A Critical Assessment Of “Fat-Shaming” In Anti-Obesity Public Health Interventions – Brian Charest

Introduction

A number of organizations whose aim is to curb obesity have been using images of overweight and obese individuals, including children, with the belief that inciting fear or shame will motivate parents and children to lose weight.  This paper identifies the key reasons why this approach is ineffective, and provides recommendations for an alternative campaign that addresses and resolves the issues inherent in the current approach.  

There are numerous instances of so-called “fat shaming” in recent public health anti-obesity campaigns.  For example, a television commercial created by Blue Cross and Blue Shield of Minnesota depicts two boys arguing about whose father can eat more food, and concludes by showing a father looking shamefully at his fast food meal (1).  Other ads depict overweight and obese children with provocative captions in an apparent attempt to incite disgust or disdain in the viewer (2,3).  In 2012, Disney World’s Epcot Center opened an exhibit called “Habit Heroes,” which depicted obese characters as villains (with names such as Leadbottom, The Snacker, and The Glutton), in contrast to the exhibit’s heroes (named Will Powers and Callie Stenics) (4).  

Taken together, these campaigns are rooted in the idea that shame will provide strong motivation for overweight and obese individuals to take action and lose weight.  This approach is fundamentally flawed, for several reasons.

Critique Argument #1:  Reactance Theory

One problem with “fat-shaming” ads is that they may cause psychological reactance in those who view them.  Brehm and Brehm first described psychological reactance theory in 1966.  In part, the theory states that if someone is told that they cannot do something, this will trigger feelings that their freedom is being curtailed and in response, the individual will find ways to re-establish that freedom (5).  In further work on the subject, reactance theory’s authors cited four basic principles (5):  

1. Reactance may not occur in an individual if he/she is not aware that they have the freedom to act in opposition (i.e., if he/she is not aware that freedom is being limited);
2. The strength of reactance is directly and positively correlated with the perceived importance of the freedom that is being threatened;
3. More reactance occurs if multiple freedoms are being threatened (e.g., being told never to do something as opposed to being told not to do it just one time); and
4. Reactance increases if the individual perceives that a threat is implied (e.g., if an individual is told not to snack, and they perceive this to imply that they are not to smoke or drink coffee either).

An important consequence of reactance theory is that when faced with social pressure to change, an individual will often react to this threat by acting in direct opposition to the message (5).  A 2008 study characterized reactance as a two-step process, whereby a message containing forceful language will cause the person to feel threatened, which in turn becomes reactance, expressed via anger and negative emotions (6).  In the context of these anti-obesity ads, the provocative wording may cause a person to feel threatened by the message, and as a result, he or she may continue to purchase/eat unhealthy foods, or consume large quantities of foods, as a way to re-establish the notion of personal freedom.

Critique Argument #2:  Socioeconomic Inequities

The “fat-shaming” approach is also ineffective because it ignores socioeconomic realities.  People who live in poorer areas have limited access to fresh foods, and also may lack the economic means with which to purchase healthier options (7).  A qualitative study was performed that identified the barriers that were most often cited by low-income individuals with regard to access to fruits and vegetables.  The key obstacles cited were cost (mentioned 4x as frequently as any other factor), transportation (e.g., proximity to locations that sell the items), quality of produce, variety, changing food environment (some individuals noted that there used to be more stores that sold fresh produce), and changing societal norms on food (e.g., less at-home cooking and more fast food) (8).  

Predominantly black and/or low-income neighborhoods have a higher number of fast food restaurants compared to neighborhoods that are higher-income and/or predominantly white (9).  Areas where residents have limited access to healthy and/or fresh foods have been described as “food deserts”; the authors of a study conducted in Portland, OR described the concept of a “food mirage” – i.e., an area where full-service grocery stores are easily found, but where the items are cost-prohibitive for many poorer residents (10).  This is a common problem in neighborhoods that are undergoing gentrification, and underscores the fact that even if healthy foods are physically available, they may be monetarily inaccessible to some people.  Other studies have noted that people living in some inner-city neighborhoods lack easy access to physical activity:  some of these residents either do not feel safe exercising outside, or do not live in areas that are conducive to walking (11).

