Differences in weight loss among ethnicities points to need to look at socio-economic issues, York University study suggests

Lack of coverage for obesity medications for some groups is systemic discrimination, says prof

York University

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TORONTO, May 14, 2025 – A new study led by York University looking at the health data of nearly 15,000 people enrolled in a medically supervised weight-loss program found disparities among ethnic and sub-ethnic groups in how much weight they lost. Lead author, York University Faculty of Health Professor Jennifer Kuk, says the results show that the very broad ethnic categories typically examined in clinical settings may mask differences in sub-ethnic groups. Further, she says the findings suggest the need for understanding how socio-economic issues may come into play to better support Black, Middle Eastern, Latin and South Asian communities with their weight-loss. 

The study found that the white ethnic group had the greatest weight loss, with Black, South Asian, Latin, and Middle Eastern adults having significantly less weight loss. Indigenous, East Asian, and other ethnic groups did not differ in the amount of weight loss compared to the white group. 

“We found that the ethnicities that lost the least amount of weight are also the ethnicities that tend to have the highest risk for obesity. So those that have the greatest need are seeing the least effectiveness from the treatment they're getting, which is something that we need to unpack and figure out why that’s happening,” says Kuk.

For the study, published in the journal Clinical Obesity, Kuk worked with longtime research collaborator Dr. Sean Wharton and examined data for patients enrolled in weight management programs through Wharton Medical Clinics across Southern Ontario. York School of Kinesiology and Health Science PhD student Parmis Mirzadeh also contributed to the study. 

They found there were also differences when looking at sub-ethnic categories. For example, while Black patients overall lost less weight than other racial groups in the program, there were significant differences in weight loss for African Americans and Blacks of direct African descent. 

Despite losing less weight, Black and other non-white patients were also more likely than white patients to be prescribed older obesity medications. While the study was completed before weight loss drug Wegovy was available on the market, Ozempic, a diabetes drug that is commonly used off-label for weight loss and is often covered by insurance plans, did not have differences in prescription rates. Kuk says one limitation of this study is that they did not know whether patients filled the prescriptions or how long they took the medications for.

“Obesity medications are rarely covered. And so when you compound that with the fact that ethnic minorities tend to make less money, are less likely to have private insurance, overall, it's adding another financial burden to a population that's already marginalized,” says Dr. Wharton. 

“The fact that certain populations can't access newer, more expensive medications at the cost of their health is systemic discrimination,” adds Kuk. 

Obesity is a condition that has been linked to diabetes, high blood pressure, high cholesterol, some forms of cancer, joint pain, liver conditions, and can have impacts on the immune system, respiratory disease and cognitive function. In Canada, 30 per cent of the adult population is classified as having obesity, with some ethnic groups at a higher risk. 

“Because of the stigma associated with obesity, it's always seen to be the fault of the individual, as opposed to a result of many complex structural issues that result in certain people being at higher risk, and then also perhaps results in those same people not being able to get the treatment that they need,” says Kuk. 

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York University is a modern, multi-campus, urban university located in Toronto, Ontario. Backed by a diverse group of students, faculty, staff, alumni and partners, we bring a uniquely global perspective to help solve societal challenges, drive positive change, and prepare our students for success. York's fully bilingual Glendon Campus is home to Southern Ontario's Centre of Excellence for French Language and Bilingual Postsecondary Education. York’s campuses in Costa Rica and India offer students exceptional transnational learning opportunities and innovative programs. Together, we can make things right for our communities, our planet, and our future. 

Media Contact: 

Emina Gamulin, York University Media Relations, 437-217-6362, egamulin@yorku.ca

 

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Journal

Clinical Obesity

DOI

10.1111/cob.70022 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Ethnic differences in weight loss during a clinical obesity management program

Article Publication Date

11-May-2025

COI Statement

SW is the Medical Director of the Wharton Medical Clinic and has received consulting fees, honoraria or support for attending scientific meetings from Novo Nordisk, Eli Lilly, Behringer Ingelheim, GLG Industries, AMGEN, Astra Zeneca and Bausch Health Canada unrelated to the submitted work. JK is an unpaid research consultant for the Wharton Medical Clinic. PM has no conflicts to disclose.

 

Social media content focused on muscularity linked to muscle dysmorphia among boys and men

It's not just how much time boys and men spend on social media, but the specific content they consume—especially muscularity-oriented posts—that plays a critical role in shaping body image concerns and increasing the risk of muscle dysmorphia.

University of Toronto

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TORONTO, ON, Canada — A new study reveals a concerning association between viewing social media content emphasizing muscularity and muscle dysmorphia among boys and men in Canada and the United States. The research, part of the 2024 Study of Boys and Men, analyzed data from 1,553 participants and found that exposure to specific types of content is linked to higher rates of probable muscle dysmorphia.

