Weighing in on Soda

Sara Brown

Department of Sociology

Lycoming College

December 2006

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 Obesity is a growing epidemic in the United States (U.S. Congress 2003; Panagopoulos

2006). Previous research focusing on obesity has evaluated childhood effects, inequalities across

populations, effects of stigmatization on individuals, mental health effects, and soft drink

contribution to obesity (Ferraro, Thorpe, & Wilkinson 2003; DeJong 1980; Cahnman 1968;

Malik, Schulze, & Hu 2006; Ross 1994). My research combines all of these aspects when

examining obesity. If soft drinks contribute to obesity (Bawa 2004) and obesity varies across

age, race, and gender (American Obesity Association 2002; Ferraro, Thorpe, & Wilkinson 2003;

Yancy, Leslie, & Abel 2006), then soft drink consumption should also vary across these

variables. I hypothesize that soft drink consumption will vary across these variables similar to

obesity variations through the factors of age, race, and gender. Also, I make an argument that if

cigarettes and alcohol are dangerous to ingest and soft drinks also have a dangerous effect, then a

warning label should also be implemented on soft drinks.

First, I will define obesity and its relevance to social issues. Second, I will discuss the

inequalities or variations across populations of obesity. Since the research shows that obesity is

not equally prevalent across populations, it is important to show its trends across race, age, and

gender. Third, I will discuss the social factors and implications of obesity described in current

research along with the stigmatization of obesity and link to mental illness. Then, I will explore

the causes of obesity; this is where I assert the connection between obesity and soft drinks.

Leading up to that section, I will discuss the soft drink market, consumption of soft drinks,

relationship to obesity, and soft drinks in schools. In that section, I imply that soft drinks are

dangerous to a person’s health and contribute to obesity. In the next section, I make an argument

that a warning label was implemented on cigarettes and alcohol because they were both

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dangerous to individuals. If soft drinks pose an equal peril to a person’s health, then there should

be a warning label on soda. Finally, I discuss the alleviation of obesity as a social problem. I

also examine current NY Times articles for current policies or implementations to combat the

obesity epidemic. My research examines the implications of obesity and the emerging focus on

the societal problems associated with obesity.

In the United States, obesity is a growing epidemic and is the second leading cause of

preventable death (U.S. Congress 2003). The American Obesity Association defines obesity as a

chronic disease involving “environmental, genetic, physiologic, metabolic, behavioral and

psychological components” (2002). The CDC defines obesity as an “increased body weight

caused by an excessive accumulation of adipose tissue (body fat) in relations to lean body mass

(Panagopoulos 2006). Almost two-thirds or one-hundred twenty-seven million adults are

considered overweight and one-third or sixty million are obese (Yancy, Leslie & Abel 2006).

Most citizens believe that obesity is a major concern in the United States. At least three in four

adults surveyed claimed obesity to be a very serious or extremely serious problem

(Panagopoulos 2006).

When researching obesity, most analysis uses Body Mass Index (BMI) as the determinant

of obesity. BM I is calculated from a mathematical equation representing a relationship between

weight and height in adults. Some researcher combines levels of obesity but there are six general

categories of weight. The first is underweight with a BMI of 18.5 or lower. Second, normal, is

with a BMI between 18.5 and 24.9. Overweight, the third level, is a BMI between 25 and 29.9.

After overweight, three levels of obesity are arranged in a hierarchy. Obesity I is a BMI between

30 and 34.9. BMI between 35 and 39.9 is obese II. Finally, obese III is a BMI of 40 or higher

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(Carr & Friedman 2005). Other research may combine two of these categories such as II and III

for statistical analysis. Body mass index is the best indicator of overweight and obesity. When

using BMI as a research tool, it classifies obesity and allows researchers to see how factors such

as allocation of resources, adequate diet, and consumption of soft drinks are associated with

obesity.

Many health problems are associated with obesity (Yancy, Leslie, & Abel 2006;

American Obesity Association 2002). It causes approximately 300,000 excess deaths in the

United States (AOA 2002). Obesity contributes common chronic diseases that include heart

attack, stroke, postmenopausal breast cancer, colon cancer, diabetes, gallbladder disease, sleep

apnea, osteoarthritis, and high blood pressure (Yancy, Leslie, & Abel 2006). Healthcare costs of

American adults with obesity amount to approximately one-hundred billion dollars (AOA 2002).

