Impacts of Sugar Warnings on Weight Bias

Impacts of Prolonged Exposure to Added Sugar Warning Labels on Explicit Weight Bias: a Randomized Controlled Trial

This study aims to examine the effects of added sugar warning labels for sugar-sweetened beverages (SSBs) on explicit weight bias and body weight attributional judgements. Participants will be assigned to view either control labels or added sugar warning labels applied on SSBs in an experimental store. Participants will shop for beverages in the store and take a computer survey during four visits to the store, spaced approximately one week apart.

Study Overview

• Status: Recruiting
• Conditions: Nutrition; Diet Interventions
• Intervention / Treatment: Behavioral: Control label; Behavioral: Added sugar warning

Detailed Description

This study aims to determine whether applying added sugar warnings on sugary drinks impacts explicit weight bias and body weight attributional judgements. Approximately 543 adults (ages 18 and older) who have bought at least one SSB in the past week will attend four in-person visits at an experimental store, spaced approximately one week apart. Participants will be randomized to see either neutral control labels or added sugar labels on SSB containers during their visits to the experimental store. At each study visit, participants will shop for beverages in the store and take a computer survey. Explicit weight bias and attribution of responsibility for body weight will be assessed via the computer surveys at the first and last visit.

• Study Type: Interventional
• Enrollment (Estimated): 543
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Aline D'Angelo Campos, PhD, MPP; Phone Number: 9199663215; Email: adangelo-campos@unc.edu

Study Locations

• United States
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27514
      • Recruiting
      • UNC MiniMart Chapel Hill
      • Contact: Violet Noe; Phone Number: 252-714-3572; Email: violetn@email.unc.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• 18 years and older
• Bought sugary drinks from a store at least once during the past week
• Willing to attend 4 in-person study appointments

Exclusion Criteria:

• Living in the same household as someone else in the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Control label	Behavioral: Control label; The control label will display a neutral, square-shaped barcode. Labels will be placed on the front of SSB containers in the experimental store.
Experimental: Added sugar warning	Behavioral: Added sugar warning; The added sugar warning will be octagon-shaped and will state "HIGH IN ADDED SUGAR." Warnings will be placed on the front of SSB containers in the experimental store.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Explicit weight bias, mean score	Explicit weight bias will be measured by survey through seven items. Items will present participants with pairs of antonyms and ask that they select the box between antonyms that they feel best describes their feelings and beliefs about people with obesity: (1) lazy - hard-working, (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, which will be presented as 5 boxes between antonyms, will be coded in a categorical 1-5 range, where higher scores represent higher endorsement of a stereotype that contributes to weight bias. Each participant's responses to each item will then be averaged across the seven items to obtain their final score on the outcome in a 1-5 range, where higher scores represent higher explicit weight bias.	Assessed via survey after exposure to intervention (i.e., shopping task) 2 times approximately 4 weeks apart (i.e., in visits 1 and 4)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Body weight attributional judgements, mean score	Body weight attributional judgements will be measured by survey through two items. Items will ask participants how much they agree with two statements: (1) People with obesity are responsible for their weight; (2) People with obesity are to blame for their weight. Response options will be on a 5-point scale from strongly disagree to strongly agree, with higher scores representing higher agreement. Each participant's responses to each item will be averaged to obtain their final score on the outcome in a 1-5 range, where higher scores represent higher attribution of personal responsibility for body weight.	Assessed via survey after exposure to intervention (i.e., shopping task) 2 times approximately 4 weeks apart (i.e., in visits 1 and 4).

Collaborators and Investigators

• Sponsor: University of North Carolina, Chapel Hill
• Investigators: Principal Investigator: Aline D'Angelo Campos, PhD, MPP, University of North Carolina, Chapel Hill

Study record dates

Study Major Dates

• Study Start (Actual): February 16, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: January 6, 2026
• First Submitted That Met QC Criteria: January 6, 2026
• First Posted (Actual): January 16, 2026

Study Record Updates

• Last Update Posted (Actual): April 16, 2026
• Last Update Submitted That Met QC Criteria: April 14, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 24-0901b

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The Study Protocol and Statistical Analysis Plan will be shared prior to data collection. After data collection and analysis, a de-identified version of individual participant data and the analytic code will be shared through the Open Science Framework (OSF).
• IPD Sharing Time Frame: The Study Protocol and statistical analysis plan will be available by February 2026 (prior to data collection). A de-identified version of the data collected and analytic code used will become available after data collection and analysis and will remain available indefinitely.
• IPD Sharing Access Criteria: Open access.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No