RESEARCH
Perspectives in Practice
Knowledge and Psychosocial Effects of the Film
Super Size Me on Young Adults
ELLEN COTTONE, MS, RD; CAROL BYRD-BREDBENNER, PhD, RD, FADA
ABSTRACT
The prevalence of overweight and obesity has risen dramatically over the past 2 decades. Among the many contributing factors is increased consumption of fast foods.
Mass media outlets have cited the potential of the film
Super Size Me to alter this behavior. The purpose of this
study was to determine the effect of this film on young
adults’ fast-food knowledge and psychosocial measures
(ie, attitudes, self-efficacy, healthy weight locus of control, and stage of change) and evaluate the effectiveness
of this film as a form of emotional arousal and consciousness-raising. A pretest-posttest follow-up control group
design with random assignment was used. Young adults
(n⫽135; 54% female) completed the pretest; approximately 10 days later viewed a film then completed the
posttest; and about 9 days later completed the follow-up
test. The experimental group (n⫽80) viewed Super Size
Me. The control group (n⫽55) viewed an unrelated film.
Unpaired t tests revealed that the study groups did not
differ significantly (P⬎0.05) at pretest on any measure.
Analysis of covariance, with pretest score as the covariate, revealed the experimental group scored substantially
better than the control group at posttest on knowledge
and nearly all psychosocial measures. In addition, the
experimental group continued to score substantially
higher than the control group at follow-up on knowledge,
stage of change, and consciousness-raising and lower on
external: chance health locus of control. Super Size Me
represents a potentially powerful tool for nutrition education. Nutrition practitioners should consider using Super Size Me as a consciousness-raising and emotional
arousal change process with patients in pre-action stages
of change for reducing fast-food intake.
J Am Diet Assoc. 2007;107:1197-1203.
E. Cottone is a renal dietitian, Renal Center of Trenton,
Trenton, NJ; at the time of the study, she was a graduate research assistant, Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ. C. ByrdBredbenner is professor of nutrition/extension specialist,
Department of Nutritional Sciences, Rutgers University,
New Brunswick, NJ.
Address correspondence to: Carol Byrd-Bredbenner,
PhD, RD, FADA, Rutgers University, 26 Nichol Ave, 220
Davison Hall, New Brunswick, NJ 08901. E-mail:
bredbenner@aesop.rutgers.edu
Copyright © 2007 by the American Dietetic
Association.
0002-8223/07/10707-0014$32.00/0
doi: 10.1016/j.jada.2007.04.005
© 2007 by the American Dietetic Association
T
he prevalence of obesity in the United States and
worldwide has risen dramatically over the past 2
decades. Identification of the causes of this complex
multifactorial disease has been as difficult as the disease
is pervasive. Among the many contributing factors are
increasing portion sizes and increased consumption of
fast food (1). Larger portion sizes, coupled with the fact
that most Americans underestimate portion sizes (2) and
tend to eat more when portions are larger (3), results in
consumption of excess calories (3), contributing to the
obesity epidemic.
Just as portion sizes have increased over the past 15 to
20 years (4), so has the frequency of eating outside the
home. The number of fast-food meals eaten per week is
positively associated with total energy intake, percentage
of energy from fat, and body mass index in women (5).
Reducing or altering fast-food intake could result in improvement in weight status. Changing behaviors to promote weight management remains a challenging and
elusive process. According to the Prochaska’s Transtheoretical Model of Behavior Change, progressive behavior
changes are facilitated by intervention methods known as
change processes (6). Emotional arousal (also called dramatic release or catharsis) and consciousness-raising (increasing level of awareness and information available to
individuals) are change processes that can assist individuals in making changes to improve their health.
Commercial films and television programs are forms of
media that can increase knowledge of health issues, while
simultaneously appealing to the emotions of viewers
(7,8). An emotionally arousing and consciousness-raising
film that may contribute to behavior change, Super Size
Me (9), illustrates the detrimental effects of a diet consisting entirely of fast food. Following its release, Super
Size Me received extensive press coverage because of its
unique and somewhat shocking subject matter. Media
sources (10-12) provided commentary on the film, some
even citing its potential to alter eating behavior. USA
Today reported that the film could “work . . . effectively to
change minds and behavior” (13). This film, as a form of
emotional arousal and consciousness-raising may be a
vehicle for initiating changes, such as reducing fast-food
intake, that help combat the problem of obesity. Thus, the
purposes of this study were to examine the effects of the
film Super Size Me on college students’ fast-food knowledge, attitudes, self-efficacy, healthy weight locus of control, and stage of change. A second purpose was to evaluate the film’s effectiveness as a form of emotional
arousal and consciousness-raising for maintaining a
healthy weight and following a healthful diet.
