"Obesity Is a Disease" 5 containing more calories)for individuals with higher and (b)inspire additional empirical inguiry in order to e dodyfacton aid more scientifically informed decisions about both the costs and benefits of an"obesity is a disease"message. le eight-rel Author Contributions public-health messages are targe ing because even mod. est weight loss in obese individuals can have lasting and benefits (Oster, Thompson, Hoytand J Bumete analyzed and interpreted the data.C. erg.B g the All manu script for submission. ioral measures of eating behavior should be employed (Baumeister,Vohs,Funde ,2007 Future work sh Declaration of Conflicting Interests ontinue to examine w viduals and should explore additional mediating mecha- nisms in order to foster a better understanding of the Notes psychological effects of this message.Considering tha 1.Data on body mass index(BMD)were unavailable for 1 par- a more nu. 2.Participants were asked to summarize the theme of the artide sigificant implications for patient-level and polic-level one sentence.Less tha n 5%of participants across all stu outcomes,and we hope this article sparks such inquiry on the deleterious Excluding the nonresponders did not meaningfully change the age on at i .BMI was slighly skewed across studies.A square. mortality and morbidity (e.g,Miller,1999).Furthermore but re antidieting movements often incorporate a physiologica BMI was used as continuc d rent work sug est that such efforts ould be suco improving body satisfaction but that such increases may BMI lead to increased calorie consumption.Thus,we encou siy（BM BMI data were unavailable for 3 participants in S ch to exan ne the dissatisfaction. stronger,when they were included).Eight people did not com We are not advocating that t he "thin"ideal that pe vade cultu an ad goal,nor Ancillary analyses revealed a significant intera action that the ndition and t diverse body sizes is laudable.as is the goal to increase medical treatment for obese individua hemes that no sign the argu ent in support of ob diy as References nd empirical support in social psychology more generally Ablow.K.(013.June 2).Obesity is not a disease (e.g.,Major O'Brien,2005)and within a weight-man- is-not-dis to 2010) uhl He Psychol as the science of self. orts and finger mo of the current work was to (a)highlight some of the hid- 03.do101117 den self-regulatory costs of this public-health message 6916.2007.00051.x“Obesity Is a Disease” 5 containing more calories) for individuals with higher BMIs. Furthermore, a disease message, relative to a not￾disease message, increased body satisfaction, which also predicted less healthy food choices for individuals with higher BMIs. It is these very people whom weight-related, public-health messages are targeting, because even mod￾est weight loss in obese individuals can have lasting health and economic benefits (Oster, Thompson, Edelsberg, Bird, & Colditz, 1999). However, before putting these findings into practice, additional work is needed. For example, actual behav￾ioral measures of eating behavior should be employed (Baumeister, Vohs, & Funder, 2007). Future work should also continue to examine whether there is a direct effect of a disease message on eating behavior for obese indi￾viduals and should explore additional mediating mecha￾nisms in order to foster a better understanding of the psychological effects of this message. Considering that obesity is a crucial public-health issue, a more nuanced understanding of an “obesity is a disease” message has significant implications for patient-level and policy-level outcomes, and we hope this article sparks such inquiry. For example, we focused primarily on the deleterious effects of the disease message on calorie consumption. However, some researchers argue that it is this focus on reduced calories, not obesity itself, that leads to increased mortality and morbidity (e.g., Miller, 1999). Furthermore, antidieting movements often incorporate a physiological explanation for obesity in the hopes of diminishing stigma and increasing body esteem. Results from the cur￾rent work suggest that such efforts could be successful at improving body satisfaction but that such increases may lead to increased calorie consumption. Thus, we encour￾age future research to examine the costs and benefits of various policy messages about obesity and to move beyond the narrow focus on the negative effects of body dissatisfaction. We are not advocating that the “thin” ideal that per￾vades Western culture is an admirable goal, nor that internalizing these unhealthy standards is a worthwhile strategy. In addition, we agree that the acceptance of diverse body sizes is laudable, as is the goal to increase medical treatment for obese individuals—themes that emerge in the argument in support of obesity as a dis￾ease. Furthermore, the positive effects of reducing stigma for goal engagement and attainment have substantial empirical support in social psychology more generally (e.g., Major & O’Brien, 2005) and within a weight-man￾agement context more specifically (Puhl & Heuer, 2010). Recognizing that there are potential benefits to labeling obesity as a disease, we conclude by noting that the aim of the current work was to (a) highlight some of the hid￾den self-regulatory costs of this public-health message and (b) inspire additional empirical inquiry in order to aid more scientifically informed decisions about both the costs and benefits of an “obesity is a disease” message. Author Contributions C. L. Hoyt and J. L. Burnette conceived and designed the study. Data collection was performed by L. Auster-Gussman, and C. L. Hoyt and J. L. Burnette analyzed and interpreted the data. C. L. Hoyt drafted the manuscript, and J. L. Burnette provided critical revisions. All authors approved the final version of the manu￾script for submission. Declaration of Conflicting Interests The authors declared that they had no conflicts of interest with respect to their authorship or the publication of this article. Notes 1. Data on body mass index (BMI) were unavailable for 1 par￾ticipant in Study 1 and 6 participants in Study 2. 2. Participants were asked to summarize the theme of the article in one sentence. Less than 5% of participants across all studies failed to give a meaningful response to this question, which indicates that participants read and understood the article. Excluding the nonresponders did not meaningfully change the results. 3. BMI was slightly skewed across studies. A square-root trans￾formation reduced the skewness, but results were indistinguish￾able from those using the untransformed variable. 4. BMI was used as a continuous predictor. To graph interac￾tions, we used the standard ±1 standard-deviation approach. In these samples, values 1 standard deviation below and above the mean corresponded precisely with the World Health Organization’s (2006) classifications of average weight (BMI = 18.5–24.99 kg/m2 ) and obesity (BMI ≥ 30 kg/m2 ), respectively. 5. BMI data were unavailable for 3 participants in Study 3. 6. Given our focus on obesity, we excluded people (n = 40) who reported wanting to be larger (analyses were similar, and stronger, when they were included). Eight people did not com￾plete the dissatisfaction measure, which left a final sample of 311 participants with both dissatisfaction and BMI scores. 7. Ancillary analyses revealed a significant interaction between BMI and message type on calories in Study 2 (p = .049; BMI negatively predicted calories in the control condition and posi￾tively predicted calories in the disease condition), but there was no significant relationship in Study 3. References Ablow, K. (2013, June 20). Obesity is not a disease—and nei￾ther is alcoholism. Fox News. Retrieved from http://www .foxnews.com/health/2013/06/20/dr-keith-ablow-obesity￾is-not-disease-and-neither-is-alcoholism/ Baumeister, R. F., Vohs, K. D., & Funder, D. C. (2007). Psychology as the science of self-reports and finger move￾ments: Whatever happened to actual behavior? Perspectives on Psychological Science, 2, 396–403. doi:10.1111/j.1745- 6916.2007.00051.x Downloaded from pss.sagepub.com by Cai Xing on February 13, 2014