In the 1940’s, Abraham Maslow introduced the concept of a “hierarchy of needs”, in which human needs are classified into tiers, which are (listed from most important to least important):  physiological (i.e., those needed for basic survival), safety (e.g., housing), love/belonging (e.g., family or community), esteem (e.g., a sense of self-worth), and self-actualization (12).  Inherent to Maslow’s hierarchy is the idea that people will only focus on less essential needs once the more essential needs are met.  For example, an individual will only begin to concentrate on securing safety once basic physiological needs of food and water are satisfied.  For those who are living in poverty and are not physically ill, health is a need that is not seen as a priority by the individual.  Therefore, it stands to reason that simply telling an individual that he or she should lose weight, when other more urgent priorities and needs must be met first, will be ineffective.  

The Health Belief Model should also be considered with regard to people of limited means and their access to healthy foods.  The Health Belief Model assumes that when an individual is making health decisions, he or she will conduct an internal cost-benefit analysis, weighing the perceived benefits of taking a particular action against the inherent perceived costs of doing so (13).  In this case, the key assumption would be that the individual sees the benefit of healthy eating as worth the tangible economic costs that are involved, and also that the individual perceives obesity to be a severe condition that will have adverse long-term effects.

Therefore, it seems that a “fat-shaming” approach that simply tells people that they should lose weight is overly simplistic, particularly because it does not address ways to overcome some of the obstacles faced by people in lower-income or inner-city environments.

Critique Argument #3:  Labeling Theory

The “fat-shaming” approach to solving obesity is also problematic because of the stigma that individuals will feel when the label is applied to them.  Erving Goffman made early contributions to labeling theory in the 1950’s and 1960’s.  He wrote about different types of stigma suffered by individuals, and described three major classifications:  stigma as a result of physical abnormalities or limitations; as a result of defects of character or personality; and as a result of “tribal stigma,” related to ethnicity, national origin, or religious affiliation (14).

An important implication of labeling theory is that when a person is labeled, it can affect his or her behavior (15,16).  A recent study investigating the short- and long-term effects of negative labeling on adolescent girls found that the effects of such labeling can persist into adulthood.  This was true for white females in their study more than for black females.  The study’s authors concluded that while the physical aspects of a public health campaign to combat obesity are important, it is also recommended that mental health concerns be addressed (17).  Such a recommendation is in direct opposition to an approach that uses negative labeling as a way to curb obesity.  

A 2013 study that assessed participants’ perceptions of various anti-obesity messages found that the most positive messages, and in particular those that did not expressly use the word “obesity,” were deemed to be the most motivating.  The negative messages were deemed by participants to be the least motivating (18).  In addition, a survey conducted of patients who had lost over one hundred pounds after bariatric surgery found that most of them would prefer to be blind, deaf, or lose a limb rather than return to their pre-surgery weight (19).  This underscores the fact that many obese people do not want to be that way, and that many would change if they knew how to.

Therefore, if a label itself impacts a person’s behavior, negative labeling (such as “fat-shaming”) might in fact have a negative effect on a person’s self-worth, and in turn may impact the belief in whether he/she can change the situation.  This would cause a “fat-shaming” campaign to be at best ineffective, and at worst to yield the exact opposite of the intended effect.

Recommended Alternative Intervention:

Based on the three criticisms of anti-obesity campaigns that use fat-shaming, which were described above, I recommend a public health approach that will have the following goals:

• Provide education on the topics of healthy food choices and exercise;
• Provide concrete and tangible steps that can be taken that are designed to promote weight loss; and
• Fulfill the above goals while promoting a positive message that makes the individual feel good about him- or herself, and instills confidence that these goals can be achieved.

The next sections will discuss, in detail, how the proposed approach will address each of the shortcomings of the existing “fat-shaming” campaigns.