Journal of the AMERICAN DIETETIC ASSOCIATION
1197
METHODS
Sample
The sample was comprised of young adults (18 to 26
years) enrolled in an introductory psychology course at
Rutgers University. In return for participation, participants received research points required by this course.
College students were studied because they consume fast
food frequently (14,15).
Research Design
A pretest-posttest follow-up control group design with
random assignment was used (16). Both the experimental
and control groups completed the pretest, posttest, and
follow-up test. The pretest included all eight of the questionnaires described here. All questionnaires, except the
demographic questionnaire, were completed again at the
posttest and follow-up test. Participants completed the
pretest online. An average of 10 days later, they participated in the intervention (ie, viewed a movie). The experimental group saw Super Size Me and the control group
was shown either the movie Finding Neverland or First
Daughter, neither of which was related to nutrition. Participants were blind to the movie that would be shown
until they arrived at the showing. To assess short-term
effects, immediately following the intervention, both
groups completed the posttest in a pencil-and-paper format. An average of 9 days later, both groups participated
in the online follow-up test administered to examine persisting effects of the film. This study was approved by the
university’s Institutional Review Board.
Assignment to the experimental or control group was a
three-step process. First, to keep the study purpose obscure, it was decided a priori that participants who had
seen Super Size Me and/or read Fast Food Nation (17)
prior to the study would be permitted to participate, but
their data would be discarded. To avoid the possibility
that they might inadvertently cue or bias the experimental group during the intervention, it was decided a priori
that those that had seen Super Size Me and/or read Fast
Food Nation (17) would be shown a control group movie.
At the pretest, participants indicated which of six films
(one of which was Super Size Me) they had seen, which of
10 books [one of which was Fast Food Nation (17)] they
had read, and which time slots they were available to
view a film. In the second step, the films were assigned to
each of the 29 time slots available for showing the film.
Film assignment was determined by the times participants that had seen Super Size Me and/or read Fast Food
Nation (n⫽46) were available; that is, time slots selected
by these participants were assigned a control film (15
showings) and the experimental film was assigned to all
other time slots (14 showings). Third, those that had not
seen Super Size Me and/or read Fast Food Nation
(n⫽148) were assigned to the experimental or control
group based on when they were available to see a film.
Instruments
The study included eight instruments. The rules of cognitive and psychosocial item construction (18-21) were
rigorously followed in the development of these instruments. The item pool was reviewed by a panel of experts
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July 2007 Volume 107 Number 7
(n⫽10) in nutrition and/or tests and measurement for
clarity, usefulness, and contextual value and being representative of the construct measured (ie, content validity) (20,22), then revised. Next, nutrition and health
graduate students (n⫽5) completed the instruments to
assess their readability, identify grammatical errors, and
provide feedback with regard to appropriateness of questions and responses. Subsequently, all instruments, with
the exception of one that was added after the pilot test (ie,
consciousness-raising), were refined, pilot-tested with undergraduate students (n⫽69), and further refined. Lastly,
all instruments were reviewed again by the panel of experts to establish content validity (20,22).
The first instrument collected demographic information (ie, age, sex, race/ethnicity, college major, number of
college level nutrition courses completed, height, weight,
personal weight satisfaction, personal and family history
of obesity-related health conditions, recent movies seen,
and books read). The second instrument assessed knowledge related to nutrition, fast food, and obesity-related
health conditions and was based on factual information
presented in the movie Super Size Me. Fast-food knowledge score was computed by awarding one-point for each
correct answer and summing the total. This 31-item true/
false questionnaire had a reliability coefficient of 0.85
(23).
The remaining instruments assessed psychosocial measures including attitudes, self-efficacy, locus of control,
stage of change, emotional arousal, and consciousnessraising. The third instrument was a 16-item Likert-type
attitude questionnaire with three constructs (scales): Perceived Personal Susceptibility to Obesity and Related
Health Conditions, Feelings About the (Un)Healthfulness of Fast Food, and Personal Concern about Maintaining a Healthy Weight. Attitude scale items were constructed using previous research studies as a guide
(24,25); however, little research has been done to develop,
validate, and establish the unidimensionality of obesityrelated attitudinal constructs. Thus, this instrument was
developed almost entirely de novo. First, a series of Likert-type items with five response choices (ie, strongly
agree, agree, uncertain, disagree, strongly disagree) were
written for each construct and then reviewed by the expert panel, revised, and pilot-tested. Pilot-test data were
subjected to principal components factor analysis (26)
using an orthotran/varimax transformation method to
refine the scales and establish the unidimensionality of
the statements reflecting each construct. Finally, the expert panel reviewed the statements in each scale that
remained after factor analysis to confirm their content
validity. Statements from each scale were mixed throughout the instrument and some statements were worded
negatively to prevent a response set. For each statement,
a score of 5, 4, 3, 2, or 1 was assigned to strongly agree to
strongly disagree, for positively worded statements. The
scoring was reversed for negatively worded statements.
