540
DOI
10.1037/0022-006X.53.4.538

A comparison of two very-low-calorie diets: Protein-sparing-modified fast versus protein-formula-liquid diet

This study investigated the acceptability of two very-low-calorie diets in 16 moderately overweight persons participating in a weight reduction program. Subjects were prescribed a 1000-1200 kcal balanced diet the first month and asked to complete apetite and mood scales on a weekly basis. They were then randomly assigned to either a protein-sparing-modified fast (PSMF) or a protein-formula-liquid diet, each of which provided about 400 kcal daily. Analysis of the appetite data showed that PSMF subjects reported significantly less hunger and preoccupation with eating than did liquid diet subjects during 2 of the 4 weeks on very-low-calorie diet. Subjects in both conditions reported significant reductions in anxiety. Results are discussed in terms of possible advantages of PSMF.

Authors
Wadden, TA; Stunkard, AJ; Brownell, KD; Day, SC
MLA Citation
Wadden, TA, Stunkard, AJ, Brownell, KD, and Day, SC. "A comparison of two very-low-calorie diets: Protein-sparing-modified fast versus protein-formula-liquid diet." American Journal of Clinical Nutrition 41.3 (1985): 533-539.
PMID
3976552
Source
scival
Published In
American Journal of Clinical Nutrition
Volume
41
Issue
3
Publish Date
1985
Start Page
533
End Page
539

Weight reduction at the work site: A promise partially fulfilled

Three consecutive studies of weight reduction at the work site were conducted with 172 female union members, who participated in 16-week behavioral group programs. There was no significant difference in weight loss over the three studies, but attrition decreased from 57.5% to 33.8% and weight loss maintenance improved. Groups that met three to four times weekly had less attrition than those which met once a week, but had no more weight loss. These behavioral weight reduction programs were as effective as self-help and commercial groups, and lay leaders produced results equivalent to those produced by professional therapists at one-third the cost.

Authors
Brownell, KD; Stunkard, AJ; McKeon, PE
MLA Citation
Brownell, KD, Stunkard, AJ, and McKeon, PE. "Weight reduction at the work site: A promise partially fulfilled." American Journal of Psychiatry 142.1 (1985): 47-52.
PMID
3917617
Source
scival
Published In
American Journal of Psychiatry
Volume
142
Issue
1
Publish Date
1985
Start Page
47
End Page
52

In Reply

Authors
Wadden, TA; Stunkard, AJ; Brownell, KD; Van Itallie, TB
MLA Citation
Wadden, TA, Stunkard, AJ, Brownell, KD, and Van Itallie, TB. "In Reply." JAMA: The Journal of the American Medical Association 252.7 (August 17, 1984): 897-898. (Letter)
Source
scopus
Published In
JAMA : the journal of the American Medical Association
Volume
252
Issue
7
Publish Date
1984
Start Page
897
End Page
898
DOI
10.1001/jama.1984.03350070015005

Confronting obesity in children: behavioral and psychological factors.

The problem of obesity in children must be taken seriously and treated aggressively. The long-term psychological, social, and medical consequences of childhood obesity can be quite serious. Behavior modification has shown new promise compared to the discouraging results of traditional approaches such as inpatient starvation, the use of appetite suppressants, and dietary counseling. The behavioral program involves a systematic approach to nutrition, exercise, eating patterns, attitudes, and family support.

Authors
Brownell, KD; Wadden, TA
MLA Citation
Brownell, KD, and Wadden, TA. "Confronting obesity in children: behavioral and psychological factors." Pediatric Annals 13.6 (1984): 473-480.
PMID
6462794
Source
scival
Published In
Pediatric Annals
Volume
13
Issue
6
Publish Date
1984
Start Page
473
End Page
480

Behavioral, psychological, and environmental predictors of obesity and success at weight reduction

Several behavioral, psychological, and environmental factors are related to the likelihood that an individual will be obese and to that person's chances of success at weight reduction. This paper identifies ten such factors and proposes that this combination of factors will explain as much of the nonphysiological variance in weight change as current knowledge will permit.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Behavioral, psychological, and environmental predictors of obesity and success at weight reduction." International Journal of Obesity 8.5 (1984): 543-550.
PMID
6394524
Source
scival
Published In
International Journal of Obesity
Volume
8
Issue
5
Publish Date
1984
Start Page
543
End Page
550

Behavioral and psychological aspects of motivation to exercise

Obesity is a major public health problem because of its prevalence, its serious medical and psychosocial effects, and its striking resistance to treatment. Popular thought is that overeating is the prime contributor to positive energy balance (hence a 'diet' for weight loss), and that physical activity is fruitless because little energy is expended and because increased appetite offsets the energy cost of the exercise. In reality, a relative lack of physical activity may play a major role in the genesis and maintenance of obesity, and increased activity is important for weight reduction. Some principles from behavioral psychology which are useful in facilitating exercise in obese persons are briefly discussed. The degree to which a person lives in a supportive social environment has been implicated as a major factor in whether that person develops and recovers from serious illness. A number of studies have shown that social support can be influential in facilitating adherence to weight loss programs. The same potential exists for adherence to exercise programs. Many obese patients prefer activities that can include others. Examples are walking with a friend, playing tennis, joining an exercise group, and doing some regular activity with family members. This can be a powerful incentive for adhering to a program over the long-term. Whether patients maintain new exercise habits may depend as much on social variables as on the nature of the exercise itself.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Behavioral and psychological aspects of motivation to exercise." International Journal of Sports Medicine 5.SUPPL. (1984): 69-70.
Source
scival
Published In
International Journal of Sports Medicine
Volume
5
Issue
SUPPL.
Publish Date
1984
Start Page
69
End Page
70

A comprehensive treatment plan for obese children and adolescents: Principles and practice

Authors
Brownell, KD; Wadden, TA; Foster, GD
MLA Citation
Brownell, KD, Wadden, TA, and Foster, GD. "A comprehensive treatment plan for obese children and adolescents: Principles and practice." Pediatrician 12.2-3 (1984): 89-96.
PMID
6571156
Source
scival
Published In
Pediatrician
Volume
12
Issue
2-3
Publish Date
1984
Start Page
89
End Page
96

Weight loss competitions at the work site: Impact on weight, morale and cost-effectiveness

Three weight loss competitions were held in business/industrial settings. One competition was between three banks; the other two were within industries, either between employee teams selected at random or between divisions of the industry. Attrition in the competitions was less than 1 per cent and weight loss averaged 5.5 kg. Both employees and management reported positive changes in morale and employee/management relations, and both considered the competition important to the success of the program. The cost-effectiveness ratio ($2.93 per 1 per cent reduction in percentage overweight) is the best yet reported.

