Kevin Lewis

January 05, 2016

Will a Fat Tax Work?

Romana Khan, Kanishka Misra & Vishal Singh

Marketing Science, forthcoming

Of the many proposals to reverse the obesity epidemic, the most contentious is the use of price-based interventions such as the fat tax. Previous investigations of the efficacy of such initiatives in altering consumption behavior yielded contradictory findings. In this article, we use six years of point-of-sale scanner data for milk from a sample of over 1,700 supermarkets across the United States to investigate the potential of small price incentives for inducing substitution of healthier alternatives. We exploit a pricing pattern particular to milk in the United States, whereby prices in some geographical regions are flat across whole, 2%, 1%, and skim milk; whereas in other regions they are decreasing with the fat content level. The prevailing price structure is determined at a chain and regional level, and is independent of local demand conditions. This exogenous variation in price structure provides a quasi-experimental set-up to analyze the impact of small price differences on substitution across fat content. We use detailed demographics to evaluate price sensitivity and substitution patterns for different socioeconomic groups. Results show that small price differences are highly effective in inducing substitution to lower calorie options. The impact is highest for low-income households who are also most at risk for obesity. Our results suggest that a selective taxation mechanism that lowers the relative prices of healthier options, such that those price changes are reflected in shelf prices at the point-of-purchase, can serve as an effective health policy tool in the efforts to control obesity.


The Effect of Medical Marijuana Laws on Body Weight

Joseph Sabia, Jeffrey Swigert & Timothy

Young Health Economics, forthcoming

This study is the first to examine the effects of medical marijuana laws (MMLs) on body weight, physical wellness, and exercise. Using data from the 1990 to 2012 Behavioral Risk Factor Surveillance System and a difference-in-difference approach, we find that the enforcement of MMLs is associated with a 2% to 6% decline in the probability of obesity. We find some evidence of age-specific heterogeneity in mechanisms. For older individuals, MML-induced increases in physical mobility may be a relatively important channel, while for younger individuals, a reduction in consumption of alcohol, a substitute for marijuana, appears more important. These findings are consistent with the hypothesis that MMLs may be more likely to induce marijuana use for health-related reasons among older individuals, and cause substitution toward lower-calorie recreational ‘highs’ among younger individuals. Our estimates suggest that MMLs induce a $58 to $115 per-person annual reduction in obesity-related medical costs.


Obesity and Bariatric Surgery Drive Epigenetic Variation of Spermatozoa in Humans

Ida Donkin et al.
Cell Metabolism, forthcoming

Obesity is a heritable disorder, with children of obese fathers at higher risk of developing obesity. Environmental factors epigenetically influence somatic tissues, but the contribution of these factors to the establishment of epigenetic patterns in human gametes is unknown. Here, we hypothesized that weight loss remodels the epigenetic signature of spermatozoa in human obesity. Comprehensive profiling of the epigenome of sperm from lean and obese men showed similar histone positioning, but small non-coding RNA expression and DNA methylation patterns were markedly different. In a separate cohort of morbidly obese men, surgery-induced weight loss was associated with a dramatic remodeling of sperm DNA methylation, notably at genetic locations implicated in the central control of appetite. Our data provide evidence that the epigenome of human spermatozoa dynamically changes under environmental pressure and offers insight into how obesity may propagate metabolic dysfunction to the next generation.


Becoming Overweight without Gaining a Pound: Weight Evaluations and the Social Integration of Mexicans in the United States

Claire Altman, Jennifer Van Hook & Jonathan Gonzalez

International Migration Review, forthcoming

Mexican women gain weight with increasing duration in the United States. In the United States, body dissatisfaction tends to be associated with depression, disordered eating, and incongruent weight evaluations, particularly among white women and women of higher socioeconomic status. However, it remains unclear how being overweight and obesity are interpreted by Mexican women. Using comparable data of women aged 20–64 from both Mexico (the 2006 Encuesta Nacional de Salud y Nutricion; N = 17,012) and the United States (the 1999–2009 National Health and Nutrition Examination Surveys; N = 8,487), we compare weight status evaluations among Mexican nationals, Mexican immigrants, US-born Mexicans, US-born non-Hispanic whites, and US-born non-Hispanic blacks. Logistic regression analyses, which control for demographic and socioeconomic variables and measured body mass index and adjust for the likelihood of migration for Mexican nationals, indicate that the tendency to self-evaluate as overweight among Mexicans converges with levels among non-Hispanic whites and diverges from blacks over time in the United States. Overall, the results suggest a US integration process in which Mexican-American women's less critical self-evaluations originate in Mexico but fade with time in the United States as they gradually adopt US white norms for thinner body sizes. These results are discussed in light of prior research about social comparison and negative health assimilation.