Healthcare costs are extremely costly for obese individuals; however, research in the field of

obesity and funding for programs to combat the spreading epidemic are inadequate and in some

places nonexistent. The National Institutes of Health only contributed one percent of its annual

budget towards obesity research (AOA 2002). All of the health problems and inadequate

research associated with obesity contribute to its growing epidemic and the emphasis on

evaluating the prevalence and effects of weight problems. Children are the most susceptible to

weight problems because of poor dietary habits and inactivity (AOA 2002).

Childhood obesity is a growing problem and continues to be a major component of

obesity research. Sixteen percent of children are overweight (Panagopoulos 2006). One in seven

of the youth population is obese and one in three is overweight (Ogden, Carroll, & Johnson

2002). Approximately thirty percent of children aged six to eleven are overweight and fifteen

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percent are obese. Adolescents ages twelve to nineteen exhibit similar percentages of thirty

percent overweight and fifteen percent obese. The prevalence of obesity in U.S. children has

increased one-hundred percent between 1980 and 1994 (Ludwig, Peterson, & Gortmaker 2001).

The harmful health effects are not only prevalent in adults; childhood obesity can lead to

deleterious effects such as diabetes, high blood pressure, and high cholesterol during childhood

(U.S. Department of Health and Human Services 2001). Along with the health effects of obesity

during childhood, it was found that obese children suffered from lower self-esteem than their

peer counterparts (Strauss 2000).

Some research has put emphasis on a correlation between overweight and obesity in

childhood with the same condition in adulthood. It has been shown that excess weight in

childhood matters later in life. Overweight children aged ten to fourteen with at least one

overweight or obese parent were seventy-nine percent more likely to be overweight in adulthood

(AOA 2002). Also, obesity in populations such as African Americans and people aged 45-64

was more prevalent if they were overweight during childhood (Ferraro, Thorpe, & Wilkinson

2003). Also, obese children are twice as likely to become obese adults compared to their non-

obese counterparts (Serdula et al. 1993). Childhood overweight/obesity is a key component of

the obesity epidemic. It is important to examine the effects of childhood obesity because it can

contribute later in life. As with children, obesity varies across different populations such as race,

age, and gender.

When examining obesity, it is important to examine the differences and experiences

across populations. Also, for my research, variations across populations may also be compared

to soft drink consumption in certain populations. Age and gender are common variables

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researched; however, research concerning race is not readily studied. If obesity varies across

populations it may implicate larger sociological differences between these variables. Age is one

of the most popular aspects to examine variations across age ranges.

Research from the American Obesity Association (2002) regarding age shows that

overweight and obesity in adulthood increases steadily for both men and women. Approximately

half of all age groups are overweight; while almost twenty percent are obese. Men ages sixty-

five to seventy-four experiences the highest prevalence of overweight and obesity; women ages

fifty-five to sixty-four experiences the highest percentage of overweight and obesity. According

to age, adults aged fifty-five to seventy-four experienced the highest percentage of overweight

and obesity compared to every other age group. Research regarding age has also shown

differences across gender.

Gender is an important variation to research because it may imply different experiences

between men and women. Compared to women, men experience a higher percentage of

overweight. However, women experience obesity and severe obesity at higher percentages

compared to their male counterparts. Gender issues in race is also an important research topic.

Black women have the highest prevalence of overweight (78 percent) and obesity (50.8 percent).

For men, the Mexican American population has the highest prevalence of both overweight and

obesity. Also, both men and women in all racial categories have exhibited an increase in

overweight, obesity, and severe obesity. In children, overweight prevalence is higher in boys

than girls aged six to eleven. However, in adolescents overweight prevalence is about the same

for both males and females. Boys are more likely to experience obesity compared to girls. (AOA

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2002) Clearly, there are differences across gender because it plays an important role when

examining obesity. Race is also an important factor to examine when researching obesity.

As with gender, there are variations of obesity across race. According the American

Obesity Association (2002), overweight and obesity occurs at higher rates in minority

populations such as African American and Hispanic American compared to their white

counterparts. Women of minority status and of lower class show overweight and obesity levels

more than any other category. Mexican Americans exhibit higher percentages of overweight

with a BMI greater than 25; but, blacks have higher percentages of obesity with a BMI greater

than 30. Along with higher percentages of obesity in minority populations, health disparities are

also more prevalent in minorities compared to whites; examples include diabetes, cancer,

hypertension, and heart disease. Research focusing on race and gender also discusses

socioeconomic status (SES).

SES is a classification determined by factors such as income, occupation, and education.

It plays an important role when examining obesity and the social factors associated with obesity.

