In light of proposals to improve diets by shifting food prices, it is important to understand how price changes affect demand for various foods. We reviewed 160 studies on the price elasticity of demand for major food categories to assess mean elasticities by food category and variations in estimates by study design. Price elasticities for foods and nonalcoholic beverages ranged from 0.27 to 0.81 (absolute values), with food away from home, soft drinks, juice, and meats being most responsive to price changes (0.7-0.8). As an example, a 10% increase in soft drink prices should reduce consumption by 8% to 10%. Studies estimating price effects on substitutions from unhealthy to healthy food and price responsiveness among at-risk populations are particularly needed.

Objective: Limited data are available on the prevalence and patterns of body weight discrimination from representative samples. This study examined experiences of weight/height discrimination in a nationally representative sample of US adults and compared their prevalence and patterns with discrimination experiences based on race and gender. Method and procedures: Data were from the National Survey of Midlife Development in the United States, a 1995-1996 community-based survey of English-speaking adults aged 25-74 (N ¼ 2290). Reported experiences of weight/height discrimination included a variety of institutional settings and interpersonal relationships. Multivariate regression analyses were used to predict weight/height discrimination controlling for sociodemographic characteristics and body weight status. Results: The prevalence of weight/height discrimination ranged from 5% among men to 10% among women, but these average percentages obscure the much higher risk of weight discrimination among heavier individuals (40% for adults with body mass index (BMI) of 35 and above). Younger individuals with a higher BMI had a particularly high risk of weight/height discrimination regardless of their race, education and weight status. Women were at greater risk for weight/ height discrimination than men, especially women with a BMI of 30-35 who were three times more likely to report weight/height discrimination compared to male peers of a similar weight. Discussion: Weight/height discrimination is prevalent in American society and is relatively close to reported rates of racial discrimination, particularly among women. Both institutional forms of weight/height discrimination (for example, in employment settings) and interpersonal mistreatment due to weight/height (for example, being called names) were common, and in some cases were even more prevalent than discrimination due to gender and race.

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ANDREYEVA, TATIANA, ROLAND STURM, AND JEANNE S. RINGEL. Moderate and severe obesity have large differences in health care costs. Obes Res. 2004;12: 1936-1943. Objective: To analyze health care use and expenditures associated with varying degrees of obesity for a nationally representative sample of individuals 54 to 69 years old. Research Methods and Procedures: Data from the Health and Retirement Study, a nationwide biennial longitudinal survey of Americans in their 50s, were used to estimate multivariate regression models of the effect of weight class on health care use and costs. The main outcomes were total health care expenditures, the number of outpatient visits, the probability of any inpatient stay, and the number of inpatient days. Results:The results indicated that there were large differences in obesity-related health care costs by degree of obesity. Overall, a BMI of 35 to 40 was associated with twice the increase in health care expenditures above normal weight (about a 50% increase) than a BMI of 30 to 35 (about a 25% increase); a BMI of over 40 doubled health care costs (ϳ100% higher costs above those of normal weight). There was a difference by gender in how health care use and costs changed with obesity class. The primary effect of increasing weight class on health care use appeared to be through elevated use of outpatient health care services. Discussion: Obesity imposes an increasing burden on the health care system, and that burden grows disproportionately large for the most obese segment of the U.S. population. Because the prevalence of severe obesity is increasing much faster than that of moderate obesity, average estimates of obesity effects obscure real consequences for individuals, physician practices, hospitals, and health plans.

Are older Americans becoming more or less disabled? Unhealthy body weight has increased dramatically, but other data show that disability rates have declined. We use data from the Health and Retirement Study to estimate the association between obesity and disability, and we combine these data with trend estimates of obesity rates from the Behavioral Risk Factor Surveillance Survey. If current trends in obesity continue, disability rates will increase by 1 percent per year more in the 50-69 age group than if there were no further weight gain.