{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T17:39:11Z","timestamp":1792777151952,"version":"4.5.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"USDA Hatch Funds"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"abstract":"<jats:p>\n                    Nutrition education in schools is a key health promotion strategy that has the potential to influence lifelong relationships with food, bodies, and health. However, many programs in U.S. schools are taught from a weight-centric approach that positions body weight as a primary indicator of health despite evidence of associated stigma and harm. Weight-inclusive nutrition (WIN) offers an alternative framework that emphasizes non-weight-based indicators of health, rejects diet culture, and acknowledges the social determinants of health; yet little is known about student outcomes when nutrition is taught from this paradigm. This study examined the implementation and preliminary outcomes of a newly developed eight-lesson WIN curriculum in high school health education classrooms. Pre- and post-intervention surveys were administered to students in Grades 7\u201312 across 17 classrooms in eight schools in the Northeast United States (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    pre = 292;\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    post = 263) during fall 2024. Quantitative results showed positive shifts across all items, with statistically significant improvements in students\u2019 endorsement of weight-inclusive beliefs, including reduced moralization of food, decreased reliance on appearance-based health judgments, and increased recognition that health is socially shaped. Qualitative findings revealed emerging critical nutrition literacy\u2014particularly students\u2019 ability to identify and critique diet culture\u2014alongside continued difficulty disentangling weight from health. These findings suggest that, while WIN curricula can initiate meaningful shifts in how students conceptualize food, bodies, and health, continued efforts are needed to support appropriate educator training and strengthen alignment with school-wide policies to sustain long-term change.\n                  <\/jats:p>","DOI":"10.1177\/15248399261494608","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:50:49Z","timestamp":1792497049000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Weight-Inclusive Approach in High School Nutrition Education: An Exploratory Mixed-Methods Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0954-2788","authenticated-orcid":false,"given":"Janet","family":"Gamble","sequence":"first","affiliation":[{"name":"University of Vermont, Burlington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan A.","family":"Levinson","sequence":"additional","affiliation":[{"name":"University of Vermont, Burlington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernice R.","family":"Garnett","sequence":"additional","affiliation":[{"name":"University of Vermont, Burlington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Hinchey","sequence":"additional","affiliation":[{"name":"University of Vermont, Burlington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizzy","family":"Pope","sequence":"additional","affiliation":[{"name":"University of Vermont, Burlington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Babbott K. M. Cavadino A. Brenton-Peters J. Consedine N. S. Roberts M. (2023). Outcomes of intuitive eating interventions: A systematic review and meta-analysis. Eating Disorders 31(1) 33\u201363. https:\/\/doi.org\/10.1080\/10640266.2022.2030124","DOI":"10.1080\/10640266.2022.2030124"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Braun V. Clarke V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3(2) 77\u2013101. https:\/\/doi.org\/10.1191\/1478088706qp063oa","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/17479541241313052"},{"key":"e_1_3_2_5_1","volume-title":"Designing and conducting mixed methods research","author":"Creswell J.","year":"2018","unstructured":"Creswell J., Plano Clark V. (2018). Designing and conducting mixed methods research (3rd ed.). Sage.","edition":"3"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","unstructured":"Fischer N. R. (2022). School-based harm reduction with adolescents: A pilot study. Substance Abuse Treatment Prevention and Policy 17(1) 79. https:\/\/doi.org\/10.1186\/s13011-022-00502-1","DOI":"10.1186\/s13011-022-00502-1"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","unstructured":"Gamble J. Levinson J. A. Hinchey D. Rose K. Garnett B. R. Pope L. (2026a). Ditching diet talk: A qualitative study of teachers implementing weight-inclusive nutrition curriculum in the high school health classroom. Journal of School Health 96 Article e70150. https:\/\/doi.org\/10.1111\/josh.70150","DOI":"10.1111\/josh.70150"},{"key":"e_1_3_2_8_1","doi-asserted-by":"crossref","unstructured":"Gamble J. Levinson J. A. Hinchey D. Rose K. Garnett B. R. Pope L. (2026b). Weight-inclusive nutrition education in K-12 schools: Deconstructing the weight-normative narrative. Health Education. Advance online publication. https:\/\/doi.org\/10.1108\/HE-10-2025-0214","DOI":"10.1108\/HE-10-2025-0214"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metip.2021.100080"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Guttersrud \u00d8. Dalane J. \u00d8. Pettersen