The prevalence and harms of societal weight stigma have increased attention to its presence in public health approaches and communication. Calls to action from scholars, advocates, and health professionals emphasize the need to address weight stigma as a social justice issue and eliminate harmful narratives that perpetuate weight bias and discrimination in public health messages, practices, and policies. However, debates surrounding issues of weight stigma in public health complicate, and at times impair, efforts to effectively address this problem. Different (and sometimes opposing) perspectives include views about the health risks versus stigma effects of high body weight, the use of body mass index (BMI) as a metric of health, weight-normative (i.e., weight-centric) versus weight-inclusive treatment approaches, stigmatizing language used to describe body weight, and potential challenges when framing obesity as a disease. This review summarizes the current evidence, debates, and best practices related to weight stigma in public health efforts.

Full Citation: Puhl R. M. (2025). Facing Challenges for Reducing Weight Stigma in Public Health Policy and Practice. Annual review of public health, 46(1), 133–150. https://doi.org/10.1146/annurev-publhealth-060722-024519

A growing body of research has found that perceptions of social–emotional support from school personnel and lesbian, gay, bisexual, transgender, and queer (LGBTQ) in-school resources (e.g., gender and sexuality alliances, inclusive curricula, inclusive sexual education, presence of affirming adults) contribute to sexual and gender diverse youth’s (SGDY) positive development. However, no research has investigated how support from school personnel and LGBTQ in-school resources might jointly modify the associations between SGDY’s experiences with sexual orientation and gender identity (identity)-based harassment and mental health outcomes. Thus, the current study examined how school personnel support and LGBTQ in-school resources, together, moderated the association between identity-based harassment, depressive symptoms, and anxiety symptoms among a national sample of SGDY (N = 13,500, Mage = 15.50, SD = 1.34). Multigroup path analysis revealed that for SGDY in middle school (i.e., 6–8) and high school grade levels (i.e., 9–12), school personnel support and LGBTQ in-school resources jointly moderated the association between identity-based harassment and depressive symptoms. Among SGDY who reported high levels of harassment, support from school personnel buffered the association between identity-based harassment and depressive symptoms. However, at low levels of harassment, it was a combination of high support from school personnel and LGBTQ in-school resources that was linked to the lowest levels of depressive symptoms. SGDY reported more depressive symptoms when they perceived low levels of support from school personnel, regardless of the concentration of LGBTQ in-school resources.

Full Citation: McCauley, P. S., Eaton, L. A., Puhl, R. M., & Watson, R. J. (2025). Support from school personnel and in-school resources jointly moderate the association between identity-based harassment and depressive symptoms among sexual and gender diverse youth. Journal of Educational Psychology, 117(3), 445–465. https://doi.org/10.1037/edu0000945

School meals play an important role in supporting children’s nutrition. Despite substantial improvements in the nutritional quality of school meals following the 2010 Healthy, Hunger-Free Kids Act, concerns remain regarding the level of processing of the foods served in schools. This may be due to growing evidence of potential adverse outcomes associated with ultra-processed foods, which are industrial formulations designed to enhance the hyper-palatability and shelf life of foods. To better understand how frequently schools serve processed or minimally processed foods, a sample of 1,226 school food authorities (SFAs) across 8 states with and without state-level healthy school meals for all (HSMFA) policies were surveyed.

Full Citation: Cohen J, Chapman L, Gombi-Vaca M, Gosliner W, Hecht C, Hecht K, Schwartz M, Zuercher M, Ritchie L. Research Brief: Current State of Processed Foods in Schools. https://www.childnourishlab.org/healthy-school-meals-for-all

High-sugar breakfast cereal brands target their TV advertising directly to children under age 12, resulting in greater household purchases of these unhealthy children’s cereals, according to a new study from researchers at the Rudd Center for Food Policy and Health at the University of Connecticut.

The study’s findings, published in the American Journal of Preventive Medicine, revealed that advertising of high-sugar children’s cereals to children – but not to adults – leads to increased purchases of advertised children’s cereals in a large sample of households with children. These findings provide further evidence that the food industry’s promises to self-regulate child-directed food advertising will not have a meaningful impact on children’s diets until companies stop marketing unhealthy foods directly to children altogether.

Research is needed to demonstrate the impact of child-directed advertising on household purchases of nutrient-poor children’s foods to support mandatory government regulations. This study examines the relationship between total TV advertising to children versus adults and U.S. household purchases of high-sugar children’s cereals. Posthoc analyses examine potential differential marginal effects of advertising on households experiencing health disparities.

Advertising children’s cereals directly to children may increase household purchases and children’s consumption of these high-sugar products. Child-directed advertising may also disproportionately influence purchases by Black households. This study supports further restrictions on advertising of nutrient-poor foods directly to children.

Full Citation: Harris, J. L., Khanal, B., Fleming-Milici, F., & Andreyeva, T. (2025b). Children’s cereal purchases by U.S. households: Associations with Child Versus Adult TV ad exposure. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2024.11.022

Incorporating scratch-cooked, organic, and locally grown foods into school meal programs can enhance meal quality and support local food systems. 430 California school food authorities were surveyed to (1) evaluate their use of scratch-cooked, organic, and locally grown foods in their programs; (2) identify demographic and operational characteristics related to this use; and (3) analyze the relationship between serving more of these foods and perceived barriers to student meal participation.