Authors
Brownell, KD; Cohen, RY; Stunkard, AJ; Felix, MR; Cooley, NB
MLA Citation
Brownell, KD, Cohen, RY, Stunkard, AJ, Felix, MR, and Cooley, NB. "Weight loss competitions at the work site: Impact on weight, morale and cost-effectiveness." American Journal of Public Health 74.11 (1984): 1283-1285.
PMID
6437259
Source
scival
Published In
American journal of public health
Volume
74
Issue
11
Publish Date
1984
Start Page
1283
End Page
1285

Treatment of obesity by behavior therapy and very low calorie diet: A pilot investigation

Treated 17 obese females (mean age 37.5 yrs) who averaged 87% overweight for 6 mo on a program of diet and behavior modification designed for weight loss maintenance. Ss, who were paid to participate, received a balanced diet of 1,000-2,200 kilocalories/day for Month 1, a low calorie protein liquid (400-500 kilocalories/day) for Month 2, low calorie protein (fish, fowl) for Month 3, and a balanced diet for Months 4-6. Results show that Ss lost an average 20.5 kg during treatment and showed significant reductions in anxiety and depression even while consuming the low calorie diet. At 1-yr follow-up, Ss had regained an average of 2.1 kg. (6 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.

Authors
Wadden, TA; Stunkard, AJ; Brownell, KD; Day, SC
MLA Citation
Wadden, TA, Stunkard, AJ, Brownell, KD, and Day, SC. "Treatment of obesity by behavior therapy and very low calorie diet: A pilot investigation." Journal of Consulting and Clinical Psychology 52.4 (1984): 692-694.
PMID
6470296
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
52
Issue
4
Publish Date
1984
Start Page
692
End Page
694
DOI
10.1037/0022-006X.52.4.692

Self-concept in obese and normal-weight children

Compared self-concept (as measured by the Piers-Harris Children's Self-Concept Scale) for 716 White children in Grades 3-8, who were classified as obese or normal-weight after their ideal weight was calculated accounting for age, sex, and height. Ss 20% or more over ideal weight were characterized as obese. No significant differences were found in self-concept in the 2 groups. (5 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1984 American Psychological Association.

Authors
Wadden, TA; Foster, GD; Brownell, KD; Finley, E
MLA Citation
Wadden, TA, Foster, GD, Brownell, KD, and Finley, E. "Self-concept in obese and normal-weight children." Journal of Consulting and Clinical Psychology 52.6 (1984): 1104-1105.
PMID
6520282
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
52
Issue
6
Publish Date
1984
Start Page
1104
End Page
1105
DOI
10.1037/0022-006X.52.6.1104

The psychology and physiology of obesity: Implications for screening and treatment

This article examines the psychological and physiological concomitants of obesity and presents practical methods for working with obese patients. Three areas of physiology are covered: fat cell theory, set point theory, and dietary obesity. The social and emotional consequences of obesity are discussed, as are the psychological stages experienced by both patients and professionals during a typical course of weight reduction. Screening is a most important aspect of a program. There are several methods for determining which patients will profit from treatment. Recent advances in treatment include a focus on physical activity, improvements in behavior modification, and the development of aggressive methods for promoting weight loss in moderately and morbidly overweight persons. Finally, social support is discussed, because the social context in which a program is administered may be more important than the nature of the program itself.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "The psychology and physiology of obesity: Implications for screening and treatment." Journal of the American Dietetic Association 84.4 (1984): 406-414.
PMID
6368650
Source
scival
Published In
Journal of the American Dietetic Association
Volume
84
Issue
4
Publish Date
1984
Start Page
406
End Page
414

New developments in the treatment of obese children and adolescents.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "New developments in the treatment of obese children and adolescents." Research publications - Association for Research in Nervous and Mental Disease 62 (1984): 175-183.
PMID
6695113
Source
scival
Published In
Research publications - Association for Research in Nervous and Mental Disease
Volume
62
Publish Date
1984
Start Page
175
End Page
183

The Cambridge diet. More mayhem?

Authors
Wadden, TA; Stunkard, AJ; Brownell, KD; Van Itallie, TB
MLA Citation
Wadden, TA, Stunkard, AJ, Brownell, KD, and Van Itallie, TB. "The Cambridge diet. More mayhem?." JAMA 250.20 (November 1983): 2833-2834.
PMID
6644962
Source
epmc
Published In
JAMA : the journal of the American Medical Association
Volume
250
Issue
20
Publish Date
1983
Start Page
2833
End Page
2834
DOI
10.1001/jama.1983.03340200067031

Very low calorie diets: Their efficacy, safety, and future

Very low calorie diets used to treat moderate and severe obesity produce average weight losses of 20 kg in 12 weeks. This paper reviews the development of very low calorie diets from research on fasting in the late 1950s and examines data on the amount of dietary protein needed to achieve positive nitrogen balance. The desirability of including carbohydrate in the diet, the choice of protein sources (formula versus animal protein), and the anorectic value of ketosis are discussed, as are patient selection and the clinical course of the diet. As contrasted to the earlier 'liquid protein' diets that were associated with at least 60 deaths, very low calorie diets of high-quality protein appear safe when limited to 3 months or less under careful medical supervision. Evidence of this safety is provided by the results of 24-hour Holter monitoring and the fact that no diet-related fatalities have been reported in over 10,000 cases. The major problem to be resolved is the maintenance of the large weight losses achieved with these diets.