Reducing Reactance

A 2005 study concluded in part that people would be more receptive to a message if it were positive rather than negative.  It has been shown that one way to reduce reactance is to relay the intended information using a messenger who is similar and shares common characteristics with the recipient (20).  Therefore, it is recommended that the people used in these campaigns be individuals with whom the target audience can identify – this can mean showing the real journey of an overweight or obese person as he or she works to change health habits; or perhaps using a celebrity spokesperson who has had struggles with weight in the past.  As a way to target children and provide a positive message, the use of celebrities that children look up to could be very effective.  An example might be to show a series of ads encouraging physical activity, using stars of kid-oriented television programs, such as those aired on the Disney Channel or Nickelodeon, to reinforce the positive message.  Providing positive encouragement and reinforcement will have the dual benefits of reducing reactance and reducing stigma.  

Addressing Socioeconomic Inequities

The recommended approach will have a component that directly addresses the fact that cost and availability of healthy foods can be prohibitive.  A recent study found that while many consumers hold the belief that healthy food is too expensive, that is in part a perception that is perpetuated and supported by what the individual sees in the media and in their social interactions (7).  Nutritional education and food budgeting proved helpful to lower-income individuals and families in that study, and therefore it is recommended that these concepts be included in our proposed public health intervention.  One of the drawbacks noted above about the “fat-shaming” ad campaigns is their reductive nature.  The ads tell people that they need to lose weight, but they do not provide any information about how to accomplish this.  The proposed campaign will show individuals engaged in activities such as learning how to read nutrition labels, cooking at home, or beginning to exercise.  By outlining steps that can be taken, this gives the target audience some degree of structure and guidance.

Advertising and Marketing Theory

The proposed anti-obesity campaign will utilize the theories of advertising and marketing.  The three key components of advertising theory are:

• Promise:  effective advertising makes a promise to the viewer/consumer
• Support:  it is important to provide examples and reasons for the viewer/consumer to believe in the message
• Core values:  the message must appeal to a strong and identifiable core value.

Marketing theory is based on the idea that rather than identifying the product that people want and marketing it to them, it is better to identify exactly what people want and then package and market a product in a way that seemingly fulfills an individual’s needs and/or wants.  An offshoot of traditional marketing theory is what is known as social marketing theory.  The key idea behind social marketing theory is to take the fundamental underpinnings of marketing theory and apply them to address problems in the social sciences.  While traditional marketing theory has been argued to create and perpetuate unnecessary needs and wants, social marketing theory applies the same concepts with the goal of improving the common good (21).  In the context of this proposed anti-obesity campaign, social marketing theory can be used to promote the concepts of health and well being.  The campaign will promote the promise of improved health and increased energy, in addition to weight loss.  Instead of appealing to a core value of health, the campaign will rely on a core value of family.  One ad can show a couple and their kids cooking a meal and then enjoying it together.  Another ad could show a dad and his son going on a bike ride together.  Using a positive message with a core value of family would be far more motivating, and far less stigmatizing, than the “fat-shaming” approach.

Conclusion

Based on the evidence shown above, it is clear that the “fat-shaming” approach to fighting obesity is simplistic and ineffective; and it may indeed have the unintended consequence of making overweight and obese people more entrenched in their current habits.  The proposed approach is far more comprehensive, and addresses the shortcomings of the “fat-shaming” campaigns, while using the theories of advertising and social marketing to effectively deliver the message.  Obesity in America is a complex problem, and therefore it will require a comprehensive, multi-pronged solution.  Hopefully, the campaign outlined above will resonate with the intended audience.