With women, SES has an inverse relationship meaning that as income decreases, obesity

increases. Basically, more women with low SES have a higher occurrence of obesity. Also,

low-income women in minority populations are more likely to be overweight (AOA 2002). Both

men and women are affected by overweight and obesity across all SES levels. However,

minority women appear to have the greatest likelihood of being overweight. Also, in the

Mexican American population, adult women over the age of 20 living under the poverty line

have a rate of overweight thirteen percent more than women above the poverty line (AOA 2002).

Basically, Mexican American women in poverty are more likely to be overweight than women

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not in poverty. SES is an important factor to examine because it shows differences in the

experience and occurrence of obesity.

The link between SES and obesity is an important factor in obesity research. It shows

that access to resources to avoid obesity or minimize the deleterious effects does vary across

populations (Peralta 2003). If obesity varies across SES then there is clearly inequality in the

access to resources to minimize obesity. These resources include money, power, prestige, and

social connectedness which are all factors of SES and influence the prevalence of diseases such

as obesity (Peralta 2003). SES and poverty issues are important to examine because it shows

unequal occurrence of obesity which may indicate other social factors.

Previous research examining the social factors that contribute to obesity have focused on

components such as allocation of resources, poor eating habits, distribution of supermarkets in

neighborhoods, education of proper nutrition, and increases in the number of fast food

restaurants (Peralta 2003; Rashad 2003). The social effects of obesity must be evaluated fully to

understand the growing epidemic. One aspect is an increase in portion sizes which is important

because now consumers are getting more calorie-dense fast food items that may contribute to

obesity (Peralta 2003). Another aspect is the access to educational sources of nutrition. It is

believed that individuals of lower SES do not have the proper access to nutritional information.

They do not know how to properly offer their children nutritional meals that are need to alleviate

weight problems (Peralta 2003). Another aspect related to obesity is the number of fast food

restaurants and supermarkets in impoverished areas. It has been shown that more fast food

restaurants and corner convenient stores are present in impoverished areas; but there are not large

supermarkets offering nutritional foods available to the marginalized population (Alaimo et al.

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2001). Other social aspects that contribute to obesity include inadequate food and higher prices

in impoverished areas; also, individuals in poverty consume more fast food (Rashad 2003). With

these social factors, obesity can have consequences.

Obesity is thought to be a personal problem; it can place a burden on society. It can lead

to higher public health costs, pensions in retirement, and lost productivity (Rashad 2003). With

childhood obesity, the social factors include poor eating habits, availability of fast food, and not

enough physical activity (Panagopoulos 2006). All of these show that the social aspects of

obesity are important and need to be included when discussing the causes and consequences of

obesity. Along with the social consequences of obesity, individuals with weight problems may

experience stigmatization, mental illness, and discrimination.

An important factor to research that is experienced by obese individuals is stigmatization.

Stigmatization has a long history of being in obesity research. The effect of obesity on the

individual is important to evaluate because it contributes to larger social consequences such as

discrimination. Stigmatization is defined by the rejection and disgrace that is viewed as physical

deformity (Cahnman 1968). A section of obesity stigmatization includes positive and negative

peer evaluations. When determining positive peer evaluations, obese individuals do not rate high

on the positive side. Actually, obese individuals have a negative evaluation unless their

condition can be attributed to a medical condition or if the individual admits to the problem and

are seeking help (DeJong 1980). Along with negative evaluations, obese individuals are not well

liked compared to their non-obese counterparts. These negative attitudes towards obesity are

held because it is believed that it is a direct result of self-indulgence or laziness. Obese

individuals are held responsible for their condition. This mindset of the non-obese populations

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causes negative evaluations towards the obese; however, if an excuse such as a medical

condition or recent weight loss is given then obese individuals are rated more positively (DeJon

1980). The consequence of stigmatization of obesity results in discrimination based on physical

appearance.

Obesity is identified as a defect that is accompanied with many levels of discrimination.

Obese teenagers are defined as disadvantaged because they are discriminated against, internalize

the treatment, and then accept it as fair (Cahnman 1968). When evaluating discrimination of

obese individuals, it was found that overly obese individuals reported a lower level of self-

acceptance and institutional and day-to-day interpersonal discrimination (Carr & Friedman

2005). Obese individuals experienced discrimination because obesity is considered less

desirable and is stigmatized in American society. The feeling of being discriminated against can

lead to feelings of depression (Cahnman 1968). Some research has focused on the effect on

women. They are much more likely to experience discrimination compared to men based on

their weight. Also, after a weight-loss surgery was performed, a drop in unemployment for

women occurred which shows that obese women experience more unemployment (AOA 2002).

Along with discrimination associated with appearance, obesity has a strong connection to mental

illness specifically depression and self-esteem.

