03-07-2025
How do Front-of-Package Warnings Influence People?
One of the most common arguments put forth against front-of-package label reforms and warnings meant to help fight obesity is that enacting them will exacerbate weight bias and stigmatization.
A recent randomized study set out to look at the impact four different types of front-of-package label warnings on sugar-sweetened beverages had on perceived weight stigmatization and attributional judgments of responsibility for weight and explicit weight bias. The different label types were nutrient warnings indicating a beverage was high in calories or added sugars, text-only health warnings, or graphic health warnings indicating the beverages were linked to obesity, diabetes, and tooth decay. The labels also differed on whether the content referenced calories and obesity or not.
Bottom line findings are easy to describe and not particularly surprising. Labels that referenced obesity as a risk were perceived to be more weight stigmatizing than those that did not, while labels that focused solely on nutrients had a lower perceived efficacy — but only slightly.
However, there's still a bit to unpack regarding this study's outcomes and utility. Most important, and as acknowledged by the authors, is that this study did not measure the actual impact of these labels' long-term repetitive use but rather simply studied participants' conscious perceptions after a singular, nonorganic exposure. While some might presume that longer term repetitive shopping exposure would amplify all effects, it's also plausible that long-term exposure will see effects dissipate as consumers become inured to the messaging.
But it was heartening to read that nutrient only front-of-package warnings were found to be nearly as plausibly effective as those specifically linked to obesity, because the consumption of sugar-sweetened beverages is something that should be minimized regardless of the weight of the person drinking them. The same of course is true for any food or nutrient of concern as weight does not dictate whether something is or is not healthful or risky to consume.
It is also worth remembering that front-of-package warnings are just one deployable strategy vs the flood of unhealthy food and predatory marketing, and that the more sandbags we fill, the greater the likelihood of benefit. Looking to front-of-packages specifically, along with warnings we might layer on health claim reforms which could, for instance, prevent a box of Froot Loops from bragging on its front that it is fortified with Vitamin D. We might also look to the banning of cartoon mascots designed to entice children and to laws around advertising as a whole in terms of what and when unhealthy food advertising is permitted.
Back to this study, though: If the goal as implied is to reduce the consumption of sugar-sweetened beverages, specifically as a sandbag vs societal weight gain, an additional question to ask is whether the impact these same labels might differ between consumers who are and are not utilizing obesity medications.
The impact of a warning meant to change food purchases might be influenced by a consumer's degree of hunger and cravings and where those are reduced dramatically by obesity medications. This hypothesis is markedly strengthened by the fact that, even without front-of-package labeling changes and reforms GLP-1 users' purchases have been shown to skew away from calorie-dense, ultra-processed items and towards more healthful items.
And if it is found that, yes, people on GLP-1 medications purchasing behaviors are more strongly influenced by labeling reforms and changes than non-users; that observation supports both the implementation of these sorts of reforms (as more and more people with obesity begin to utilize medications, perhaps especially given their coming genericization) and for their formalized coverage through Medicare and/or government interventions designed to help reduce their price.