Authors
Wadden, TA; Stunkard, AJ; Brownell, KD
MLA Citation
Wadden, TA, Stunkard, AJ, and Brownell, KD. "Very low calorie diets: Their efficacy, safety, and future." Annals of Internal Medicine 99.5 (1983): 675-684.
PMID
6357020
Source
scival
Published In
Annals of Internal Medicine
Volume
99
Issue
5
Publish Date
1983
Start Page
675
End Page
684

The Cambridge diet. More mayhem?

Authors
Wadden, TA; Stunkard, AJ; Brownell, KD; Itallie, TBV
MLA Citation
Wadden, TA, Stunkard, AJ, Brownell, KD, and Itallie, TBV. "The Cambridge diet. More mayhem?." Journal of the American Medical Association 250.20 (1983): 2833-2834.
Source
scival
Published In
Journal of the American Medical Association
Volume
250
Issue
20
Publish Date
1983
Start Page
2833
End Page
2834
DOI
10.1001/jama.250.20.2833

Treatment of obese children with and without their mothers: Changes in weight and blood pressure

Weigt and blood pressure changs were evaluated in a 16-month controlled trial comparing three methods of involving mothers in the treatment of their obese adolescents (aged 12 to 16 years). The treatments were: (1) Mother-Child Separately - children and mothers attended separate groups; (2) Mother-Child Together - the children and mothers met altogether in the same group; and (3) Child Alone - the chldren met in groups and mothers were non involved. The program consisted of behavior modification, social support, nutrition, and exercise. The Mother-Child Separately group lost more weight (8.4 kg) during treatment than did the other two groups (5.3 and 3.3 kg). Differences between the groups increased at the 1-year follow-up: compared to pretreatment weight, the Mother-Child Separately group lost 7.7 kg compared with gains of approximately 3 kg in the other two groups. Blood pressures of children with the highest initial pressures decreased by 16/9 mm Hg at the end of treatment and by 16/5 mm Hg at the 1-year follow-up. These results suggest that a program of behavior modification and parent involvement can lead to significant weight losses in obese children, and that the nature of parent involvement may be important.

Authors
Brownell, KD; Kelman, JH; Stunkard, AJ
MLA Citation
Brownell, KD, Kelman, JH, and Stunkard, AJ. "Treatment of obese children with and without their mothers: Changes in weight and blood pressure." Pediatrics 71.4 (1983): 515-523.
PMID
6835735
Source
scival
Published In
Pediatrics
Volume
71
Issue
4
Publish Date
1983
Start Page
515
End Page
523

Heterosocial-skills training and covert sensitization. Effects on social skills and sexual arousal in sexual deviants

There are few experimental investigations of the effects of social-skills training (SST) on sexual deviation. This study used a multiple baseline across 4 subjects with undesired sexual arousal to investigate the effects of heterosocial-skills training and covert sensitization on heterosocial skills and sexual-arousal patterns. SST produced large increases in heterosocial skills but it had unclear effects on sexual arousal. Subsequently, covert sensitization tended to reduce remaining deviant arousal but did not increase appropriate arousal significantly. These data generally support the view that individual components of sexual arousal require separate assessment and intervention. © 1983.

Authors
Hayes, SC; Brownell, KD; Barlow, DH
MLA Citation
Hayes, SC, Brownell, KD, and Barlow, DH. "Heterosocial-skills training and covert sensitization. Effects on social skills and sexual arousal in sexual deviants." Behaviour Research and Therapy 21.4 (1983): 383-392.
PMID
6138027
Source
scival
Published In
Behaviour Research and Therapy
Volume
21
Issue
4
Publish Date
1983
Start Page
383
End Page
392
DOI
10.1016/0005-7967(83)90007-4

Comparison of school-based treatments for adolescent obesity.

Authors
Lansky, D; Brownell, KD
MLA Citation
Lansky, D, and Brownell, KD. "Comparison of school-based treatments for adolescent obesity." The Journal of school health 52.8 (1982): 384-387.
PMID
6922317
Source
scival
Published In
The Journal of school health
Volume
52
Issue
8
Publish Date
1982
Start Page
384
End Page
387

Plasma fenfluramine levels, weight loss and side effects: A failure to find a relationship

Thirty-six women were treated for 16 weeks with fenfluramine and behavior therapy. There was a strong correlation between drug dosage and plasma levels of fenfluramine. In contrast to two previous reports, however, there was no correlation between plasma levels of fenfluramine and its metabolite norfenfluramine and weight loss, nor was there any correlation between these levels and side effects. If weight loss is not related to drug levels, as suggested by this report, there is no merit in increasing drug levels to tolerance as is the current practice; modest dosage to produce modest drug levels is indicated.

Authors
Pietrusko, R; Stunkard, A; Brownell, K; Campbell, DB
MLA Citation
Pietrusko, R, Stunkard, A, Brownell, K, and Campbell, DB. "Plasma fenfluramine levels, weight loss and side effects: A failure to find a relationship." International Journal of Obesity 6.6 (1982): 567-571.
PMID
7160955
Source
scival
Published In
International Journal of Obesity
Volume
6
Issue
6
Publish Date
1982
Start Page
567
End Page
571

Obesity: Understanding and treating a serious, prevalent, and refractory disorder

Examines the psychology and physiology of obesity, its assessment and treatment, the role of exercise in weight reduction, and new directions for the field. The health risks of obesity are discussed, particularly the controversy about weight reduction for persons less than 30% overweight. Several physiological factors are presented, including the set point theory of body weight regulation, the role of fat cell size and number, and dietary influences on body weight. Assessment issues are noted along with results from treatment programs for obese children and adults. The role of exercise is emphasized, not only because of increased energy expenditure, but also because exercise may suppress appetite, offset the decline in basal metabolic rate caused by dieting, minimize loss of lean body mass, and counteract the ill effects of obesity. Two problems in the field are raised: the misinterpretation of the strengths of behavior therapy and the trap of focusing on long-term results. New directions are urged, including aggressive approaches to dieting, treatment combinations, and the use of social support. (5 p ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1982 American Psychological Association.