References

1. NPR.  New Anti-Obesity Ads Blaming Overweight Parents Spark Criticism.  Washington, DC:  National Public Radio. http://www.npr.org/blogs/thesalt/2012/09/27/161831449/new-anti-obesity-ads-blaming-overweight-parents-spark-criticism
2. About-Face.  Georgia’s Strong4Life campaign relies heavily on fat shaming.  San Francisco, CA:  About-Face.  http://www.about-face.org/georgias-strong4life-campaign-relies-heavily-on-fat-shaming/
3. The Atlantic.  Think Of The (Fat) Children:  Minnesota’s ‘Better Example’ Anti-Obesity Campaign.  http://www.theatlantic.com/health/archive/2012/09/think-of-the-fat-children-minnesotas-better-example-anti-obesity-campaign/262674/
4. Huffington Post.  Disney's Anti-Obesity 'Habit Heroes' Exhibit At Epcot Causes Controversy.  New York, NY:   http://www.huffingtonpost.com/2012/02/24/disney-habit-heroes-anti-obesity-disney-world-epcot_n_1299664.html
5. Brehm, J.; Brehm S.  Psychological Reactance: A Theory of Freedom and Control. Mahwah, NJ:  Erlbaum, 1981.
6. Quick, B.; Considine J.  Examining the use of forceful language when designing exercise persuasive messages for adults:  a test of conceptualizing reactance arousal as a two-step process.  Health Communication 2008; 23:483-491.
7. Carlson A.; Frazao E.  Food costs, diet quality and energy balance in the United States.  Physiology & Behavior 2014; http://dx.doi.org/10.1016/j.physbeh.2014.03.001.
8. Haynes-Maslow L. et al.  A qualitative study of perceived barriers to fruit and vegetable consumption among low-income populations, North Carolina, 2011.  Preventing Chronic Disease 2013; 10:E34.
9. Larson N.  Neighborhood environments:  Disparities in access to healthy foods in the U.S.  American Journal of Preventive Medicine 2009; 36(1):74-81.
10. Breyer B, Voss-Andreae A.  Food mirages: geographic and economic barriers to healthful food access in Portland, OR.  Health & Place 2013; 24:131-139.
11. Rundle A.; Neckerman K.; Freeman L.; Lovasi G.; Purceil M.; Quinn J.; Richards C.; Sircar N.; Weiss C.  Neighborhood Food Environment and Walkability Predict Obesity in New York City.  Environmental Health Perspectives 2009; 117(3):442-447.
12. Maslow AH.  A Theory Of Human Motivation.  Psychological Review (1943), 50:370-396.
13. Rosenstock I.  Historical Origins Of The Health Belief Model.  Health Education Behavior 1974; 2(4):328-335.
14. Goffman E. 1963. Stigma: Notes on the Management of Spoiled Identity. New York, NY: Touchstone.
15. Link B.; Cullen F.; Struening E.; Shrout P.; Dohrenwend B.  A Modified labeling Theory Approach To Mental Disorders:  An Empirical Assessment.  American Sociological Review 1989 54:400-423.
16. Link B.; Phelan J.  Conceptualizing Stigma.  Annual Review of Sociology (2001); 27:363-385.
17. Mustillo S.; Budd K.; Hendrix K.  Obesity, Labeling, and Psychological Distress in Late-Childhood and Adolescent Black and White Girls: The Distal Effects of Stigma.  Social Psychology Quarterly 2013 76:268.
18. Puhl R.; Peterson JL; Luedicke, J.  Fighting Obesity Or Obese Persons?  Public Perceptions of Obesity-Related Health Messages.  International Journal of Obesity (2012), 1–9.
19. Tomiyama AJ; Mann T.  If Shaming Reduced Obesity, There Would Be No Fat People. Hastings Center Report (2013), 43: 4–5.
20. Silvia P.J.  Deflecting reactance: The role of similarity in increasing compliance and reducing resistance.  Basic and Applied Social Psychology 2005;  27:277-284.
21. Hastings G.; Saren M.  The critical contribution of social marketing.  Marketing Theory 2003 3: 305.

