Weight StigmaNCT06179043
Impact of Front-of-package Warning Labels on Perceived Weight Stigmatization
A study testing Nutrient warning labels, Text-only health warning labels and Graphic health warning labels in people with Weight Stigma, run by University of North Carolina, Chapel Hill at 1 site in United States.
Trial summary
The goal of this experiment is to examine the effects of three different types of front-of-package warning labels for sugar-sweetened beverages on perceived weight stigmatization, as well as the effect of making such labels more weight-neutral. Read more about this study
- Who is it for?
- Ages 21 years and olderHealthy volunteers can take part
- Conditions the study is for
- Weight Stigma
- What is being tested?
- Nutrient warning labels, Text-only health warning labels and Graphic health warning labels
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 2,522 participants
- Where
- 1 siteUnited States
- Study dates
- 18 Jan 2024to 26 Jan 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- At least 21 years of age.
- Residing in the US.
Who cannot join
- -Involved in any pre-testing.
Trial locations and contacts
1 site in 1 country.
United States1 site
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27516
About this study
Official title: Examining the Impact of Different Types of Front-of-package Warning Labels for Sugar-sweetened Beverages on Perceived Weight Stigmatization Among a Sample of US Adults
The goal of this experiment is to examine the effects of three different types of front-of-package warning labels for sugar-sweetened beverages on perceived weight stigmatization, as well as the effect of making such labels more weight-neutral. The main questions this experiment aims to answer are:
- Are certain types of front-of-package warning labels perceived as more stigmatizing than others?
- Are more weight-neutral versions of front-of-package warning labels perceived as less stigmatizing than their regular versions?
- Is there a trade-off between label effectiveness in discouraging product consumption and perceived weight stigmatization?
Read more
Additionally, this experiment also aims to answer the following questions:
- Does exposure to certain types of front-of-package warning labels lead to changes in participants' weight bias?
- Are changes in participants' weight bias as a result of label exposure mediated by attribution of personal responsibility for body weight, pathogen disgust, or perceived social consensus?
Read the detailed description
Participants will be randomly assigned to see one of four types of labels: control labels, nutrient warning labels, text-only health warning labels, or graphic health warning labels. Participants will then see an image depicting different types of fictional sugar-sweetened beverages carrying the label type that they were assigned to. Participants will see this image twice, in random order, each time differing in whether the label is weight-neutral or not (i.e., whether the label references calories/obesity or not). Each time, participants will answer survey questions about the label. Last, participants will answer survey questions measuring their weight bias and potential mediating variables.
- Conditions
- Weight Stigma
- Being tested
- Nutrient warning labels, Text-only health warning labels, Graphic health warning labels, Control labels
- Medical subject headings
- Weight Prejudice
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Nutrient warning labelsBehavioural
In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:
- Labels that read "high in sugars" and "high in calories"
- A label that reads "high in sugars"
Text-only health warning labelsBehavioural
In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:
- A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay"
- A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay"
Graphic health warning labelsBehavioural
In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:
- A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay" and contains graphics illustrating obesity, type 2 diabetes, and tooth decay
- A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay" and contains graphics illustrating type 2 diabetes and tooth decay
Control labelsBehavioural
In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:
- A neutral bar code label
- A neutral quick response (QR) code label (not scannable)
| Study group | Role | What they receive |
|---|---|---|
| Control labels | Sham comparator | Individuals in this trial arm will see neutral control labels on sugar-sweetened beverages. Receives: Behavioral: Control labels |
| Nutrient warning labels | Experimental | Individuals in this trial arm will see nutrient warning labels on sugar-sweetened beverages. Receives: Behavioral: Nutrient warning labels |
| Text-only health warning labels | Experimental | Individuals in this trial arm will see text-only health warning labels on sugar-sweetened beverages. Receives: Behavioral: Text-only health warning labels |
| Graphic warning labels | Experimental | Individuals in this trial arm will see graphic health warning labels on sugar-sweetened beverages. Receives: Behavioral: Graphic health warning labels |
What is being measured
The primary outcome is the main question the study is designed to answer.
Perceived weight stigmatization, mean score
Stigmatization of people with obesity will be measured by survey through a three-item scale. Items will inquire about how much participants perceive the label to (1) stigmatize people with obesity, (2) promote negative stereotypes about people with obesity, and (3) portray people with obesity in a disrespectful manner. Response options will be on a 1 to 5 scale, with higher scores representing a higher perceived weight stigmatization by the study labels. Each participant's responses to each item will be combined to obtain their final score on the outcome.