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Obesity: Understanding and treating a serious, prevalent, and refractory disorder." Journal of Consulting and Clinical Psychology 50.6 (1982): 820-840.
PMID
7174975
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
50
Issue
6
Publish Date
1982
Start Page
820
End Page
840
DOI
10.1037/0022-006X.50.6.820

Estimates of food quantity and calories: Errors in self-report among obese patients

The authors report three studies that examine the accuracy and usefulness of food records among dieting obese patients. In study 1 errors in quantity and calorie estimates for 10 common foods averaged 63.9% (quantity) and 53.4% (calories). The results of study 2 indicate that only 53% of entries in daily food records were specified enough to permit objective estimates of the calories consumed. In study 3, blind raters could not predict weight loss based on subjects' self-recorded behavior changes. Collectively, these results question the utility of food records for estimating energy intake or predicting weight loss.

Authors
Lansky, D; Brownell, KD
MLA Citation
Lansky, D, and Brownell, KD. "Estimates of food quantity and calories: Errors in self-report among obese patients." American Journal of Clinical Nutrition 35.4 (1982): 727-732.
PMID
7072625
Source
scival
Published In
American Journal of Clinical Nutrition
Volume
35
Issue
4
Publish Date
1982
Start Page
727
End Page
732

A school-based behavior modification, nutrition education, and physical activity program for obese children

Sixty-three obese children, ages 5 to 12 yr, participated in a school-based program of behavior modification, nutrition education, and physical activity. The 10-wk program involved educating the children and those in the childrens' social network (parents, teachers, physical education instructor, food service personnel, school administrators, and the nurse's aide). Two methods were used to evaluate weight loss: the children were compared to a control group of obese children who did not receive the program, and the children in the program were used as their own controls by analyzing weight records for the 3 yr before the program. Sixty (95%) of the 63 children in the program lost weight, compared to only three (21%) of the 14 control children. The program children showed a mean decrease of 15.4% in their percentage overweight, and lost an average of 4.4 kg. These children also reversed the steady weight gain that had occurred before the program. These results suggest that a comprehensive program in the schools can produce significant weight losses, and that children left untreated tend to increase their degree of obesity.

Authors
Brownell, KD; Kaye, FS
MLA Citation
Brownell, KD, and Kaye, FS. "A school-based behavior modification, nutrition education, and physical activity program for obese children." American Journal of Clinical Nutrition 35.2 (1982): 277-283.
PMID
7064888
Source
scival
Published In
American Journal of Clinical Nutrition
Volume
35
Issue
2
Publish Date
1982
Start Page
277
End Page
283

The double-blind in danger: Untoward consequences of informed consent

Patients and physicians correctly identified medication assignments in 70% of the cases in a double-blind trial of an appetite suppressant. The breach of the double-blind design may have had therapeutic consequences; correct identification was associated with favorable outcome. These findings suggest that requirements for describing the side effects of medications to patients before they give informed consent may help them guess which medication they receive and thus may influence the integrity of double-blind studies and the results of controlled trials.

Authors
Brownell, KD; Stunkard, AJ
MLA Citation
Brownell, KD, and Stunkard, AJ. "The double-blind in danger: Untoward consequences of informed consent." American Journal of Psychiatry 139.11 (1982): 1487-1489.
PMID
6753613
Source
scival
Published In
American Journal of Psychiatry
Volume
139
Issue
11
Publish Date
1982
Start Page
1487
End Page
1489

Changes in plasma lipid and lipoprotein levels in men and women after a program of moderate exercise

Levels of high-density lipoprotein (HDL) cholesterol and other lipids and lipoproteins of 24 men and 37 women were measured before and after a 10-week exercise program. The program involved three sessions of aerobic exercise each week, with 15-20 minutes of activity at 70% of maximal heart rate. Men and women had significantly different lipid patterns in response to exercise, despite equivalent increases in maximal oxygen uptake. Men showed a 5.1% increase in HDL cholesterol, a 6% decrease in low-density lipoprotein (LDL) cholesterol, and a 12.4% increase in the HDL/LDL ratio. In contrast, women showed a 1% decrease in HDL cholesterol, a 4.3% decrease in LDL cholesterol, and no significant change in the HDL/LDL ratio. The number of sessions attended correlated positively with HDL/LDL changes in men and correlated negatively with HDL/LDL changes in women. These findings suggest that moderate exercise may have different effects on men and women.

Authors
Brownell, KD; Bachorik, PS; Ayerle, RS
MLA Citation
Brownell, KD, Bachorik, PS, and Ayerle, RS. "Changes in plasma lipid and lipoprotein levels in men and women after a program of moderate exercise." Circulation 65.3 (1982): 477-484.
PMID
7055869
Source
scival
Published In
Circulation
Volume
65
Issue
3
Publish Date
1982
Start Page
477
End Page
484

Differential changes in plasma high-density lipoprotein-cholesterol levels in obese men and women during weight reduction.

Levels of high-density lipoprotein-cholesterol (HDL-cholesterol) and other lipoproteins of 73 obese men and women were measured before and after a 16-week weight reduction program. There were significant differences between men and women. In men, a 10.7-kg weight loss was associated with a 5% increase in the HDL-cholesterol level, a 15.8% decrease in the low-density lipoprotein-cholesterol (LDL-cholesterol) level, and a 30.1% increase in the HDL-LDL ratio. Women, in contrast, showed an 8.9-kg weight loss, a 3.3% decrease in the HDL-cholesterol level, a 4.7% decrease in the LDL-cholesterol level, and no significant change in the HDL-LDL ratio. These differences suggest that weight raeduction may be an important means of improving plasma lipoprotein patterns in men but may be of more limited value in women.