An overall mean scale score was computed by summing
item scores and dividing by the number of items in the
scale. Thus, mean scale scores ranged from 5 to 1. Confirmatory factor analysis using data from study participants revealed each item had a high factor loading on it a
priori, indicating construct validity (20,22), and verified
the unidimensionality of each scale. Cronbach ␣ reliabil-
ity coefficients are .89, .78, and .89 for the scales in the
sequence they are named above.
The 19-item Likert-type self-efficacy instrument measured self-efficacy for reducing fast-food intake and was
modified from previous measures (24,27-30). Scores for
each item ranged from 5 (“I am sure I could do it”) to 1 (“I
am sure I could not do it”). Total scale score was calculated by summing ratings for all items and dividing by
the number of items in the scale. Thus, scores could range
from 1 (low self-efficacy) to 5 (high self-efficacy). Cronbach ␣ coefficient was .95.
The fifth instrument assessed nutritional locus of control, which is the degree to which an individual believes
that following a nutritious diet and maintaining a
healthy weight is controlled internally, by powerful others, and/or by chance (31). The format of the statements
and scale assignment were derived from the Health Locus
of Control Scale (32,33) and Weight Control Locus of
Control Scale (34) and modified to reflect locus of control
for maintaining a healthy weight. Like the instruments
on which it was based (31-34), the locus of control instrument included three Likert-type scales (ie, internal, external: powerful others, and external: chance), each of
which contained six items having the same five answer
choices and scoring method as the attitude scales. Factor
analysis procedures like those described above confirmed
the unidimensionality and construct validity of the three
scales. Cronbach ␣ coefficients for internal, external: powerful others, and external: chance health loci of control
were .69, .55, and .58, respectively. Items from each scale
were mixed throughout the Locus of Control section to
prevent a response set.
The sixth instrument was a single item designed to
assess participants’ stage of change (ie, precontemplation, contemplation, preparation, action, and maintenance) for reducing fast-food intake. The format of this
item was similar to that used in previous studies (35,36).
Specifically, the item asked participants if they consistently avoid or minimize high-fat fast-food intake. Those
answering “no and don’t intend to in the next 6 months”
were classified as precontemplators. Contemplators were
those replying “no, but intend to in the next 6 months.”
Preparers were those answering “no, but intend to in the
next 30 days.” Replies of “yes, and have been for more
than 30 days” were classified as being in the action stage.
Maintainers were those that answered, “yes, and have
been for more than 6 months.”
The last two instruments were Likert-type scales using
the same response choices and scoring method as the
attitude scales. The seventh instrument, a six-item Likert-type questionnaire, was slightly modified from a previously reported questionnaire (37) and had a Cronbach ␣
coefficient of .81. The eighth instrument, an eight-item
consciousness-raising questionnaire, was based on items
utilized in two previous studies (37,38). Its Cronbach ␣
coefficient was .85.
Data Analysis
Descriptive statistics were generated for demographic
characteristics. Unpaired t-tests determined whether
study groups differed on any pretest measure. Analyses
of covariance (ANCOVA), with pretest score as the covariate, were conducted for each measure to determine if the
experimental and control groups’ mean scores differed
significantly (P⬍0.05) at the posttest and follow-up test.
Data were analyzed using Statview (version 5, 2002, SAS
Institute, Cary, NC).
RESULTS
A total of 194 individuals participated in the study; 135
remained after eliminating 12 that did not complete all
study parts, one who was older than age 26 years, and 46
that had previously seen Super Size Me and/or had read
Fast Food Nation (17). The final sample size was 135
participants, with the experimental group being larger
(n⫽80 vs 55 for control) because of several factors, including a priori decisions regarding participation and group
assignment of those who had seen Super Size Me and/or
read Fast Food Nation, group assignment based on availability at the times films were to be shown, and attrition.
