Nicola J. Buckland

Background: Weight stigma refers to prejudice and discrimination based on body weight. Healthcare professionals often hold negative attitudes towards patients with overweight, which can negatively affect patient care and health outcomes. However, weight stigma is yet to be explored in midwifery and dental students. Methods: Two online experimental studies using hypothetical patient vignettes were conducted in midwifery ( n = 281; Study 1) and dental and non‐dental students ( n = 528; Study 2). Participants were randomly assigned to view a healthy‐weight, overweight or obese patient vignette and then reported their attitudes, predicted time, advice they would provide and beliefs about obesity. Data were analysed using ANOVA and logistic regression. Results: In Study 1, midwifery students held significantly more stigmatizing attitudes towards patients who were overweight than healthy‐weight patients; however, there was no significant difference in attitudes towards patients with obesity. Predicted time spent with patients did not significantly differ as a function of patient weight status. In Study 2, dental and non‐dental students reported more stigmatizing attitudes towards overweight and obese patients compared to healthy‐weight patients. Predicted time spent with patients did not differ significantly. Dental and non‐dental students were more likely to offer lifestyle‐related advice to overweight and obese patients. There was no significant relationship between beliefs about obesity and attitudes towards treating patients. Conclusions: Weight stigma is evident among healthcare students and can affect healthcare advice. Increased awareness of potential biases in midwives and dental students is needed and should form formal training to improve equitable healthcare delivery.

Women experience hormonal fluctuations throughout the menstrual cycle and report changes in appetite and emotional states. Although the menstrual cycle has been associated with eating behaviour and affective processes, whether appetite-related responses systematically differ across phases remains unclear. This study used complementary approaches to examine mood, eating behaviour, and food reward across the menstrual cycle. In Study 1, 302 women (27.2 ± 5.1 years; BMI 24.9 ± 5.8 kg/m²) with natural cycles completed Profile of Mood States (POMS) and Three-Factor Eating Questionnaire (TFEQ-R21). Confirmatory factor analysis, ANOVA, and structural equation modeling were conducted. In Study 2, 31 naturally cycling women (25.97 ± 7.54 years; BMI 23.35 ± 3.5 kg/m²) participated in a crossover study during the mid-follicular and mid-luteal phases. Food reward (liking and wanting) was assessed using the Leeds Food Preference Questionnaire (LFPQ-BR) under fasted and fed conditions, and multiple regression analyses identified predictors of food reward. In Study 1, only the ”confusion” differed across menstrual cycle phases. Mood states and BMI, rather than menstrual cycle phases, predicted emotional eating, uncontrolled eating, and cognitive restraint. In Study 2, no direct phase differences in food reward were observed. However, phase-stratified models identified distinct correlates of food reward across phases. Overall, the findings provide limited evidence that menstrual cycle phase itself is associated with mood, eating behaviour, or food reward. Instead, psychological and physiological factors showed stronger associations with appetite-related outcomes, supporting a multidimensional approach to understanding women’s eating behaviour.

Certified compostable packaging has the potential to be a more sustainable alternative to some conventional plastics, but only if disposed of appropriately. This study developed and evaluated the effects of a behaviour change intervention on the disposal of compostable packaging in the co-mingled food and garden waste bin for industrial composting in households in the United Kingdom. The intervention targeted barriers to the appropriate disposal of compostable packaging as identified via focus groups, previous research and the capability, opportunity, motivation-behaviour model. Intervention components included front- and back-of-pack labels, tips on positioning of household bins, visual reminders to check packaging labels and which bin to use, and a bag of compost with an infographic highlighting what happens during the composting process. The intervention was delivered over 6 weeks to 120 households who were provided with compostable and non-compostable items. The results from online surveys completed at three time points (pre-intervention, post-intervention and follow-up) and weekly waste audits that assessed the weight of compostable packaging in the food and garden waste bin showed significant increases in perceived capability, opportunity and motivation to correctly dispose of compostable packaging via the food and garden waste bin over the course of the intervention and increased amounts of compostable packaging disposed of. The implications are that standardised, clear labels on industrially compostable packaging are needed to help residents to identify and appropriately dispose of this packaging. Strategies that automatically prompt which bin to use and increase residents’ awareness and motivation to appropriately dispose of compostable packaging are also recommended.

Compostable packaging may provide a more sustainable alternative to conventional packaging. However, people often inappropriately dispose of compostable packaging which limits its potential benefits. This study applied the Behaviour Change Wheel and the capability, opportunity, motivation-behaviour model to develop and evaluate the effect of a behaviour change intervention on the disposal of compostable packaging at workplaces. Focus groups, observations, analysis of existing materials and a review of the literature identified barriers in relation to capability, opportunity and motivation to compost packaging. The intervention addressed the identified barriers through clear and distinctive labels on packaging, matching bin signage, a motivational video and an onboarding presentation for workplaces. The intervention was implemented in three workplaces and evaluated using a pre–post design. The intervention led to sustained increases in compostable packaging in compostable bins and reduced contamination. A post-intervention survey and roundtable event suggested that the intervention was acceptable to workplace leads and employees. There was no evidence that the intervention changed perceived capability, opportunity and/or motivation. The main recommendations for packaging producers and workplaces include using consistent distinctive bin signage that corresponds with standardized packaging labels.