Measured: Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.
Secondary outcomes (2)
Perceived message effectiveness, mean score
How much the labels discourage participants from wanting to consume the products will be measured by survey. Response options will be on a 1 to 5 scale, with higher scores representing a higher perceived message effectiveness.
Measured: Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.
Weight bias, mean score
Weight bias will be measured by survey through a seven-item scale. Items will present participants with adjective pairs and ask that they select the box closest to the adjective that they feel best describe their feelings and beliefs about people with obesity: (1) lazy-industrious, (2) no will power - has will power, (3) good self-control - poor self-control, (4) active - inactive, (5) self-indulgent - self-sacrificing, (6) dislikes food - likes food, (7) undereats - overeats. Response options will be 5 boxes between adjectives, which will be coded on a 1 to 5 scale so that higher scores represent higher weight bias. Each participant's responses to each item will be combined to obtain their final score on the outcome.
Measured: Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Dec 2023
- Study start18 Jan 2024
- Primary completion26 Jan 2024
- Study completion26 Jan 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Weight StigmaStudies of the same condition, open and under way.
- More trials run by University of North Carolina, Chapel HillThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Factorial
- Model description
- Between-subjects intervention: label type (4 arms); Within-subjects intervention: regular or weight-neutral version of label (2 versions).
- Masking
- None (open label)
- Enrolment
- 2,522 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of North Carolina, Chapel Hill
- Sponsor type
- University, hospital or other
- Collaborators
- Stanford University
- Responsible party
- Sponsor
- Investigators
- Aline D'Angelo Campos, MPP, Principal investigator, University of North Carolina, Chapel Hill
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06179043
- Sponsor's protocol ID
- 23-3069
- Status last verified
- Jan 2024
- First submitted
- 11 Dec 2023
- Last updated
- 13 Feb 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: A deidentified dataset and analytic code will be uploaded to a public repository upon publication of the study.
Publications
Grummon AH, Gibson LA, Musicus AA, Stephens-Shields AJ, Hua SV, Roberto CA. Effects of 4 Interpretive Front-of-Package Labeling Systems on Hypothetical Beverage and Snack Selections: A Randomized Clinical Trial. JAMA Netw Open. 2023 Sep 5;6(9):e2333515. doi: 10.1001/jamanetworkopen.2023.33515.
PubMed 37703015Hayward LE, Vartanian LR. Potential unintended consequences of graphic warning labels on sugary drinks: do they promote obesity stigma? Obes Sci Pract. 2019 Aug 2;5(4):333-341. doi: 10.1002/osp4.353. eCollection 2019 Aug.
PubMed 31452918D'Angelo Campos A, Grummon AH, Ng SW, Puhl RM, Golden SD, Hall MG. Front-of-Package Food Labels and Perceived Weight Stigmatization: A Randomized Clinical Trial. JAMA Netw Open. 2025 Jun 2;8(6):e2516821. doi: 10.1001/jamanetworkopen.2025.16821.
PubMed 40540266
Study at a glance
From the registry record, last updated by the sponsor on 13 Feb 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Examining the Impact of Different Types of Front-of-package Warning Labels for Sugar-sweetened Beverages on Perceived Weight Stigmatization Among a Sample of US Adults
- ClinicalTrials.gov ID
- NCT06179043
- Acronym / sponsor ID
- 23-3069
- Conditions
- Weight Stigma
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 2,522 participants (actual)
- Lead sponsor
- University of North Carolina, Chapel HillUniversity, hospital or other
- Collaborators
- Stanford University
- Study start
- 18 Jan 2024 (actual)
- Primary completion
- 26 Jan 2024 (actual)
- Study completion
- 26 Jan 2024 (actual)
- First posted
- 21 Dec 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this experiment is to examine the effects of three different types of front-of-package warning labels for sugar-sweetened beverages on perceived weight stigmatization, as well as the effect of making such labels more weight-neutral. The main questions this experiment aims to answer are:
- Are certain types of front-of-package warning labels perceived as more stigmatizing than others?
- Are more weight-neutral versions of front-of-package warning labels perceived as less stigmatizing than their regular versions?
- Is there a trade-off between label effectiveness in discouraging product consumption and perceived weight stigmatization?
Additionally, this experiment also aims to answer the following questions:
- Does exposure to certain types of front-of-package warning labels lead to changes in participants' weight bias?
- Are changes in participants' weight bias as a result of label exposure mediated by attribution of personal responsibility for body weight, pathogen disgust, or perceived social consensus?