Muscle dysmorphia, a condition characterized by an obsessive preoccupation with perceived insufficient muscularity, is often overlooked in discussions about body image and social media. This study examined the impact of viewing three types of content on social media: images of muscular bodies, posts promoting muscle-building dietary supplements (e.g., whey protein), and content featuring muscle-building drugs (e.g., anabolic-androgenic steroids).

“We found strong, positive associations between the frequency of viewing all three types of content and experiencing muscle dysmorphia in the study,” says lead author Kyle T. Ganson, PhD, MSW, assistant professor at the Factor-Inwentash Faculty of Social Work at the University of Toronto. “Most importantly, these associations persisted even after accounting for overall time spent on social media. This suggests that the type of content viewed—not just total screen time—plays a critical role in shaping body image concerns among boys and men.”

These authors highlight a growing need to examine how specific social media content contributes to body image-related mental health issues in boys and men. Understanding the influence of muscularity-oriented media is vital for developing prevention strategies.

“We need to ensure that boys and men engage in media and health literacy to foster healthier relationships with social media and body image,” says Ganson.

The authors also call for more longitudinal research to clarify the long-term risks of viewing muscularity-oriented content.

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Journal

Body Image

DOI

10.1016/j.bodyim.2025.101903 

Article Title

Associations between Muscularity-Oriented Social Media Content and Muscle Dysmorphia among Boys and Men

Article Publication Date

13-May-2025

 

Barbies today are much less likely to be on their tip-toes than in past decades

Analysis of 2,750 dolls produced since 1959 also finds that “employed” versions of Barbie are more likely to have flat-foot posture than fashion-focused dolls

PLOS

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image: 

The Barbie Team (from left to right): Barbie Fashionista (#171) wears a high heel white ankle boot, Barbie Fashionista (#197) wears an amazing yellow platform heel with ankle straps, Barbie Interior Designer wears ballet flats on both her foot and prosthetic limb, Barbie Paramedic has her workboots ready to go, Barbie Fashionista (#208) has Down Syndrome and uses sneakers to accommodate her ankle foot orthoses, and Barbie Fashionista (#210) models comfy yellow slides.

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Credit: Cylie Williams, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

According to a new study, the proportion of Barbie-brand dolls with the toy’s iconic tip-toe posture has dropped over time. Cylie Williams of Monash University in Frankston, Australia, and colleagues present these findings in the open-access journal PLOS One on May 14, 2025.

Since introducing Barbie in 1959, Mattel has released many versions of the doll that appear to reflect societal shifts in women’s employment, empowerment, and body shape. In 2023, a humorous scene in the movie “Barbie” drew popular attention to Barbie’s foot posture, which is commonly in tip-toe “equinus” posture to accommodate high heels, but may be flat for other footwear.

However, while prior academic studies have assessed Barbie’s body shape, few have focused on the doll’s iconic tip-toe posture. Williams and colleagues wondered how Barbie’s foot posture may have shifted over time as Mattel released new versions with different occupations, ethnicities, and disabilities.

The researchers developed a novel system for categorizing certain characteristics for any version of Barbie, which they named FEET: Foot posture; Equity (diversity and inclusion); Employment (job-themed, such as Eye Doctor Barbie, or fashion-themed, such as Twirly curls Barbie); and Time period of manufacture. They used FEET to analyze 2,750 versions of Barbie-brand dolls made between 1959 and June 2024.

The analysis revealed that the percentage of Barbie dolls with tip-toe posture dropped over time, from 100% in the first decade of production, to 40% in 2020 through June 2024. “Employed” versions were significantly more likely to have flat feet, while fashion-focused dolls were more likely to have tip-toe posture. There were also strong statistical links between dolls representing people of color and the tip-toe posture. Less strong links were found between flat feet and diversity, as well as between flat feet and dolls with disabilities.

The authors state that “our observed strong relationship between flat foot posture and time, suggests … changing [workforce] roles and laws were reflected in Barbie’s foot posture.” They suggest that “Barbie [is] making foot posture and footwear choices that best enable her participation in employment and physical activity”.

While this study reveals new insights into Barbie’s foot morphology, the researchers note that it excluded special-collections dolls, which may have different foot-posture proportions. The findings cannot be generalized to the broader scope of real world women’s fashion choices and employment, and cannot confirm any cause-effect relationship with these. Additionally, while Mattel’s Barbie design decisions might reflect trends and historical events, they are likely marketing-based.

The authors add: “Barbie chooses her shoes based on what she’s doing—flats for function, heels for fashion—mirroring how many people wear high heels in real life. Since she reflects societal norms, it’s time health messaging caught up by focusing less on heel-shaming and more on empowering informed, body-autonomous choices.”