Mental illnesses connected to obesity such as depression and low self-esteem because

individuals experience distress and anxiety from stigmatization (Ross 1994). Overweight has a

direct effect on depression. The stress of dieting and possible failure contributes to high levels of

depression in obese individuals (Ross 1994). Along with the stress of dieting, poor physical

health add to the factors that can lead to depression. Another perspective that is present in the

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research is that obese individuals are trying to fit social norms; thus creating stress and anxiety

which can also contribute to depression. The media plays a key role in portraying norms of

attractiveness which makes individuals obtain a desire to fit that mold (Ross 1994). Also,

besides depression, obesity has an effect on self-esteem (Cawley 2003). In children, it was found

that obese Hispanic and white females have significantly lower levels of self-esteem by early

adolescence (Strauss 2000). This shows that self-esteem especially in children have an effect on

obese individuals. Research focusing on obesity must also examine its causes.

Some research focuses on social factors while others examine the medical or genetic

factors that cause obesity (AOA 2002; Hardus et al. 2003; Jéquier 2002; Terry & Alper 2006).

Research regarding school-aged children, found that the main causes of obesity were the

overconsumption of unhealthy food, parental responsibility, modern technology, and the

influence of mass media (Hardus et al. 2003). Other social factors associated with the cause of

obesity involve two important factors of the increased intake of high fat foods and the lack of

physical activity. These two factors are the driving force behind the growing obesity epidemic

(Jéquier 2002). Also, genetic factors can also contribute to obesity (Terry & Alper 2006).

Basically, people are eating more and not exercising or engaging in physical activity which

causes obesity. The American Obesity Association (2002) claims some individuals have a

genetic predisposition to gain weight and store fat that may cause obesity. Current research is

trying to track the obesity gene; however, more research is needed to fully understand the

contribution that genetics has on obesity. Also, AOA (2002) claims that individuals need to

adopt healthy habits to prevent obesity and maintain weight control. These methods include

regular physical activity and nutritious eating. Some research has attributed obesity to an

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increase in consumption of inexpensive and easily accessed energy from soft drinks (Yancey,

Leslie, & Abel 2006). Soft drinks and high sugar beverages are an important cause and

contributor to the rising rates and percentages of obesity.

The first portion to examine is the soft drinks market. According to Datamonitor (2005),

an industry profile that uses information from panels and consumers, the soft drinks market

consists of bottled water, carbonates, concentrates, sports drinks, juices, and ready-to-drink tea

and coffee. The largest revenue for this industry is from carbonated beverages such as sodas. In

2004, almost ninety-five billion dollars was spent in the soft drink market. Carbonates make up

approximately sixty-six percent of the market. With its large prevalence and influence, the soft

drink industry has created a phenomenon, coca-colonization, in other countries. Coca-

colonization is the emergence of a new diet with calorie-dense, low-nutrition snacks, and

beverages brought by modern companies specifically in the Yucatan (Leatherman & Goodman

2005). This new diet brings an increase in overweight and obese adults which show that a diet

packed with such foods contributes to overall obesity.

High intake of soft drinks leads to overweight and obesity because of extra calories and

lack of nutritional content (Bawa 2004; Committee on School Health 2004). Children receive

eleven percent of their daily diet calories from soft drinks (The Food Trust 2004) and it has

replaced milk as the drink of choice among children. Also, soft drinks are a key contributor to

obesity because of its high added sugar content, low satiety, and incomplete compensation for

total energy (Malik, Shculze, & Hu 2006). Basically, soft drinks are empty calories that have

high sugar content and make individuals drink more because it does not satisfy thirst or

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compensate for energy. Soft drinks are a clear contributing factor and cause of obesity. Given

the research, some schools have implemented policies on soft drinks.

Previous research has shown that overweight and obesity in childhood is a determining

factor of overweight and obesity in adulthood. Thus, it is important to examine the trends of

soda consumption in children. Since eleven percent of children’s daily calorie intake is

composed of soft drinks (The Food Trust 2004) and the primary source of added sugar

(Committee on School Health 2004), schools have decided to implement policies restricting the

sale of soft drinks. The best solution to combat the effect of soft drinks on the rising rate of

childhood obesity is to restrict the sale of soda in schools (Committee on School Health 2004).