A reduction in meat consumption is urgently needed to address multiple harms related to the environment, animal welfare, and human health. Social norm interventions have been found to be feasible and effective at shifting consumer behaviour, however, evidence related to meat reduction behaviour is limited – especially in naturalistic settings. Two social norm interventions were conducted at university food outlets in Aotearoa New Zealand and in the UK, to assess the effect of social norm messages on meat and meatless food purchases. Both interventions consisted of a week-long intervention phase during which descriptive dynamic social norm messages referring to reduced meat intake were displayed in the food outlets (study one and two) and via social media (study two). Meat and meatless food purchases during the interventions were compared to pre- and post-intervention weeks. Surveys were also conducted with a sub-group of customers to assess demographics, dietary habits, and awareness of the social norm message. In both studies, there was no significant effect of the social norm interventions on meat or meatless food purchases, and awareness of the norms message across both studies was low. These findings indicate that social norm interventions alone may be ineffective in encouraging meat reduction. Implications for interventions to reduce meat intake to support pro-environmental food choices are discussed.

In this digital era, individuals are regularly exposed to sexual objectification in a variety of media types, which may negatively affect body image. However, existing measures do not fully capture exposure to and direct experiences of sexual objectification in different media. The purpose of the current programme of research was to develop and evaluate the Women-Sexually Objectifying Media Exposure Scale (W-SOMES) and Men-Sexually Objectifying Media Exposure Scale (M-SOMES), to measure exposure to and experiences of sexual objectification in the media. In Study 1, drawing from existing literature and two online surveys (women = 80, men = 76, age representative samples), items for the W-SOMES and M-SOMES were developed. Optimal items solely reflected exposure to sexual objectification in the media. In Study 2, exploratory factor analysis (women = 340, men = 100) suggested an underlying structure of three correlated factors for the W-SOMES and a single factor for the M-SOMES. In Study 3, confirmatory factor analysis (women = 331, men = 328) supported a higher-order model for the W-SOMES (15 items across three subscales: Importance of Physical Appearance, Sexualised Body Representation and Body Evaluation) and a single factor model for the M-SOMES (4 items measuring Sexualised Body Representation). The W-SOMES and M-SOMES displayed satisfactory internal consistency, test-retest reliability, and differentiation by known groups but did not adequately display convergent and discriminant validity. The M-SOMES also displayed satisfactory incremental validity. Future research should further examine the psychometric properties of the W-SOMES and M-SOMES for measuring exposure to sexual-objectification in the media.

A large body of literature demonstrates that self-objectification can harm individuals’ body image. However, measures of self-objectification are primarily designed for women and have not been adequately validated in men. This research investigated the psychometric properties of the Self-Objectification Questionnaire (SOQ), the Objectified Body Consciousness Body Surveillance Scale (OBC-Surv), and the Self-Objectification Beliefs and Behaviors Scale (SOBBS) in cisgender heterosexual women and men. Study 1 (women = 180, men = 163) and Study 2 (women = 137, men = 138, age-representative samples) used an online longitudinal study design, with a follow up after two weeks to assess test-retest reliability. While the SOQ, OBC-Surv and SOBBS generally displayed satisfactory psychometric properties in women, only the OBC-Surv and SOBBS displayed satisfactory psychometric properties in men. In addition, while women scored significantly higher on the SOQ, OBC-Surv, SOBBS Factor 1 and SOBBS Total in both Studies 1 and 2, sexual objectification experience only adequately accounted for gender-differences in scores on the SOBBS, and not the SOQ or OBC-Surv. To confirm that the SOBBS is appropriate for measuring and comparing self-objectification across women and men, Study 3 reanalysed the data from Study 2 to examine measurement invariance. This analysis demonstrated measurement invariance of the SOBBS between women and men. Accordingly, the SOBBS is recommended for measuring and comparing self-objectification in women and men. Future research should further examine the psychometric properties of the SOBBS in men and potential explanations of gender-differences in scores on the OBC-Surv.

Summary: Objectives: We aim to describe and provide a discussion of methods used to conduct economic evaluations of dietary interventions in children and adolescents, including long‐term modelling, and to make recommendations to assist health economists in the design and reporting of such evaluations.Methods: A systematic review was conducted in 11 bibliographic databases and the grey literature with searches undertaken between January 2000 and December 2021. A study was included if it (1) was an economic evaluation or modelling study of an obesity‐prevention dietary intervention and (2) targeted 2‐ to 18‐year‐olds.Results: Twenty‐six studies met the inclusion criteria. Twelve studies conducted an economic evaluation alongside a clinical trial, and 14 studies modelled long‐term health and cost outcomes. Four overarching methodological challenges were identified: modelling long‐term impact of interventions, measuring and valuing health outcomes, cost inclusions and equity considerations.Conclusions: Variability in methods used to predict, measure and value long‐term benefits in adulthood from short‐term clinical outcomes in childhood was evident across studies. Key recommendations to improve the design and analysis of future economic evaluations include the consideration of weight regain and diminishing intervention effects within future projections; exploration of wider intervention benefits not restricted to quality‐of‐life outcomes; and inclusion of parental or caregiver opportunity costs.