“Who better to unpack Barbie’s high-heel habits than a team of podiatrists and a Barbie Collector? We came for the biomechanics, stayed for the glitter. Research doesn't always have to be serious and we were surprised to see tiny feet can have interesting stories to tell about cultural shoe wearing practices. Hopefully we see a Podiatrist Barbie on the market soon, we're pretty sure we know what sort of shoes she'd wear.”

 

 

In your coverage, please use this URL to provide access to the freely available article in PLOS One: https://plos.io/44eUxxb

Citation: Williams C, Graham K, Griffiths I, Wakefield S, Banwell H (2025) Flat out Fabulous: How Barbie’s foot posture and occupations have changed over the decades, and the lessons we can learn. PLoS One 20(5): e0323719. https://doi.org/10.1371/journal.pone.0323719

Author countries: Australia

Funding: The author(s) received no specific funding for this work.

Barbie foot positions to accommodate high heel and flat shoe wearing.

Credit

Cylie Williams, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

Journal

PLOS One

DOI

10.1371/journal.pone.0323719 

Method of Research

Observational study

Subject of Research

People

Article Title

Flat out Fabulous: How Barbie’s foot posture and occupations have changed over the decades, and the lessons we can learn

Article Publication Date

14-May-2025

Shifting pollution abroad is a major reason why democratic countries are rated more environmentally friendly compared to non-democratic states

OFFSHORING IS GREENWASHING

PLOS

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Industrial pollution 

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Credit: Wikimedia Commons, CC0 (https://creativecommons.org/publicdomain/zero/1.0/)

Democratic countries tend to be rated “greener”, or more environmentally friendly, compared to other countries—but this may be because they more often outsource the environmental impacts of their consumption to other nations, according to a study published May 14, 2025, in the open-access journal PLOS Climate by Thomas Bernauer and Ella Henninger from ETH Zurich, Switzerland and Tobias Böhmelt from the University of Essex.

Prior studies suggest that democracies have a better environmental protection record compared to more authoritarian nations. Here, the authors investigated the link between democracy and environmental behaviors—in particular, focusing on “pollution offshoring” (when countries shift their production and/or consumption patterns so that highly polluting goods or processes are made or take place abroad instead of domestically) and the environmental impact of this.

Bernauer, Böhmelt, and Henninger analyzed 161 countries individually between 1990-2015 on, focusing on the relationship between democracy and pollution offshoring, and then evaluating how democratic pollution offshoring correlates to domestic environmental pollution as measured by greenhouse gas emissions.

They found that democratic countries tended to offshore environmentally-damaging products and processes significantly more than other countries. Their analysis also showed that pollution offshoring was significantly associated with lower emission levels locally, particularly for countries categorized as more democratic: greenhouse gas emissions for these more democratic nations were over one metric ton per capita lower (-1.55; -0.45) when increasing pollution offshoring, compared to less democratic nations. These findings call into question the moral high ground of democracies versus autocracies in terms of environmental protection, and suggest that particularly high-income democracies should seek to reorient environmental polices to focus on the global environmental impact of their domestic economic activity.

The authors add: “We provide one of the first systematic studies on how much “pollution offshoring” is associated with domestic (territorial) emission levels in democracies. The main result is that pollution offshoring is linked significantly and substantively with lower greenhouse gas emissions “at home” in democracies.”

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In your coverage please use this URL to provide access to the freely available article in PLOS Climate: https://plos.io/44sPmd1

Citation: Bernauer T, Böhmelt T, Henninger E (2025) Shifting environmental pollution abroad contributes to lower emissions in democracies. PLOS Clim 4(5): e0000602. https://doi.org/10.1371/journal.pclm.0000602

Author Countries: Switzerland, United Kingdom

Funding: The authors received no specific funding for this work.

 

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Journal

PLOS Climate

DOI

10.1371/journal.pclm.0000602 

Method of Research

Observational study

Subject of Research

People

Article Publication Date

14-May-2025

Members of marginalized groups are at disproportionate risk in earthquakes, study finds

Emergency plans should take socio-economic factors into account and there should be targeted investments in older buildings, say researchers who examined data from Montreal and Ottawa-Gatineau through the lens of equity

McGill University

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Members of socially and economically marginalized groups in Montreal and Ottawa-Gatineau are at disproportionate risk in earthquakes, a new study has found.

Co-authored by McGill civil engineering professor Daniele Malomo, the study is the first in Canada to examine earthquake vulnerability through the lens of equity.

The researchers used spatial mapping and statistical techniques to identify where earthquake risk and social vulnerability intersect, revealing patterns of inequality tied to race, income, language and housing conditions. They drew their data from the 2021 Canadian Census and Canada’s Probabilistic Seismic Risk Model.

“Traditional seismic risk assessment frameworks focus exclusively on tangible building vulnerability indicators and/or economic data,” said Malomo, principal investigator of the project. “Adding the social component to it is unprecedented and particularly relevant in the diverse Canadian context. It adds a deeper level of understanding that better informs decision- and policymakers.”