Mean age was 19.3⫾0.06 standard error years (range 18
to 23 years). The majority were female (n⫽73; 54%) and
white (n⫽71; 53%). Participants were from a wide variety
of majors, with business being the most common (n⫽23;
17%). The majority (n⫽132; 98%) had not completed any
college-level nutrition courses. The mean body mass index, 22.7⫾0.38, indicated the average participant was a
healthy weight. Overall, participants were fairly satisfied
with their body weight; only about 11% in both study
groups reported they weighed a lot less or a lot more than
they would like. Obesity-related health conditions were
uncommon among participants. In contrast, these conditions were common among their immediate family members with the dominant problems being hypertension
(n⫽64; 47%), high blood cholesterol (n⫽56; 41%), obesityrelated cancers (n⫽34; 25%), type 2 diabetes (n⫽27;
20%), heart disease (n⫽25; 19%), and respiratory problems (n⫽21; 16%). Participants (n⫽25; 19%) reported
that one or more individuals in their immediate families
were obese.
Overall, the study groups had similar demographic
characteristics, with the exception of race/ethnicity (ie,
white vs nonwhite). The experimental group had significantly more whites than the control group (61% vs 40%;
P⫽0.0149). Unpaired t-tests revealed that the study
groups did not differ significantly on any measure at
pretest. In addition, there were no significant differences
on any measure between whites and nonwhites.
Knowledge test data revealed that at the pretest, participants in both study groups correctly answered about
two thirds of the questions. ANCOVA, with mean pretest
knowledge score as the covariate, indicated that the experimental groups’ mean posttest knowledge score was
significantly greater (P⬍0.0001) than the control group,
indicating that Super Size Me increased their knowledge
(see Table). Furthermore, ANCOVA revealed that the
experimental group’s mean follow-up knowledge score
was significantly higher than that of the control group.
The Table also shows that both groups had positive
attitudes at baseline. ANCOVA revealed that the groups
did not differ at posttest or follow-up on the Perceived
Personal Susceptibility to Obesity scale. However, the
experimental group’s mean score for Feelings About the
(Un)Healthfulness of Fast Food was significantly higher
at the posttest, indicating that they believed fast food was
less healthful immediately after seeing Super Size Me.
July 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
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Table. Means and significant differences between those viewing (experimental) and not viewing (control) Super Size Me and those as
determined by analysis of covariance with pretest score as covariate
Pretest
Variable
Knowledge
Attitudes
Perceived personal susceptibility to
obesity and related health
conditions
Feelings about the (un)healthfulness
of fast food
Personal concern about maintaining
a healthful weight
Self-efficacy
Locus of control
Internal
External: powerful others
External: chance
Stage of change for reducing fastfood intake
Emotional arousal
Consciousness-raising
Experimental Control
(nⴝ80)
(nⴝ55)
Posttest
Experimental
(nⴝ80)
Control
(nⴝ55)
Follow-up Test
Experimental
(nⴝ80)
Control
(nⴝ55)
4™™™™™™™™™™™™™™™™™™™™™™™™™™™™ mean⫾standard error ™™™™™™™™™™™™™™™™™™™™™™™™™™™™3
20.04⫾0.35 20.22⫾0.42 24.78⫾0.36***** 21.11⫾0.46***** 24.71⫾0.34***** 20.91⫾0.47*****
3.92⫾0.05
3.96⫾0.10 4.20⫾0.07
4.06⫾0.08
4.08⫾0.07
3.97 ⫾ 0.08
4.29⫾0.05
4.24⫾0.08 4.47⫾0.05****
4.21⫾0.06****
4.24⫾0.06**
4.03⫾0.07**
4.19⫾0.07
3.84⫾0.07
4.03⫾0.13 4.24⫾0.08*
3.80⫾0.12 4.05⫾0.07***
4.06⫾0.09*
3.83⫾0.11***
4.14⫾0.07
3.98⫾0.09
4.03⫾0.09
3.81⫾0.10
3.13⫾0.06
1.73⫾0.05
1.52⫾0.05
3.21⫾0.07 3.31⫾0.05*
3.15⫾0.06*
3.18⫾0.05
1.80⫾0.08 1.74⫾0.06
1.68⫾0.08
1.76⫾0.07
1.64⫾0.09 1.28⫾0.06***** 1.63⫾0.08***** 1.44⫾0.06****
3.07⫾0.07
1.84⫾0.07
1.75⫾0.09****
3.31⫾0.17
3.20⫾0.08
3.44⫾0.03
3.04⫾0.21 3.85⫾0.14**
3.35⫾0.11 3.70⫾0.09***
3.27⫾0.11 3.60⫾0.08**
3.27⫾0.19****
3.01⫾0.13
3.37⫾0.11*
3.36⫾0.21**
3.32⫾0.13***
3.36⫾0.12**
3.85⫾0.14****
3.22⫾0.09
3.59⫾0.08*
*P⬍0.05.