Why Lincoln University’s Bold Attempt to Help Reduce the Prevalence of Obesity on Campus and in the African-American Community has Great Intentions but a Misguided Approach - Rahotep Alkebulan

Introduction

It is no secret that preventable diseases such as heart disease, diabetes, and lung cancer disproportionately affect African-Americans.   The prevalence of stress, poor diet, lack of exercise, alcohol use, and smoking in the Black community has been largely responsible for the heavy disease burden African-Americans face as well as poor access to quality health services.  According to the American Diabetes Association, 4.9 million or 18.7% of all African-Americans aged 20 years or older have diabetes and are 50% as likely to develop diabetes-related blindness compared to whites (1).     On average, African-Americans are twice as likely as whites to have diabetes (2).  The US Department of Health & Human Services has statistics that reveal African-American women having the highest rates of being overweight or obese compared to other groups with approximately four out of five African-American women being overweight or obese.  In 2011, African-Americans were 1.5 times as likely to be obese as whites (2).

Therefore, it was commendable when historically black college Lincoln University voiced concern about “the high rates of obesity and diabetes, especially in the African-American community” (3) and decided to intervene to reduce the prevalence of obesity on campus and in turn in the overall African-American community.  However, the methods used to accomplish this worthy objective stirred up some controversy.  The University enacted a mandate that requires incoming students to submit their calculated BMI Score and those with a BMI of 30 or greater would be required to take and pass a “Fitness for Life” class in order to graduate.  The class would entail physical activities as well as information on nutrition, stress, and sleep.  University officials such as James L. DeBoy, chairman of Lincoln's department of health, physical education and recreation have emphasized that “students are not required to lose weight or lower their BMI; they must only pass the class through attendance and participation” (3).

The intent of Lincoln University’s policy to address obesity in the African-American community is noble; however, the means used to fulfill this mission have the potential to do more harm than good.  The singling out the ‘fat’ incoming freshmen for enrollment in a fitness class violates many established principles of social science and theory.  Lincoln University officials should be applauded for bringing the issue of rampant obesity in the African-American community on the agenda and for taking aggressive action, but their tactics to address the issue must be scrutinized and reconstructed in order to become more effectual.  Lincoln University must empower its student with the tools to become self-efficacious, remove the negative labels placed on obese students, and address the environmental factors in the vicinity of the university that could contribute to the perpetuation of unhealthy lifestyle choices.  Since Lincoln University is “committed to maintaining a nurturing and stimulating environment for learning” as delineated in its mission statement, the university should empower every student with the tools to incorporate healthy lifestyle changes into their daily lives by creating a university environment conducive to the health of its students.  

The Negative Labeling Potential

The intent of Lincoln University’s intervention is to identify obese individuals entering the university who are at high risk of future health complications and require them to enroll into a healthy living class to reduce their future risks.  The problem is that they are selecting a certain population and labeling them with the socially undesirable name ‘fat’ and thereby subjecting them to shame, humiliation, and isolation.  Labeling theory posits that the self-identity and behavior of individuals may be determined or influenced by the terms used to describe or classify them (4).  Furthermore, the person labeled incorporates the label into their concept of themselves (5).  In other words, the person cannot think of themselves outside of the label that has been assigned to them and fulfills the prophecy of that label.  In regards to labeling individuals as fat, particularly children and young adults, the evidence is clear: it does more harm than good.  Researchers at UCLA found that 10-year-old girls told that they were ‘fat’ by those close to them were more likely to be obese at 19 than those who were never told they were fat, regardless of what they weighed at the beginning of the study(6).  It seems as though individuals who are told that they are fat internalize that identity, causing them great pain and to quell it they often turn to food which perpetuates the vicious cycle.

So it seems as though Lincoln University did a great disservice to their incoming students by labeling them before they even get on campus as fat, especially the young women.  Since this is a historically black university, many students entering Lincoln University will be Black students seeking to escape the label of being a “Black student” that may have been automatically given to them at their predominantly white high schools.  Many students who attend historically black colleges (from experience) are seeking to just be a ‘regular’ student in a predominantly Black setting to escape the responsibility of having to be the spokesperson for the race.  Therefore, as the obese Black students enter Lincoln University they will simultaneously lose and gain a label.  Studies have proven that many Blacks people have internalized racism, particularly Black women which have lead to negative health outcomes (7-13).  It becomes troubling to consider the harm this policy could do in adding to the burden of labels of its incoming students who are statistically more likely to be obese.  