Authors
Brownell, KD; Stunkard, AJ
MLA Citation
Brownell, KD, and Stunkard, AJ. "Differential changes in plasma high-density lipoprotein-cholesterol levels in obese men and women during weight reduction." Archives of internal medicine 141.9 (August 1981): 1142-1146.
PMID
7259372
Source
epmc
Published In
Archives of internal medicine
Volume
141
Issue
9
Publish Date
1981
Start Page
1142
End Page
1146
DOI
10.1001/archinte.141.9.1142

Couples training, pharmacotherapy, and behavior therapy in the treatment of obesity

The effects of behavior therapy with and without either pharmacotherapy or couples training were studied in 124 obese adults. In a 16-week behavioral weight-reduction program, patients were assigned to medication (fenfluramine hydrochloride) and no-medication conditions and to three spouse conditions in a 2 x 3 design. Two conditions consisted of patients with 'cooperative' spouses; in one, patients were treated with their spouses, and in the other they were treated alone. In the third, patients with 'uncooperative' spouses were treated alone. Fenfluramine produced significantly greater weight losses than no medication, but patients in the medication group regained weight much more rapidly during a 12-month maintenance period. The spouse conditions did not differ in weight change during treatment or follow-up. Obese spouses lost as much weight as the patients and were slightly more successful than the patients at maintaining their losses. Patients with obese spouses lost more weight than patients with nonobese spouses. Depression decreased in proportion to decreases in weight.

Authors
Brownell, KD; Stunkard, AJ
MLA Citation
Brownell, KD, and Stunkard, AJ. "Couples training, pharmacotherapy, and behavior therapy in the treatment of obesity." Archives of General Psychiatry 38.11 (1981): 1224-1229.
PMID
7305602
Source
scival
Published In
Archives of General Psychiatry
Volume
38
Issue
11
Publish Date
1981
Start Page
1224
End Page
1229

Differential changes in plasma high-density lipoprotein-cholesterol levels in obese men and women during weight reduction

Levels of high-density lipoprotein-cholesterol (HDL-cholesterol) and other lipoproteins of 73 obese men and women were measured before and after a 16-week weight reduction program. There were significant differences between men and women. In men, a 10.7-kg weight loss was associated with a 5% increased in the HDL-cholesterol level, a 15.8% decrease in the low-density lipoprotein-cholesterol (LDL-cholesterol) level, and a 30.1% increase in the HDL-LDL ratio. Women, in contrast, showed an 8.9-kg weight loss, a 3.3% decrease in the HDL-cholesterol level, a 4.7% decrease in the LDL-cholesterol level, and no significant change in the HDL-LDL ratio. These differences suggest that weight reduction may be an important means of important plasma lipoprotein patterns in men but may be of more limited value in women.

Authors
Brownell, KD; Stunkard, AJ
MLA Citation
Brownell, KD, and Stunkard, AJ. "Differential changes in plasma high-density lipoprotein-cholesterol levels in obese men and women during weight reduction." Archives of Internal Medicine 141.9 (1981): 1142-1146.
Source
scival
Published In
Archives of Internal Medicine
Volume
141
Issue
9
Publish Date
1981
Start Page
1142
End Page
1146
DOI
10.1001/archinte.141.9.1142

Evaluation and modification of exercise patterns ion the natural environment

Using a new experimental paradigm to evaluate physical activity in the natural environment, the authors made 45.694 observations of persons using stairs or an adjacent escalator at a shopping mall, train station, and bus terminal. In study 1, stair use more than doubled for both obese and nonobese persons during two 2-week poeriods when a colorful sign encouraging use of the stairs was positioned at the stairs/escalator choice point. In study 2, stair use remained elevated fro 15 consecutive days while the sign was present, decreased during a 1-month follow-up period, and returned to baseline by 3 months. These results not only demonstrate the usefullness of this paradigm, but also suggest the strength of simple, inexpensive public health interventions to increase physical activity.

Authors
Brownell, KD; Stunkard, AJ; Albaum, JM
MLA Citation
Brownell, KD, Stunkard, AJ, and Albaum, JM. "Evaluation and modification of exercise patterns ion the natural environment." American Journal of Psychiatry 137.12 (1980): 1540-1545.
PMID
7435710
Source
scival
Published In
American Journal of Psychiatry
Volume
137
Issue
12
Publish Date
1980
Start Page
1540
End Page
1545

Determination of high density lipoprotein-cholesterol in stored human plasma

This study was performed to determine the effect of frozen and unfrozen storage on plasma high density lipoprotein (HDL) cholesterol analysis. HDL-cholesterol was determined, following removal of the other lipoproteins by precipitation with heparin and MnCl 2, in fresh plasma samples and in aliquots of the samples that had been stored 1) unfrozen (4°C), up to 14 days, 2) frozen (-20°C), up to 14 days, and 3) frozen (-20°C), 5-6 years. There were progressive changes in measured HDL-cholesterol values under all conditions of storage. The changes were significantly and most highly correlated with HDL-cholesterol level and they reached about 4 mg/dl for each 10 mg/dl initial HDL-cholesterol concentration. Samples with low HDL-cholesterol concentrations tended to increase with storage, and those with high HDL-cholesterol levels tended to decrease. Since the changes were in opposite directions, the group means tended to be preserved. The mean differences between fresh and stored samples were (stored-fresh): 1-14 days, 4°C, -0.10 to +4.60 mg/dl; 1 hour-14 days, -20°C, +0.80 to 1.92 mg/dl; 5-6 years -20°C, -1.92 mg/dl. Values changed most rapidly during storage at 4°C and were accompanied by changes in the precipitability of the lipoproteins; low density lipoproteins became progressively difficult to precipitate completely, and HDL became progressively easier to precipitate. The measured HDL-cholesterol level depends on which process predominates and can lead to grossly inaccurate measurements, particularly at the extremes of HDL-cholesterol concentration.