Detailed description
Participants will be randomly assigned to see one of four types of labels: control labels, nutrient warning labels, text-only health warning labels, or graphic health warning labels. Participants will then see an image depicting different types of fictional sugar-sweetened beverages carrying the label type that they were assigned to. Participants will see this image twice, in random order, each time differing in whether the label is weight-neutral or not (i.e., whether the label references calories/obesity or not). Each time, participants will answer survey questions about the label. Last, participants will answer survey questions measuring their weight bias and potential mediating variables.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Number of arms
- 4
- Model description
- Between-subjects intervention: label type (4 arms); Within-subjects intervention: regular or weight-neutral version of label (2 versions).
| Arm | Type | Receives |
|---|---|---|
| Control labels | Sham comparator | Behavioral: Control labelsIndividuals in this trial arm will see neutral control labels on sugar-sweetened beverages. |
| Nutrient warning labels | Experimental | Behavioral: Nutrient warning labelsIndividuals in this trial arm will see nutrient warning labels on sugar-sweetened beverages. |
| Text-only health warning labels | Experimental | Behavioral: Text-only health warning labelsIndividuals in this trial arm will see text-only health warning labels on sugar-sweetened beverages. |
| Graphic warning labels | Experimental | Behavioral: Graphic health warning labelsIndividuals in this trial arm will see graphic health warning labels on sugar-sweetened beverages. |
Who may qualify
- Ages
- 21 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- At least 21 years of age.
- Residing in the US.
Key exclusion criteria (1 listed)
- -Involved in any pre-testing.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Nutrient warning labelsIn random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying: * Labels that read "high in sugars" and "high in calories" * A label that reads "high in sugars" | Behavioural | Nutrient warning labels |
| Text-only health warning labelsIn random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying: * A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay" * A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay" | Behavioural | Text-only health warning labels |
| Graphic health warning labelsIn random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying: * A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay" and contains graphics illustrating obesity, type 2 diabetes, and tooth decay * A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay" and contains graphics illustrating type 2 diabetes and tooth decay | Behavioural | Graphic warning labels |
| Control labelsIn random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying: * A neutral bar code label * A neutral quick response (QR) code label (not scannable) | Behavioural | Control labels |
Primary outcome
Perceived weight stigmatization, mean score
Time frame: Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.
Stigmatization of people with obesity will be measured by survey through a three-item scale. Items will inquire about how much participants perceive the label to (1) stigmatize people with obesity, (2) promote negative stereotypes about people with obesity, and (3) portray people with obesity in a disrespectful manner. Response options will be on a 1 to 5 scale, with higher scores representing a higher perceived weight stigmatization by the study labels. Each participant's responses to each item will be combined to obtain their final score on the outcome.
2 secondary outcomes
Perceived message effectiveness, mean score
Time frame: Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.
Weight bias, mean score
Time frame: Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Feb 2024.
- Background: PubMed 37703015Grummon AH, Gibson LA, Musicus AA, Stephens-Shields AJ, Hua SV, Roberto CA. Effects of 4 Interpretive Front-of-Package Labeling Systems on Hypothetical Beverage and Snack Selections: A Randomized Clinical Trial. JAMA Netw Open. 2023 Sep 5;6(9):e2333515. doi: 10.1001/jamanetworkopen.2023.33515.
- Background: PubMed 31452918Hayward LE, Vartanian LR. Potential unintended consequences of graphic warning labels on sugary drinks: do they promote obesity stigma? Obes Sci Pract. 2019 Aug 2;5(4):333-341. doi: 10.1002/osp4.353. eCollection 2019 Aug.
- Derived from this study: PubMed 40540266D'Angelo Campos A, Grummon AH, Ng SW, Puhl RM, Golden SD, Hall MG. Front-of-Package Food Labels and Perceived Weight Stigmatization: A Randomized Clinical Trial. JAMA Netw Open. 2025 Jun 2;8(6):e2516821. doi: 10.1001/jamanetworkopen.2025.16821.
- Individual participant dataSharing planned: Yes. A deidentified dataset and analytic code will be uploaded to a public repository upon publication of the study.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Aline D'Angelo Campos, MPP principal investigator
University of North Carolina, Chapel Hill
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Nutrient warning labels, Text-only health warning labels and Graphic health warning labels in people with Weight Stigma, run by University of North Carolina, Chapel Hill at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 13 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Perceived weight stigmatization, mean score (time frame: Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06179043, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Feb 2024.