Unpacking the psychological weight of weight stigma: A rejection-expectation pathway

Alison Blodorn et al.
Journal of Experimental Social Psychology, March 2016, Pages 69–76

The present research tested the hypothesis that the negative effects of weight stigma among higher body-weight individuals are mediated by expectations of social rejection. Women and men who varied in objective body-weight (body mass index; BMI) gave a speech describing why they would make a good date. Half believed that a potential dating partner would see a videotape of their speech (weight seen) and half believed that a potential dating partner would listen to an audiotape of their speech (weight unseen). Among women, but not men, higher body-weight predicted increased expectations of social rejection, decreased executive control resources, decreased self-esteem, increased self-conscious emotions and behavioral displays of self-consciousness when weight was seen but not when weight was unseen. As predicted, higher body-weight women reported increased expectations of social rejection when weight was seen (versus unseen), which in turn predicted decreased self-esteem, increased self-conscious emotions, and increased stress. In contrast, lower body-weight women reported decreased expectations of social rejection when weight was seen (versus unseen), which in turn predicted increased self-esteem, decreased self-conscious emotions, and decreased stress. Men's responses were largely unaffected by body-weight or visibility, suggesting that a dating context may not be identity threatening for higher body-weight men. Overall, the present research illuminates a rejection-expectation pathway by which weight stigma undermines higher body-weight women's health.


Economic Constraints on Taste Formation and the True Cost of Healthy Eating

Caitlin Daniel
Social Science & Medicine, January 2016, Pages 34–41

This paper shows how an interaction between economic constraints and children’s taste preferences shapes low-income families’ food decisions. According to studies of eating behavior, children often refuse unfamiliar foods 8 to 15 times before accepting them. Using 80 interviews and 41 grocery-shopping observations with 73 primary caregivers in the Boston area in 2013-2015, I find that many low-income respondents minimize the risk of food waste by purchasing what their children like — often calorie-dense, nutrient-poor foods. High-income study participants, who have greater resources to withstand the cost of uneaten food, are more likely to repeatedly introduce foods that their children initially refuse. Several conditions moderate the relationship between children’s taste aversion and respondents’ risk aversion, including household-level food preferences, respondents’ conceptions of adult authority, and children’s experiences outside of the home. Low-income participants’ risk aversion may affect children’s taste acquisition and eating habits, with implications for socioeconomic disparities in diet quality. This paper proposes that the cost of providing children a healthy diet may include the possible cost of foods that children waste as they acquire new tastes.


Economic Preferences and Obesity among a Low-Income African American Community

Angela de Oliveira et al.
Journal of Economic Behavior & Organization, forthcoming

Obesity has reached epidemic proportions in the US, with a significantly higher fraction of African Americans who are obese than whites. Yet there is little understanding of why some individuals become obese while others do not. We conduct a lab-in-field experiment in a low-income African American community to investigate whether risk and time preferences play a role in the tendency to become obese. We examine the relationship between incentivized measures of risk and time preferences and weight status (BMI), and find that individuals who are more tolerant of risk are more likely to have a higher BMI. This result is driven by the most risk tolerant individuals. Patience is not independently statistically related to BMI in this sample, but those who are more risk averse and patient are less likely to be obese.


Culture, Health, and Bigotry: How Exposure to Cultural Accounts of Fatness Shape Attitudes about Health Risk, Health Policies, and Weight-Based Prejudice

David Frederick, Abigail Saguy & Kjerstin Gruys

Social Science & Medicine, forthcoming

Rationale: We conducted three experiments to examine how cultural frames shape attitudes about health, focusing on obesity, which is considered a public health crisis and is imbued with symbolic meaning.

Methods: College students (Ns = 99, 114, and 293) read news articles that presented high body weight according to one or more of the following frames: 1) public health crisis; 2) personal responsibility; 3) health at every size (HAES); or 4) fat rights.