Potential to Induce Strong Psychological Reactance

Human beings generally enjoy the freedom of choice in selecting participation in activities.  Whenever somebody threatens this choice or a human being’s autonomy they are risking psychological reactance.  Psychological reactance is an aversive affective reaction in response to regulations or impositions that impinge on freedom and autonomy (14, 15).  Psychological reactance elicits a response that seeks to restore autonomy, so if you try to force something upon somebody they are likely to counter by doing the opposite of what’s expected from them.  This effect may be greater when promoting health behavior change in college students (16).  Therefore, Lincoln University mandating that students must take a fitness class in order to graduate is likely to elicit psychological reactance because they are forcing students to take a class against their will.  When young adults go off to college they relish the opportunity to exercise their new found freedom and autonomy away from the home where they can independently choose their major and which classes to take.  However, if the university now requires students to take a class based on their BMI score then this is likely to generate a strong emotional response that will seek to establish autonomy.   Students may then become more obstinate in their health habits and refuse to incorporate the lifestyle suggestions into their life simply because the choice was taken out of their hands.  This form of rebellion may sabotage the intervention and actually cause people to gain weight rather than lose it.  To demonstrate the phenomena of psychological reactance in this instance, one student enrolled in the class told reporters in a press release that right after she gets out of the Fitness for Life class she goes directly to ‘The Grill’ to eat fried chicken (17).

No Change in Lincoln University

After reading all the press releases on this controversial issue I did not come across any evidence that the university itself changed the campus environment to become more conducive towards health.  Instead, the university expected students enrolled in the class to make all the changes and invest themselves into being healthy.  The university did not announce that they were changing the food choices being offered which include selections from KFC and ‘The Grill’ which features fried mozzarella sticks, quarter-pounders, hot dogs and Jamaican beef patties (17).     The university also did not reveal that they were remodeling the gym to accommodate more students; a sentiment that was expressed in a press release from a young man stating “If they want us to lose weight, expand the gym, don't tell us we won't graduate (17)."  The university is sending a mixed signal when it proclaims they are interested in the health of the students but are not willing to invest the necessary resources to create an environment where students have healthy food choices and adequate exercise equipment.  If the students were to see that the university was exerting the same effort and commitment they expected of them in the fitness classes, then it would create a more favorable environment to practice healthy behaviors.

Alternative Strategy

Utilizing the tools social science theory gives us, the first step of the new intervention would be to require every student regardless of BMI score or waist circumference to participate in the Fitness for Life class.  Secondly, the course would focus on fostering overall well-being and health rather than isolating obesity as the main culprit.  This would ensure that all facets relevant to the health of college students are addressed such as alcohol and drug abuse, mental health and healthy relationships (18).  The class would still have as a central theme of aerobic exercise because a significant amount of college students do not (19).  However, the course would emphasis the behaviors that are going to be continued after the course’s completion.  The current invention is overly focused on the issue of obesity because it is an easy target but there are other important health issues that affect students regardless of the BMI score.  Thirdly, the course component would be accompanied by changes to the university itself, namely making the availability of healthy food on campus the norm and not the exception.  To make exercise more feasible this intervention involves establishing a partnership with a local gym so that students will have the necessary infrastructure to work out.  This would likely fit the university’s budget while expand exercise equipment to students.  With this intervention in place the methods would support the goals of an overall healthier campus.