Authors
Bachorik, PS; Walker, R; Brownell, KD; Stunkard, AJ; Kwiterovich, PO
MLA Citation
Bachorik, PS, Walker, R, Brownell, KD, Stunkard, AJ, and Kwiterovich, PO. "Determination of high density lipoprotein-cholesterol in stored human plasma." Journal of Lipid Research 21.5 (1980): 608-616.
PMID
7400691
Source
scival
Published In
Journal of lipid research
Volume
21
Issue
5
Publish Date
1980
Start Page
608
End Page
616

Work-site treatment for obesity

The authors report here the first controlled clinical trial of treatment for obesity at the work site. The study was designed to assess the feasibility of work-site treatment for obesity, and compare the effectiveness of various treatment conditions: work site versus medical site, lay therapist versus professional therapist, and frequent versus conventional (once weekly) treatment. They found that work-site treatment for obesity is feasible and that lay therapists are at least as effective as professional therapists.

Authors
Stunkard, AJ; Brownell, KD
MLA Citation
Stunkard, AJ, and Brownell, KD. "Work-site treatment for obesity." American Journal of Psychiatry 137.2 (1980): 252-253.
PMID
7352590
Source
scival
Published In
American Journal of Psychiatry
Volume
137
Issue
2
Publish Date
1980
Start Page
252
End Page
253

Behavior therapy for obesity: An evaluation of treatment outcome

The long-term evidence on the behavioral treatment of obesity, including both experimentally controlled outcome studies and uncontrolled clinical trials, is critically reviewed. Results of the controlled studies show that weight loss at post-treatment (a mean of 10-11 lbs) is generally maintained at a one year follow-up. However, there is little evidence of continued weight loss during follow-up. The few studies with follow-ups of more than one year show less satisfactory maintenance of treatment effects. Other findings include marked variability in weight loss, the failure to find prognostic indicators, the absence of negative side-effects, and greatly reduced attrition. Ten of the 17 controlled studies included specific maintenance strategies, booster sessions being the preferred strategy despite the lack of supporting data. Findings from the controlled clinical trials are largely consistent with those of the controlled studies. Suggestions for improving the efficiency of behavioral treatment programs are made, with specific emphasis on changing treatment format, emphasizing physical activity, and incorporating improved maintenance strategies. The outcome evidence is summarized in an extended discussion of the question, what treatment method(s), administered by whom, for which populations, has what effects, on what measures, and at what cost. © 1981.

Authors
Wilson, GT; Brownell, KD
MLA Citation
Wilson, GT, and Brownell, KD. "Behavior therapy for obesity: An evaluation of treatment outcome." Advances in Behaviour Research and Therapy 3.2 (1980): 49-86.
Source
scival
Published In
Advances in Behaviour Research and Therapy
Volume
3
Issue
2
Publish Date
1980
Start Page
49
End Page
86
DOI
10.1016/0146-6402(80)90001-6

The behavioral control of obesity: A descriptive analysis of a large-scale program

A behavioral treatment program for 147 obese patients in a Weight Control Clinic was evaluated. Weight losses during treatment averaged 11.01 pounds with large intervariability. Unlike past studies, patients continued to lose weight during a 6-month follow-up period. Weight loss was associated with age and initial degree of obesity, but other demographic and psychological variables failed to predict success in treatment. A critical examination of the attrition problem was carried out to determine the relationship between patient variables and the propensity to terminate treatment prematurely. Results demonstrate the utility of behavioral treatment procedures for obesity, yet further research is needed to reduce attrition and to facilitate long-term maintenance of weight loss.

Authors
Brownell, KD; Heckerman, CL; Westlake, RJ
MLA Citation
Brownell, KD, Heckerman, CL, and Westlake, RJ. "The behavioral control of obesity: A descriptive analysis of a large-scale program." Journal of Clinical Psychology 35.4 (1979): 864-869.
PMID
512018
Source
scival
Published In
Journal of Clinical Psychology
Volume
35
Issue
4
Publish Date
1979
Start Page
864
End Page
869

Behavior therapy for obesity: Including family members in the treatment process

Authors
Wilson, GT; Brownell, K
MLA Citation
Wilson, GT, and Brownell, K. "Behavior therapy for obesity: Including family members in the treatment process." Behavior Therapy 9.5 (1979): 943-945.
Source
scival
Published In
Behavior Therapy
Volume
9
Issue
5
Publish Date
1979
Start Page
943
End Page
945

Obesity and adherence to behavioral programs Behavioral analysis and treatment of substance abuse

Authors
Brownell, KD
MLA Citation
Brownell, KD. "Obesity and adherence to behavioral programs Behavioral analysis and treatment of substance abuse." NIDA RES. MONOGR. No. 25 (1979): 224-237.
PMID
117371
Source
scival
Published In
NIDA RES. MONOGR.
Volume
No. 25
Publish Date
1979
Start Page
224
End Page
237

Cleaning the plate: food left over by overweight and normal weight persons

The amount of food left on trays after a clinner meal in a university cafeteria was measured for 146 persons. Half of the subjects were overweight and half were normal weight. Overweight women left significantly less food on their trays than did women of normal weight. Among men, the overweight also left less food but the difference did not reach significance. These findings suggest that food left over must be measured in estimating food intake from food choice, that behavior therapy injunctions to leave food on the plate are justified, and that obesity may be, at least in part, a result of learned patterns of behavior. © 1979.