S. (2014). Improving measurement in nutrition literacy research using Rasch modelling: Examining construct validity of stage-specific \u201ccritical nutrition literacy\u201d scales. Public Health Nutrition 17(4) 877\u2013883. https:\/\/doi.org\/10.1017\/S1368980013000530","DOI":"10.1017\/S1368980013000530"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1515\/jcim-2021-0294"},{"key":"e_1_3_2_12_1","doi-asserted-by":"crossref","unstructured":"Hayes D. Contento I. R. Weekly C. (2018). Position of the Academy of Nutrition and Dietetics Society for Nutrition Education and Behavior and School Nutrition Association: Comprehensive nutrition programs and services in schools. Journal of the Academy of Nutrition and Dietetics 118(5) 913\u2013919. https:\/\/doi.org\/10.1016\/j.jand.2018.03.005","DOI":"10.1016\/j.jand.2018.03.005"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneb.2022.08.008"},{"key":"e_1_3_2_14_1","doi-asserted-by":"crossref","unstructured":"Hinchey D. Garnett B. Gamble J. Pope L. (2025a). Exploring weight inclusive vs. weight-normative approaches in high school nutrition education. Health Education 125(1) 91\u2013107. https:\/\/doi.org\/10.1108\/he-04-2024-0046","DOI":"10.1108\/HE-04-2024-0046"},{"key":"e_1_3_2_15_1","doi-asserted-by":"crossref","unstructured":"Hinchey D. Garnett B. Gamble J. Pope L. (2025b). Support for a weight-inclusive curriculum? Exploring partner perspectives and influences on nutrition education in Vermont high schools. Journal of School Health 95(1) 17\u201325. https:\/\/doi.org\/10.1111\/josh.13510","DOI":"10.1111\/josh.13510"},{"key":"e_1_3_2_16_1","doi-asserted-by":"crossref","unstructured":"Hunger J. M. Smith J. P. Tomiyama A. J. (2020). An evidence-based rationale for adopting weight-inclusive health policy. Social Issues and Policy Review 14(1) 73\u2013107. https:\/\/doi.org\/10.1111\/sipr.12062","DOI":"10.1111\/sipr.12062"},{"key":"e_1_3_2_17_1","article-title":"Obesity prevention interventions in US public schools: Are schools using programs that promote weight stigma?","volume":"14","author":"Kenney E. L.","year":"2017","unstructured":"Kenney E. L., Wintner S., Lee R. M., Austin S. B. (2017). Obesity prevention interventions in US public schools: Are schools using programs that promote weight stigma? Prevention Chronic Disease, 14, Article E142.","journal-title":"Prevention Chronic Disease"},{"key":"e_1_3_2_18_1","doi-asserted-by":"crossref","unstructured":"Kolbe L. J. (2019). School health as a strategy to improve both public health and education. Annual Review of Public Health 40(1) 443\u2013463. https:\/\/doi.org\/10.1146\/annurev-publhealth-040218-043727","DOI":"10.1146\/annurev-publhealth-040218-043727"},{"key":"e_1_3_2_19_1","doi-asserted-by":"crossref","unstructured":"Levinson J. A. Gamble J. Rose K. Garnett B. R. Hinchey D. Pope L. (2026). Defining the guiding principles of weight-inclusive nutrition education. Frontiers in Public Health 14 Article 1734480. https:\/\/doi.org\/10.3389\/fpubh.2026.1734480","DOI":"10.3389\/fpubh.2026.1734480"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267997"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41110-021-00149-1"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.34172\/hpp.2020.50"},{"key":"e_1_3_2_23_1","unstructured":"SHAPE America. (2024). National health education standards. https:\/\/www.shapeamerica.org\/standards\/health\/default.aspx"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.70034"},{"issue":"1","key":"e_1_3_2_25_1","first-page":"983495","article-title":"The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss","volume":"2014","author":"Tylka T. L.","year":"2014","unstructured":"Tylka T. L., Annunziato R. A., Burgard D., Dan\u00edelsd\u00f3ttir S., Shuman E., Davis C., Calogero R. M. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014(1), 983495.","journal-title":"Journal of Obesity"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2024.107407"},{"key":"e_1_3_2_27_1","unstructured":"Vermont Department of Health. (2025). Youth Risk Behavior Survey (YRBS). https:\/\/www.healthvermont.gov\/stats\/population-health-surveys-data\/youth-risk-behavior-survey-yrbs"},{"key":"e_1_3_2_28_1","doi-asserted-by":"crossref","unstructured":"Weiss A. L. Miller J. N. Chermak R. (2023). Adolescent diet culture: Where does it originate? In Kumar M. M. Dixon Docter A. (Eds.) Fad diets and adolescents: A guide for clinicians educators coaches and trainers (pp. 17\u201324). Springer. https:\/\/doi.org\/10.1007\/978-3-031-10565-4_3","DOI":"10.1007\/978-3-031-10565-4_3"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2024.2364523"}],"container-title":["Health Promotion Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399261494608","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15248399261494608","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399261494608","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T16:58:21Z","timestamp":1792774701000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15248399261494608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":28,"alternative-id":["10.1177\/15248399261494608"],"URL":"https:\/\/doi.org\/10.1177\/15248399261494608","relation":{},"ISSN":["1524-8399","1552-6372"],"issn-type":[{"value":"1524-8399","type":"print"},{"value":"1552-6372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"article-number":"15248399261494608"}}