How the Proposed Intervention Mitigates the Current Flaws

The first step of including all students in the intervention would eliminate the stigmatizing label that was unceremoniously given to those with BMI’s over 30.  This would essentially remove both the label and the shame from having to take the class while creating an inclusive environment where all are trying to incorporate healthy behaviors.  No longer would students have to walk around in embarrassment with everybody knowing that they had to take, as one student enrolled in the class at Lincoln University put it, the “fat people class”.  In essence, everybody would be labeled which would cancel out the detrimental effects of the negative label of being in the “fat people class”.   Inclusion of all students in the class also corrects a potentially serious consequence of singling out obese individuals.  When Lincoln University selectively chose obese individuals for behavior change modification, they simultaneously validated ‘skinny’ students’ health behaviors even if they were unhealthy.  Only enrolling obese individuals into the class relays the message that only they have to change their habits while everybody can remain the same.  Under this premise the conveyed message is as long as you are not obese then you are healthy—clearly erroneous and unconstructive.  Encompassing all students in the class removes the potential for reinforcing negative health practices while sending the message that all students’ health, regardless of BMI, can improve.

The inclusion of all students would also significantly reduce the risk of psychological reactance.  Although collectively the students’ choice would be taken away in deciding if they want to take the class or not, at least everybody on campus would have to ‘suffer together’.  The resentment of being singled out would arguably be the biggest source of emotional opposition, so if that component was removed then the potential for psychological reactance would be drastically lowered.  For example, I attended a historically black university and one of the requirements for everybody was to take and pass a swimming class to counter the stereotype that Black people cannot swim.  Since this was a university-wide requirement, there were minimal complaints because we all had to take the course in something we could all agree was important.  At first it seemed unreasonable that everybody had to take the course but once the time came everybody participated and made the most out of the situation.  I suspect the same thing would take place if everybody at Lincoln University were required to take the course.  To further decrease the possibility of psychological reactance, the alternative intervention would incentivize accomplishing health goals such as losing weight or lowering blood pressure by offering legitimate prizes.  Because the intervention is taking away the students’ autonomy, it is imperative that we give them the possibility of gaining something so that they are not ‘gaining their freedom back’ through psychological reactance, but rather are regaining that sense of autonomy by achieving their health objective.  This would transform the class from being one where people would go through the motions to striving to accomplish their health goals. The class would no longer be one that they have to take but one that they get to take.

Finally, the third part of the alternative intervention which involves the University making changes to the food available and improving access to gym facilities would signal Lincoln University’s commitment to the health of their students.  Lincoln University would be holding itself accountable without expecting the students to be the only ones to change.  This would create more buy in from the students and would likely lead to healthier behavior due to the environment now being more suitable for healthy behaviors.  If the students see that the University is changing for the better then it could inspire them to do the same.

Conclusion

The prevalence of diabetes and obesity in the African-American community calls for immediate action to address the serious epidemic.  However, reasoned action that is predicated on sound social science theory must be applied before rushing into the fray.  Lincoln University’s attempt to reduce obesity and its associated complications on campus and within the greater community must be acknowledged for its impassioned approach to a serious problem.  However, singling out ‘fat’ individuals in such a way may cause more harm than good according to social science theory.  It adds negative labels to a demographic of people who already carry the burden of negative labels which increases the likelihood of psychological reactance to the intervention.  Thus individuals may resent being labelled and react against the intervention by fulfilling the prophecy of a fat person.  This could be in direct defiance of the university who itself has not committed to ensuring the most favorable conditions of health on campus.

Addressing the flaws of the intervention involves obligating every student on campus to participate in the Fitness for Life course.  Instead of socially isolating and labeling obese individuals, this creates an environment of solidarity where the health needs of all students are addressed together.  Including everybody and infusing incentives for participating in the class eliminates the stigmatizing label of being in the “fat people class” while increasing students’ willingness to participate.  This coupled with the University changing its policy on food selection and exercise capacity will create an environment where together the University’s staff, administrators, and students are all invested in the health and well-being of the campus and greater community.   

References

1. "Treatment and Care for African Americans - American Diabetes Association®." American Diabetes Association. N.p., 12 Nov. 2013. <http://www.diabetes.org/living-with-diabetes/treatment-and-care/high-risk-populations/treatment-african-americans.html>.
2. "We're in!." OMH Content. N.p., 25 Apr. 2014. Web.  <http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=62>.
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