Most respondents reported using scratch-cooked (82%) and locally grown foods (80%) in their school meals, with one-third serving organic foods (34%). Receiving grants to buy local produce and having a larger enrollment of White students were associated with more frequent use of these foods. More scratch cooking was associated with higher use of organic and locally grown foods and fewer perceptions of student nonparticipation due to concerns over meal healthfulness, taste, and freshness. More frequent use of organic and locally grown foods was also associated with fewer perceptions of student nonparticipation due to concerns about meal healthfulness.

Full Citation: Zuercher, M. D., Orta-Aleman, D., French, C. D., Cohen, J. F. W., Hecht, C. A., Hecht, K., Chapman, L. E., Read, M., Ohri-Vachaspati, P., Schwartz, M. B., Patel, A. I., Ritchie, L. D., & Gosliner, W. (2025). Factors and Outcomes Associated With Using Scratch-Cooked, Organic, and Locally Grown Foods in School Meals in California. The Journal of school health, 10.1111/josh.13533. Advance online publication. https://doi.org/10.1111/josh.13533

Objective: Prior work has documented inequities in disordered eating behavior (DEB) prevalence across gender identity, race, and ethnicity, yet has often ignored the fact that individuals belong to multiple social groups simultaneously. The present study assessed DEB inequities at the intersection of gender identity and race/ethnicity.

Method: The sample included n = 10,287 adolescents (68% gender-diverse, 33% belonging to marginalized racial/ethnic groups). Past-year prevalence of dietary restriction, self-induced vomiting, diet pill use, and binge eating was assessed. Data were analyzed with multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). MAIHDA nests individuals within social strata defined by all combinations of gender identity and race/ethnicity (a proxy for exposure to structural (cis)sexism and racism). MAIHDA allows for comparison of outcome prevalence across strata and identifies strata with disproportionately high or low prevalence.

Results: Hispanic gender-nonconforming youth had a high prevalence of multiple DEBs: restricting prevalence was 67.1% (95% CI [62.1%–72.2%]), vomiting prevalence was 25.9% (95% CI [21.6%–31.0%]), and binge eating prevalence was 46.0% (95% CI [40.2%–51.4%]). For all outcomes, at least one stratum had disproportionately low prevalence; for all outcomes except vomiting, at least one stratum had disproportionately high prevalence, indicative of intersectional interactions between gender identity and race/ethnicity.

Discussion: DEB prevalence among adolescents varies substantially at the intersection of gender and race/ethnicity, with the highest prevalence among those belonging to multiple marginalized groups. Future research is needed on the multilevel drivers of DEBs.

Summary:

• Research often compares outcome prevalence within one identity dimension, yet people belong to multiple intersecting social groups.
• We assessed how disordered eating prevalence varies at the intersection of gender identity and race/ethnicity. This revealed a complex and nuanced intersectional patterning.
• We suggest that disordered eating risk factors across levels of influence be studied so that structurally sensitive interventions can be developed.

Full Citation: Forrest, L. N., Bennett, B. L., Beccia, A., Puhl, R., & Watson, R. J. (2025). Prevalence of disordered eating behaviors among sexual and gender minority youth varies at the intersection of gender identity and Race/Ethnicity. International Journal of Eating Disorders, 58(3), 635–646. https://doi.org/10.1002/eat.24352

Weight-related conversations are common between adolescents and parents. However, there is limited understanding of how these conversations vary across sociodemographic groups, such as sex, sexual orientation, race/ethnicity, or parents’ level of education. This study assessed the prevalence of weight-related communication among adolescents and parents across sociodemographic characteristics, and identified adolescents’ preferred sources for these discussions.

While few differences emerged based on race/ethnicity or grade level, significant variation was observed for sex, sexual orientation, and parental education. Girls, sexual minority youth, high school students, and those with college-educated parents were more likely to communicate about their own weight, whereas boys were more likely to comment on others’ weight. Most adolescents preferred healthcare professionals (71%) and parents (69%) for these conversations, although sexual minority youth preferred mental health professionals considerably more than parents. Among parents, 77% discussed their child’s weight, with fathers and Latinx parents engaging more frequently in these conversations, and Black parents engaging least frequently.

Full Citation: Lessard, L. M., Wu, R., Puhl, R. M., Foster, G. D., & Cardel, M. I. (2024). Adolescent experiences of weight‐related communication: Sociodemographic differences and the role of parents. Pediatric Obesity, 20(2). https://doi.org/10.1111/ijpo.13196

The American Academy of Pediatrics (AAP) concluded that “caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents.” Aggressive marketing drives consumption and sales among young people, and a growing body of literature supports the need for energy drink regulations to protect children and teens.

The National School Lunch Program (NSLP) provides meals to over 28 million students daily and is a powerful strategy to reduce childhood food insecurity and improve diet quality. The standard “means-tested” approach to pricing provides meals to low-income students at a reduced price or no cost. However, during the COVID-19 pandemic, federal regulations were temporarily changed to allow districts to provide free school meals to all students (i.e., Universal Free School Meals, UFSM), regardless of income.

We collectively pay for public education because we believe that it is our responsibility to our youth – but it’s hard to focus in class when you are hungry. In addition to the health benefits of reducing food insecurity and improving diet quality, UFSM protects our investment in the public education of Connecticut’s children.