In a June, 9 2003, editorial, the Philadelphia Inquirer stated that Philadelphia area-schools are

the first public schools to implement a no-soft drinks policy. It is claimed that school vending

should be replaced with water and 100% juices which are better, nutritious options for children

(The Food Trust 2004). In a NY Times article published on October 7, 2006 depicted an action

by five snack companies to fight the rising percentages of childhood obesity. The article said

that these snack companies would provide healthier snacks in school’s vending machines and

cafeteria food. In another NY Times article published on May 4, 2006, three leading bottling

companies have agreed to stop supplying schools with high calorie drinks such as Pepsi and

Coke. Also, the bottling companies will provide school vending machines and cafeterias with

100% juice drinks and healthier alternatives. The restriction of soft drinks in schools shows that

the obesity epidemic is a concern and soft drinks are a public threat to health.

Given that soft drinks contribute to obesity which is a public health issue and concern,

more research and consideration should be completed on the possible implementation of warning

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labels on soft drinks. Similar to warning labels on cigarettes and alcohol, the label would advise

consumers about the health effects of soft drinks. In 1981, the Surgeon General issued a report

advising pregnant women from drinking alcohol because of the health effects (Carroll & Graf

1999). Since then, a warning label is required on all alcohol beverages advising the effect on

pregnancy. A similar advisory label is on cigarettes. These warning labels were implemented

because they both pose a personal health threat to consumers. I propose if soft drinks are a cause

of obesity which is a health problem then there should be a label on soft drinks. In a Boston

Globe article published March 5, 2006, stated that soft drinks are a good candidate to be

considered for a warning because of its health factors and contribution to obesity. Besides

issuing warning labels to combat the health effects and spread of obesity, other policies for

treatment and alleviation of obesity are slowly surfacing.

Given racial disparities in obesity, some research calls for a social and racial integration

which involves equality in access to quality education and child care along with affordable

nutritious foods (Peralta 2003). Also, physical activity is needed to slow the onset of obesity

along with a realistic specific weight loss goals and dietary restrictions (Terry & Alper 2006).

Other solutions include offering better and healthier options in schools to combat the rising

obesity rates in children (Committee on School Health 2004). Also, I propose that warning

labels should be implemented to warn consumers about the threat of soft drinks on obesity. In a

NY Times article published on September 24, 2006, claims that in 1996 a small California town

banned all fast food restaurants such as Burger King, McDonald’s, and other fast food chains.

New York City Councilman, Rivera, wants to explore the option of limiting such restaurants

based on the California law for the populated New York City. This would allow other

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restaurants with healthier options to break ground in the city allowing residents better options.

These are all appropriate actions for combating the increase in percentages of obese citizens.

Given that obesity is a serious problem in the United States and is growing as years

progress, it is important to examine the causes and contributors to obesity. Previous research

claims that obesity is a growing epidemic with a primary factor of poor eating habits

(Panagopolous 2006). Race, gender, age have all shown variations and differences across

populations (AOA 2002). The social factors associated with obesity include allocation of

resources, exercise opportunity, diet, number of fast food restaurants, and inadequate food in

certain areas (Peralta 2003; Rashad 2003). Social consequences suffered by individuals include

stigmatization; also, there is a link between obesity and mental illness. The causes of obesity

include high intake of food and low level of activity. Other causes are high-calorie, low

nutritional soft drinks. These soft drinks are inundated in schools, convenient stores, and

supermarkets. Some schools are even restricting the sale of soft drinks in vending machines and

cafeterias (Committee on School Health 2004). Warning labels should be considered because it

does pose a health risk similar to alcohol and cigarettes. However, more research is needed on

this topic to assert the effectiveness and necessity of such labels. Finally, the treatment or

alleviation of obesity includes affordable nutritious foods, equality in access to resources, and

healthier alternatives in schools (Committee on School Health 2004; Peralta 2003). Other

alternatives are realistic diet goals, more exercise activity, and less intake of foods lacking in

nutrition.

Further research should include the exploration and implementation of warning labels on

soft drinks. Also, there should be more research on obesity variations through race, gender, and

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age. The causes of each of these population variations are needed to fully understand the many

facets of obesity in each particular variable. Also, research on soft drink policies such as

restricting the sale in schools should be evaluated on its ability on decreasing childhood obesity

rates. This research is difficult to obtain because time is needed before research can evaluate the

efficacy of these policies. Finally, I believe there needs to be research exploring the variations of

soft drink consumption as it varies across populations similar to obesity trends. My research

tries to answer some of the questions regarding soft drink consumption and its relation to obesity.

Using data from the USDA Food and Nutrient Intake Survey, I will explore the consumption of

soft drinks and the differences across populations such as age, gender, and race. I assert if

obesity varies across these variables and soft drinks are a cause and contributor of obesity, then

soft drink consumption should vary similar to that of obesity trends.

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