Authors
Krassner, HA; Brownell, KD; Stunkard, AJ
MLA Citation
Krassner, HA, Brownell, KD, and Stunkard, AJ. "Cleaning the plate: food left over by overweight and normal weight persons." Behaviour Research and Therapy 17.2 (1979): 155-156.
PMID
426743
Source
scival
Published In
Behaviour Research and Therapy
Volume
17
Issue
2
Publish Date
1979
Start Page
155
End Page
156
DOI
10.1016/0005-7967(79)90024-X

The effect of couples training and partner co-operativeness in the behavioral treatment of obesity

To evaluate the influence of spouse co-operativeness and couples training in the treatment of obesity, 29 obese men and women were assigned to three experimental conditions: Co-operative spouse-couples training; subjects attended all meetings with spouses. Spouses were trained in modeling, monitoring, and reinforcement techniques; Cooperative spouse subject alone; subjects attended meetings alone even though their partners had agreed to become involved in treatment; Non-cooperative spouse; subjects had spouses refusing to participate in the program, and attended sessions alone. At the 3 month and 6 month maintenance assessments, subjects in the spouse training condition lost significantly more weight than subjects in the other two conditions. Weight losses compared favourably to those of any controlled study with subjects in the couples training group averaging nearly 30 lbs lost after 8 1/2 months of treatment. In the absence of spouse training, subjects with cooperative spouses did no better than subjects with non-cooperative spouses. The findings suggest that spouse training may have a potent facilitative effect in weight reduction, and that this effect may promote long-term maintenance of weight loss.

Authors
Brownell, KD; Heckerman, CL; Westlake, RJ; Hayes, SC; Monti, PM
MLA Citation
Brownell, KD, Heckerman, CL, Westlake, RJ, Hayes, SC, and Monti, PM. "The effect of couples training and partner co-operativeness in the behavioral treatment of obesity." Behaviour Research and Therapy 16.5 (1978): 323-333.
PMID
743074
Source
scival
Published In
Behaviour Research and Therapy
Volume
16
Issue
5
Publish Date
1978
Start Page
323
End Page
333
DOI
10.1016/S0006-3495(78)85422-8

Behavior therapy for obesity: Including family members in the treatment process

Authors
Wilson, GT; Brownell, K
MLA Citation
Wilson, GT, and Brownell, K. "Behavior therapy for obesity: Including family members in the treatment process." Behavior Therapy 9.5 (1978): 943-945.
Source
scival
Published In
Behavior Therapy
Volume
9
Issue
5
Publish Date
1978
Start Page
943
End Page
945
DOI
10.1016/S0005-7894(78)80026-4

Self and external monitoring of weight.

Authors
Heckerman, CL; Brownell, KD; Westlake, RJ
MLA Citation
Heckerman, CL, Brownell, KD, and Westlake, RJ. "Self and external monitoring of weight." Psychological Reports 43.2 (1978): 375-378.
PMID
724883
Source
scival
Published In
Psychological Reports
Volume
43
Issue
2
Publish Date
1978
Start Page
375
End Page
378

Therapist and group contact as variables in the behavioral treatment of obesity

Randomly assigned 29 obese females (average age 48.7 yrs), to 1 of 3 experimental conditions: (a) a "standard" behavioral treatment (SBT) group emphasizing self-management techniques (Ss attended group therapy meetings weekly for 10 wks, then monthly for 6 mo and were given a weight control manual); (b) a group receiving the weight control manual via mail with little professional contact (MMC); and (c) a waiting list control condition. Results reveal a superiority of both treatment conditions over the control condition at posttreatment. SBT Ss did significantly better than MMC Ss at posttreatment but not at the 6-mo follow-up. Weight loss for MMC Ss was minimal. The use of "do-it-yourself" treatment manuals is challenged. (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1978 American Psychological Association.

Authors
Brownell, KD; Heckerman, CL; Westlake, RJ
MLA Citation
Brownell, KD, Heckerman, CL, and Westlake, RJ. "Therapist and group contact as variables in the behavioral treatment of obesity." Journal of Consulting and Clinical Psychology 46.3 (1978): 593-594.
PMID
670508
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
46
Issue
3
Publish Date
1978
Start Page
593
End Page
594
DOI
10.1037/0022-006X.46.3.593

Behavioral treatment of obesity in children

The development of behavioral techniques for the control of obesity in children is reviewed. Techniques developed for the treatment of obese adults have recently been modified for use with children, and to date, six studies exist that have evaluated their use. The results are encouraging and it appears that behavior therapy offers new promise in the treatment of this difficult problem. The review ends with a survey of behavioral techniques and suggestions for further reading.

Authors
Brownell, KD; Stunkard, AJ
MLA Citation
Brownell, KD, and Stunkard, AJ. "Behavioral treatment of obesity in children." American Journal of Diseases of Children 132.4 (1978): 403-412.
PMID
645661
Source
scival
Published In
American Journal of Diseases of Children
Volume
132
Issue
4
Publish Date
1978
Start Page
403
End Page
412

The effect of couples training and partner co-operativeness in the behavioral treatment of obesity

To evaluate the influence of spouse co-operativeness and couples training in the treatment of obesity, 29 obese men and women were assigned to three experimental conditions: (1) Co-operative spouse-couples training: subjects attended all meetings with spouses. Spouses were trained in modeling, monitoring, and reinforcement techniques; (2) Co-operative spouse-subject alone: subjects attended meetings alone even though their partners had agreed to become involved in treatment; (3) Non-cooperative spouse: subjects had spouses refusing to participate in the program, and attended sessions alone. At the 3-month and 6-month maintenance assessments. subjects in the spouse training condition lost significantly more weight than subjects in the other two conditions. Weight losses compared favorably to those of any controlled study with subjects in the couples training group averaging nearly 30 lbs lost after 8 1 2 months of treatment. In the absence of spouse training, subjects with co-operative spouses did no better than subjects with non-co-operative spouses. The findings suggest that spouse training may have a potent facilitative effect in weight reduction, and that this effect may promote long-term maintenance of weight loss. © 1978.

