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The Cost of Body Dissatisfaction and Appearance-Based Discrimination
STOP Resources                 
Educators       Providers         Parents

Research has consistently demonstrated that weight bias and weight stigma are exceedingly prevalent in our society and harm people with obesity. But until recently, there has not been a comprehensive literature on the financial and non-financial costs of discrimination based on physical appearance.
A new report released by The Dove Self-Esteem Project is the first of its kind to investigate the impacts and costs of harmful beauty ideals. The research was conducted in consultation with researchers from the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) at the Harvard Chan School of Public Health, with data generated by economists at Deloitte Access Economics. The report, titled “The Real Cost of Beauty Ideals,” defines “harmful beauty ideals” as socially constructed notions of ideal beauty rooted in gender inequities and structural racism. In the United States, the most prevalent images idealize white features and thinness. These harmful ideals perpetuate the existence of bias by comparing people with larger bodies against unrealistic norms for millions of people in the US and globally.
The Dove Self-Esteem report explores two major consequences – body dissatisfaction and appearance-based discrimination – which lead to financial costs, morbidity, and mortality. Body dissatisfaction can lead to poor health outcomes, reduced engagement in social circles, risky behavior, and the use of risky cosmetic products and procedures. Appearance-based discrimination can also lead to poor health outcomes, loss of wages and employment, and other negative life course outcomes.
In the report, costs are broken down into specific categories, including health costs, productivity costs, other financial costs, and loss of well-being. Financially, anxiety was a key driver of both health costs and productivity losses. Substance abuse generated the second-highest health cost and depression accounted for the second-highest productivity losses. Well-being costs include the loss of well-being, such as disability-adjusted life years consequent to depression, anxiety, suicide, smoking, eating disorders, and substance abuse. In total, researchers found that harmful beauty ideals cost the US economy $305 billion/year due to body dissatisfaction and $501 billion/year due to appearance-based discrimination in 2019 alone.
Within its examination of appearance-based discrimination, the report analyzed weight-based discrimination. The investigators estimated that weight-based discrimination accounted for 77% of the total financial cost of appearance-based discrimination in 2019. Weight-based discrimination affected 34 million people and accounted for $206 billion in financial costs and $224 billion in well-being costs. The effect is not equal across all demographics; estimates suggested that white women with a BMI greater than 35 kg/m2 experienced a higher rate of weight-based discrimination compared to African American men and women and white men of a similar weight.
Along with examining obesity as a factor that is associated with weight-based discrimination, the researchers also looked at obesity as an outcome of appearance-based discrimination and how that drove health costs.

Source: Austin et al.

As part of the release of the report, Dove featured heart-wrenching testimonies from young women who have faced weight-based discrimination, including that of Ashton Garrison. At age 7, her doctor told her, “A fat kid is a dead adult.” Now at age 14, she reflects on the impact of that statement: “It was the first time I ever felt that… ‘Oh my gosh, am I ugly?’ I wish I could take pairs of scissors to my body and just rip everything out. ‘Cause if I didn’t, I would never feel perfect. I would never feel beautiful.”

Further research, and especially intervention and communication research, is needed to drive the social change needed to reduce the costs of harmful beauty ideals in the US. In addressing weight stigma and discrimination in healthcare settings, it is crucial that providers are properly trained and educated in obesity prevention and management competencies. Productive, non-stigmatizing conversations about weight between providers and their patients are a crucial step in ending weight stigma and discrimination.

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Upcoming Events

Nov 10-12: ASMBS Weekend
Nov 15:
COPE Webinar -- Cooking
Nov 30: COPE Webinar -- Health Policy
Dec 8: COPE Webinar -- Medical and Nutrition Education

TFAH State of Obesity 2022 Report
New WW Studies
Preventive Medicine 2023 Registration Now Open
TFAH Releases State of Obesity 2022 Report
The 19th annual State of Obesity: Better Policies for a Healthier America report, released by Trust for America’s Health (TFAH), finds that obesity rates continue to climb nationwide and within population groups. These persistent increases underscore that obesity is caused by a combination of factors including societal, biological, genetic, and environmental, which are beyond personal choice. Addressing the obesity crisis will require attending to the economic and structural factors of where and how people live.

Read the full report here.
Register for the ASMBS Weekend Meeting
The ASMBS Weekend Meeting will be held in San Antonio, TX November 10th-12th, 2022. Registration is open! 

Learn more and register here

At the Weekend Meeting, the Focused Practice Designation course will be offered, Tuesday, November 10th from 8:00 AM - 5:00PM.

Learn more here.
Upcoming Virtual Webinars with COPE
COPE's 5-module, interprofessional online series called FOOD AS MEDICINE: An Exploration of Implementation, Application and Perspective continues. 1 to 1.5 CPEUs and CH awarded for each module (based on length of educational content). See upcoming modules below.

November 15, 5:30pm ET

Social and broadcast media are powerful tools we can use to educate and spread our unique and individual health messages to the public. Learn from a "seasoned" expert about the must-have tools you need to find your niche and refine your voice in the "food as medicine” space. Jessica DeLuise, PA-C, CCMS will conclude her presentation with a live cooking segment to demonstrate how to present accurate, evidence-based information that is engaging and entertaining. 

Learn more and register here.
Food as Medicine in Health Policy and Law
November 30, 5:30pm ET

Given that almost two-thirds of adults are living with one or more chronic illnesses, a growing number of health care providers are exploring opoprtunities to integrate nutrition interventions into care. Examine how health laws and policies are ensuring - or limiting - these efforts to connect patients to critical food as medicine services and how health care providers can engage with ongoing advocacy efforts to establish more widespread, equitable access throughout the nation.

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Food as Medicine in Wellness and Disease: Practical Applications in Medical and Nutrition Education
December 8, 5:30pm ET

Boost nutrition science and culinary medicine education in your medical students’ and/or other healthcare professionals’ curriculum. Learn practical strategies for incorporating culinary instruction into curriculum to enhance the learning of core nutrition principles and competencies for the promotion of wellness and disease prevention and management. An in-depth specific example of a culinary medicine “lab” developed for medical education will be provided, including the educational component of the lab (which focuses on teaching the nutrition science) and the cooking demo component of the lab (which focuses on utilizing recipes to reinforce nutrition science content).

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New Studies from WW
Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial.

This study is a five year follow-up to the WRAP study, a multi-site randomized controlled trial in the UK where patients with overweight and obesity were referred to WW for 12 weeks, WW for 52 weeks or a brief intervention. Read the full study here.

A large multi-country randomized controlled trial (n=373, 72.9% women, mean BMI =33.8 evaluated the efficacy of WeightWatchers (WW) compared to a Do-It-Yourself (DIY) condition at 3 and 12 months. Read the full study here.
Supplementing a widely available weight loss program with gamified inhibitory control training: A randomized pilot study.

This pilot study randomized controlled trial (n=30, 86.7% female, mean BMI 35.3) evaluated the preliminary efficacy of combining an evidence-based weight management program (WeightWatchers) with a gamified inhibitory control training on changes in BMI (PolyRules!). Read the full study here.
Preventive Medicine 2023 Registration is Now Open
Preventive Medicine 2023 (PM23), which takes place March 20-23, 2023 in New Orleans, offers leaders in prevention and public health the opportunity to collaborate and learn — creating a transformation in our health care system to improve health and wellbeing for all.

PM23 creates a synergy for critical prevention topics essential to the workforce, individual, community and the population as a whole. Join us as we explore how emerging research and evidence drive practice and policy to optimize individual and population health outcomes!

Learn more and register here.

The deadline for abstract submissions is November 3. Submit an abstract here.
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