**P⬍0.01.
***P⬍0.005.
****P⬍0.001.
*****P⬍0.0001.
Although the groups differed substantially on this scale
at the follow-up test, this difference appears to be due to
a decrease in the control group’s mean score rather than
a change in the experimental group’s mean score. The
experimental group’s mean score on the Personal Concern about Maintaining a Healthy Weight scale was significantly higher than the control group at the posttest,
indicating that they were more concerned about maintaining a healthful weight after seeing Super Size Me.
This significant difference was not retained at follow-up
test.
Both groups began the study with a high level of selfefficacy; that is, they were confident in their ability to
control fast-food intake (3.82⫾0.62). At the posttest, results of ANCOVA revealed that after seeing Super Size
Me, the experimental group scored significantly higher
than the control group, a difference that was not evident
at the follow-up test.
The experimental group scored significantly higher
than the control group on the internal health locus of
control scale at the posttest. No significant difference was
found between these groups on the internal health locus
of control measure at the follow-up test. The groups did
not differ significantly on the external: powerful others
locus of control scale at the posttest or follow-up test. In
contrast, the experimental group scored significantly
lower on the external: chance locus of control scale than
the control group at both the posttest and follow-up tests.
The Table indicates that both study groups began the
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July 2007 Volume 107 Number 7
study in the preparation stage for reducing fast-food intake. ANCOVA indicates that the experimental group
advanced to a significantly higher stage at the posttest
than the control group. This significant difference was
maintained at the follow-up test.
Mean emotional arousal posttest scores differed significantly; in specific, the experimental group’s posttest
score was significantly higher than the control group’s
mean score indicating the experimental group was more
emotionally aroused after seeing Super Size Me than the
control group. For the follow-up test, however, no significant difference was found.
Pretest consciousness-raising scores indicated that
both groups were fairly conscious of the importance of
maintaining a healthy weight prior to the start of the
study. ANCOVA indicated that, at posttest, the experimental group had significantly higher consciousness of
maintaining a healthy weight after seeing Super Size Me
than the control group. At the follow-up test, mean scores
between these groups remained significantly different
from each other.
DISCUSSION
Results indicate that Super Size Me led to an increase in
knowledge of nutrition, fast food, and obesity-related
health conditions that persisted at least an average of 9
days after viewing this film. These results support recent
research investigating the impact of broadcast media on
knowledge (7,39).
Overall, Super Size Me had short-term effects on attitudes about the (un)healthfulness of fast food and personal concern about maintaining a healthful weight.
These findings are similar to those reported by others
(39,40) that viewing a health-related drama program had
a substantial impact on health-related attitudes. In contrast, the Stanford Five-City Project (41), which examined the effects of mass media on attitudes regarding
physical activity, had little effect on attitudes.
Exposure to the movie Super Size Me substantially
increased the experimental group’s self-efficacy for minimizing intake of fast food in the short term. Although this
finding contrasts with those of an education intervention
with children (42), it supports the findings of other interventions that also increased self-efficacy for health behaviors (39,43,44). It must be emphasized that the methodologies of these previous interventions were more
elaborate than the film intervention of this study. The
evidence that merely watching a film can produce
changes comparable to educational exercises or counseling sessions lends support to the concept of film as a
powerful motivational tool, at least in the short term.
The locus of control data finding that viewing Super
Size Me significantly increased internal health locus of
control at the posttest and significantly decreased external: chance health locus of control at the posttest and
follow-up test indicates that the film positively affected
locus of control. That is, Super Size Me viewers believed
they were more responsible for their health status and
that chance played a lesser role in determining their
health after viewing the film. Few studies could be located that have investigated the effects of interventions
on locus of control. Nevertheless, other researchers have
found positive associations between degree of internal
locus of control and ability to achieve or maintain a
healthful weight (45) and internal locus of control and
diet quality (46). The findings of increased internal and
decreased external: chance loci of control after seeing
Super Size Me may increase motivation to maintain a
healthy weight and minimize fast-food intake.