Results: Compared to people who read the HAES and Fat Rights articles, those who read the Public Health Crisis and Personal Responsibility articles expressed more belief in the health risks of being fat (ds = 1.28 to 1.79), belief that fat people should pay more for insurance (ds = 0.53 to 0.71), anti-fat prejudice (ds = 0.61 to 0.69), willingness to discriminate against fat people (ds = 0.41 to 0.59), and less willingness to celebrate body-size diversity (ds = 0.77 to .1.07). They were less willing to say women at the lower end of the obese range could be healthy. Exposure to these articles increased support for price-raising policies to curb obesity but not support for redistributive or compensatory policies. In Experiment 3, in comparison to a control condition, exposure to HAES or Fat Rights frames significantly reduced beliefs in the risks of obesity and support for charging fat people more for insurance. However, only people exposed to the Fat Rights frame expressed fewer anti-fat attitudes and more willingness to celebrate body-size diversity.


Does Self-Prepared Food Taste Better? Effects of Food Preparation on Liking

Simone Dohle, Sina Rall & Michael Siegrist

Health Psychology, forthcoming

Objective: The aim was to examine whether self-preparation of food increases the liking of healthy and unhealthy foods.

Method: The study used a 2 (preparation: self-prepared vs. other-prepared) × 2 (healthiness: healthy vs. unhealthy) between-subjects design. Female participants (N = 120) tasted food that was either self-prepared or other-prepared, and that either contained markedly healthy or unhealthy ingredients. Interindividual differences in dietary restraint were also assessed. Liking and perceived healthiness of the food served as the main dependent variables.

Results: A significant interaction effect of food preparation and healthiness of the food on liking was revealed: Self-preparation increased the liking of the healthy but not of the unhealthy food. This effect was particularly strong for individuals with high levels of dietary restraint. Moreover, the combined effect of food preparation and healthiness of the food on liking was mediated by perceived healthiness of the food.

Conclusion: The results bolster public health programs trying to encourage people to eat less prepared ready-to-eat foods and more self-prepared food. Because time available for home food preparation is often limited, programmatic efforts to encourage food preparation could be extended to schools and workplaces.


Half-Size Me? How Calorie and Price Information Influence Ordering on Restaurant Menus with Both Half and Full Entrée Portion Sizes

Kelly Haws & Peggy Liu
Appetite, February 2016, Pages 127–137

Many restaurants are increasingly required to display calorie information on their menus. We present a study examining how consumers’ food choices are affected by the presence of calorie information on restaurant menus. However, unlike prior research on this topic, we focus on the effect of calorie information on food choices made from a menu that contains both full size portions and half size portions of entrées. This different focus is important because many restaurants increasingly provide more than one portion size option per entrée. Additionally, we examine whether the impact of calorie information differs depending on whether full portions are cheaper per unit than half portions (non-linear pricing) or whether they have a similar per unit price (linear pricing). We find that when linear pricing is used, calorie information leads people to order fewer calories. This decrease occurs as people switch from unhealthy full sized portions to healthy full sized portions, not to unhealthy half sized portions. In contrast, when non-linear pricing is used, calorie information has no impact on calories selected. Considering the impact of calorie information on consumers’ choices from menus with more than one entrée portion size option is increasingly important given restaurant and legislative trends, and the present research demonstrates that calorie information and pricing scheme may interact to affect choices from such menus.


Impact of Health Labels on Flavor Perception and Emotional Profiling: A Consumer Study on Cheese

Joachim Schouteten et al.
Nutrients, December 2015, Pages 10251-10268

The global increase of cardiovascular diseases is linked to the shift towards unbalanced diets with increasing salt and fat intake. This has led to a growing consumers’ interest in more balanced food products, which explains the growing number of health-related claims on food products (e.g., “low in salt” or “light”). Based on a within-subjects design, consumers (n = 129) evaluated the same cheese product with different labels. Participants rated liking, saltiness and fat flavor intensity before and after consuming four labeled cheeses. Even though the cheese products were identical, inclusion of health labels influenced consumer perceptions. Cheese with a “light” label had a lower overall expected and perceived liking compared to regular cheese. Although cheese with a “salt reduced” label had a lower expected liking compared to regular cheese, no lower liking was found when consumers actually consumed the labeled cheese. All labels also influenced the perceived intensities of the attributes related to these labels, e.g., for example salt intensity for reduced salt label. While emotional profiles of the labeled cheeses differed before tasting, little differences were found when actual tasting these cheeses. In conclusion, this study shows that health-related labels might influence the perceived flavor and emotional profiles of cheese products.


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