Authors
Brownell, KD; Heckerman, CL; Westlake, RJ; Hayes, SC; Monti, PM
MLA Citation
Brownell, KD, Heckerman, CL, Westlake, RJ, Hayes, SC, and Monti, PM. "The effect of couples training and partner co-operativeness in the behavioral treatment of obesity." Behaviour Research and Therapy 16.5 (1978): 323-333.
Source
scival
Published In
Behaviour Research and Therapy
Volume
16
Issue
5
Publish Date
1978
Start Page
323
End Page
333

The use of self-administered covert sensitization in the treatment of exhibitionism and sadism

This case study examines the response-response relationships between three distinct patterns of sexual arousal-exhibitionism, sadism, and heterosexual arousal-in the treatment of a 25-year-old male arrested for exhibitionism and attempted rape. Physiological and self-report measures of appropriate and deviant arousal were obtained in a baseline phase. Subsequently, a modification of covert sensitization involving the use of realistic aversive scenes and self-administration was successively employed with the two deviant arousal patterns in multiple-baseline fashion. Implementation of the treatment program led to rapid and stable reductions in both physiological and self-report measures of the specific arousal patterns being treated, while the other patterns of sexual arousal remained unchanged. At the end of treatment the client displayed low levels of arousal to exhibitionistic and sadistic stimuli, while maintaining appropriate heterosexual arousal. These treatment gains were sustained during a 2-month follow-up period. The data support the view that patterns of sexual arousal are independent entities which require individual assessment and treatment. The theoretical advantages of self-administered covert sensitization are discussed. © 1978 Association for Advancement of Behavior Therapy.

Authors
Hayes, SC; Brownell, KD; Barlow, DH
MLA Citation
Hayes, SC, Brownell, KD, and Barlow, DH. "The use of self-administered covert sensitization in the treatment of exhibitionism and sadism." Behavior Therapy 9.2 (1978): 283-289.
Source
scival
Published In
Behavior Therapy
Volume
9
Issue
2
Publish Date
1978
Start Page
283
End Page
289
DOI
10.1016/S0005-7894(78)80114-2

Behavior therapy and behavior change: uncertainties in programs for weight control

Authors
Brownell, KD; Stunkard, AJ
MLA Citation
Brownell, KD, and Stunkard, AJ. "Behavior therapy and behavior change: uncertainties in programs for weight control." Behaviour Research and Therapy 16.4 (1978): 301--.
PMID
718597
Source
scival
Published In
Behaviour Research and Therapy
Volume
16
Issue
4
Publish Date
1978
Start Page
301-
DOI
10.1016/0005-7967(78)90033-5

Patterns of appropriate and deviant sexual arousal: The behavioral treatment of multiple sexual deviations

Single-S experimental methodology was used to evaluate the relationship between distinct patterns of deviant sexual arousal and heterosexual arousal. Five male 22-46 yr old Ss, each exhibiting 2 patterns of deviant arousal, were successfully treated with covert sensitization. Physiological and self-report measures of arousal revealed that heterosexual arousal did not increase as deviant arousal declined, and deviant arousal did not decline as heterosexual arousal increased. Each pattern of deviant arousal did not decline until sequentially treated with covert sensitization. In addition, covert sensitization was effective in treating a wide variety of deviant arousal patterns. The theoretical and clinical implications of a functional independence among various patterns of sexual arousal are discussed. (32 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1977 American Psychological Association.

Authors
Brownell, KD; Hayes, SC; Barlow, DH
MLA Citation
Brownell, KD, Hayes, SC, and Barlow, DH. "Patterns of appropriate and deviant sexual arousal: The behavioral treatment of multiple sexual deviations." Journal of Consulting and Clinical Psychology 45.6 (1977): 1144-1155.
PMID
925223
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
45
Issue
6
Publish Date
1977
Start Page
1144
End Page
1155
DOI
10.1037/0022-006X.45.6.1144

Self-control in school children: Stringency and leniency in self-determined and externally imposed performance standards

This experiment was designed to investigate the capacity of stringent and lenient performance standards to elicit and maintain academic performance when self-determined or externally imposed. The ability of stringency instructions and social reinforcement to prompt the enduring self-selection of stringent standards was also examined Children in two contingent reinforcement conditions were allowed to self-determine performance standards with one group given stringency instructions and social reinforcement, while the same requirements were externally imposed upon yoked children in two other contingent reinforcement conditions. Control subjects performed in the absence of reinforcement. Subjects allowed to self-determine performance standards performed significantly better during reinforcement on one dependent measure than did subjects whose standards were externally imposed, while on the other dependent measure the groups performed equally well. Stringency instructions and social reinforcement were effective in eliciting and maintaining the self-selection of stringent standards. On both dependent measures, stringent standards (whether self-determined or externally imposed) were more effective than lenient standards in eliciting performance during reinforcement. © 1977 Association for Advancement of Behavior Therapy. All rights reserved.

Authors
Brownell, KD; Colletti, G; Ersner-Hershfield, R; Hershfield, SM; Wilson, GT
MLA Citation
Brownell, KD, Colletti, G, Ersner-Hershfield, R, Hershfield, SM, and Wilson, GT. "Self-control in school children: Stringency and leniency in self-determined and externally imposed performance standards." Behavior Therapy 8.3 (1977): 442-455.
Source
scival
Published In
Behavior Therapy
Volume
8
Issue
3
Publish Date
1977
Start Page
442
End Page
455
DOI
10.1016/S0005-7894(77)80080-4

Measurement and treatment of two sexual deviations in one person

Measurement and modification is described of the sexual deviations of a 34-yr-old male with a history of exhibitionism and sexual contact with his stepdaughter. A multiple baseline design was employed to assess the effects of covert sensitization not only on different patterns of deviant arousal, but also on appropriate social and sexual aspects of the subject's life. The analysis of response-response relationships revealed a consistently positive pattern responding, and enabled covert sensitization to be applied to each specific pattern of sexual arousal. © 1976.

Authors
Brownell, KD; Barlow, DH
MLA Citation
Brownell, KD, and Barlow, DH. "Measurement and treatment of two sexual deviations in one person." Journal of Behavior Therapy and Experimental Psychiatry 7.4 (1976): 349-354.
Source
scival
Published In
Journal of Behavior Therapy and Experimental Psychiatry
Volume
7
Issue
4
Publish Date
1976
Start Page
349
End Page
354
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