The significant increase in emotional arousal provides
evidence that viewers responded emotionally to the film
Super Size Me in the short term, reinforcing previously
reported findings that health-related dramatic broadcast
media can inspire emotional changes (40). Super Size Me
also increased awareness of the importance of maintaining a healthy weight. Although few studies have investigated the effect of media or educational interventions on
consciousness-raising for maintaining a healthy weight,
researchers have reported an association between consciousness-raising and smoking and quitting behavior
(47). Thus, the increase in consciousness among Super
Size Me viewers may precede positive health-behavior
changes that lead to weight loss and/or maintenance.
Results indicate that Super Size Me helps viewers advance to a higher stage of change in the short term and
this change persisted for at least 9 days after viewing the
film. Thus, the film appears to prompt individuals, at
least those in the pre-action stages, toward changing
their fast-food intake. Although no studies investigating
stage of change and broadcast media could be located,
other types of interventions, such as a community-based
diabetes education program (48), have reported similar
changes in stage. Likely, the film’s ability to emotionally
arouse viewers and raise their consciousness helped participants advance their stage.
There are limitations of this study that must be acknowledged. Study participants were a convenience sample of healthy, normal-weight college students enrolled at
a large, urban university. The study participants may not
have been as sensitive to the film’s subject matter as
other population groups, such as those who are obese
and/or suffering from obesity-related conditions. Thus,
the findings cannot be generalized to other population
groups or other students at other colleges. However, it is
important to consider that participants were from a university with a highly diverse student body of more than
50,000 students from all regions of the United States and,
thus, represent a broad cross-section of students. In addition, the proportion of white and female students enrolled is reflective of national enrollment levels (49). A
second limitation was the reliability of the locus of control
scales; while these are not as high as generally desired,
they are typical of those reported by its original developer
(31). A final limitation was that dietary behavior was not
assessed; this was because participants were involved in
this study for a short time (spanning approximately 3
weeks), which precluded them from making and measuring meaningful changes in fast-food intake. Nonetheless,
factors considered to mediate actual behavior change (eg,
knowledge, attitudes, self-efficacy, locus of control) were
assessed, as was stage of change (a self-reported measure
of behavior) (50-60).
CONCLUSIONS
In conclusion, the film Super Size Me substantially increased short-term knowledge, certain attitudes, self-efficacy, internal locus of control, stage of change, emotional arousal, and consciousness-raising, and substantially decreased external: chance locus of control of
college students. However, important changes that persisted were limited to knowledge, stage of change, consciousness-raising, and external: chance locus of control.
Thus, it appears that Super Size Me positively affected
several factors thought to mediate actual behavior as well
as employed change processes (ie, emotional arousal and
consciousness-raising) that advanced stage of change for
reducing fast-food intake. These findings are particularly
noteworthy in light of the content validity of all the measures, the strength of the reliabilities of all measures
except locus of control, and the robustness of the data
analysis (ie, ANCOVA coupled with random assignment
to study groups) (26).
Praise for the film as a behavior-change catalyst, at
least over a time span of approximately 9 days, was
supported by this study’s findings. Considering the difficulty in making and maintaining dietary changes and
success of mass-media campaigns (39), incorporating Super Size Me into a comprehensive, structured nutrition
intervention program targeting obesity would perhaps
render it even more successful in facilitating behavior
change. Future research should investigate the effect of
this film on other audiences. In addition, the usefulness of
Super Size Me as a part of a comprehensive nutrition
July 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
1201
education program that includes follow-up measures administered after an extended period is recommended.
This study is one of the first to attempt to increase our
understanding of a neglected area of media research; that
is, examining and describing the effect of broadcast media
(ie, a movie) on nutrition knowledge and psychosocial
factors. Although it is difficult to conduct well-controlled,
naturalistic field experiments focusing on a medium as
ubiquitous as media, the findings of this study make it
clear that the effect of the incidental, informal nutrition
education taught via a movie can be educationally and
psychologically meaningful and, thus, warrants further
study (61).
This study provides evidence for the usefulness of Super
Size Me in dietetics practice. Food and nutrition professionals practicing in the field of weight management could benefit patients by incorporating this film into behavioral counseling sessions or utilizing it as a consciousness-raising and
emotional arousal adjunct to counseling. Incorporation of
Super Size Me into weight-management interventions may
substantially affect individual client outcomes, and may
ultimately lessen the impact of the obesity epidemic.
E.C. received the 2006 Graduate Student Research Paper
Award presented by the Research Dietetic Practice Group
of the American Dietetic Association for an earlier draft
of this paper.
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