In both urban areas studied, earthquake risk was highest in neighbourhoods with older housing stock, which may be less able than newer construction to withstand seismic shocks. Recent immigrants, single-parent families, seniors and members of visible minorities are significantly more likely to live in such areas than are other people. In Montreal, people with lower education levels, those who speak languages other than English and French and those living alone are also disproportionately affected.

Traditional disaster-risk models tend to assess physical damage to infrastructure without accounting for the social conditions that leave some groups more exposed to harm.

“This study demonstrates that earthquake risk is a new and important addition to the conversation around equity, environmental justice and social justice in disaster planning,” said Dr. Liton Chakraborty, research associate with the Climate Risk Research Group at the University of Waterloo and lead author of the study. “This shows that some people are facing more danger or environmental risks than others simply due to their social or economic situation,” he added.

Governments and city planners can use this information to design more inclusive emergency response strategies and ensure that the most at-risk communities are not overlooked in efforts to improve public safety and disaster resilience, he added.

The researchers recommend that planners and policymakers integrate social vulnerability measures – such as income, education and housing conditions – into disaster-risk assessments and emergency-preparedness efforts. They also call for neighbourhood-specific emergency plans and targeted investments in older buildings and underserved areas.

About the study

Assessing the Environmental Justice Implications of Seismic Risk in Ottawa-Gatineau and Montreal Metropolitan Areas Liton Chakraborty, Daniele Malomo, Bora Pulatsu, Sheldon Andrews, Jennifer A. Spinney, and others was published in the International Journal of Disaster Risk Reduction. The study is part of a larger project funded by the New Frontiers in Research Fund (Exploration stream), led by McGill’s Daniele Malomo (PI), with Bora Pulatsu (Co-PI, Carleton University), Sheldon Andrews (Co-Applicant, ÉTS), Jennifer Spinney (Co-Applicant, York University), and Liton Chakraborty (research consultant).

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Journal

International Journal of Disaster Risk Reduction

 

The ripple effect of small earthquakes near major faults

Minor quakes can disrupt natural tectonic patterns deep underground and change stress landscape, new study finds

University of California - Santa Cruz

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When we think of earthquakes, we imagine sudden, violent shaking. But deep beneath the Earth’s surface, some faults move in near silence. These slow, shuffling slips and their accompanying hum—called tremors—don’t shake buildings or make headlines. But scientists believe they can serve as useful analogs of how major earthquakes begin and behave.

A new study by geophysicists at UC Santa Cruz explains how some of these tremor events can yield insights into how stress builds up on the dangerous faults above where major earthquakes occur. The study, to be published on May 14 in the journal Science Advances, was led by Gaspard Farge, a postdoctoral researcher in the university’s Seismo Lab, and Earth and planetary sciences professor Emily Brodsky, the lab’s principal investigator.

When faults where tectonic plates meet slip fast past each other, earthquakes result. Tremors are produced when this happens slowly, usually tens of miles underground—often in subduction zones, where one plate dives beneath another. Tremors don’t pose immediate danger, but they also shouldn’t be ignored because they often happen in the vicinity of where the world’s biggest earthquakes eventually occur, say the study’s authors.

“We find that the faults that produce tremor are more sensitive and connected to their surroundings than previously thought,” said Farge, who researches what processes shape minute seismic activity. “Even small, frequent earthquakes can affect how a major fault behaves.”

Chaotic effect of small quakes

Farge and Brodsky discovered that small earthquakes, even those tens of kilometers away from the main fault, can disturb a tremor’s natural rhythm. As a patch of the fault begins to slip, it usually nudges its neighbors along for the ride—leading to large, synchronized tremor episodes. But when small quakes send seismic waves rippling through the area, they can throw off that coordination.

These outside disturbances can either speed up or delay tremor activity, depending on timing and location. And because small earthquakes happen far more often than large ones, they may constantly jostle the system out of synchrony.

Over time, this could explain why some segments of a fault show highly regular tremor patterns—slipping in coordinated episodes—while others remain chaotic. The segments aren’t just shaped by the rocks underground, a marble here, granite there; they also adapt to the constant perturbation from nearby seismic activity.

The dynamic Northwest

This pattern is evident in the Cascadia subduction zone, which extends from Northern California, through Oregon and Washington, to British Columbia. The zone produces extensive tremor activity and very large earthquakes on a 400-year basis. Across Oregon, the subduction is almost silent—and without perturbation from earthquakes—the plate slips like a clock, every year and a half in a section hundreds of kilometers long, tremor producing events.

In Northern California, however, the activity of small earthquakes near Cape Mendocino disturbs the regularity of the fault, and the tremor is produced in small, disorganized episodes.

Scientists have known that the shape and makeup of a fault zone—the rock types, temperature, water content, and even the slope of the sinking plate—all help define how and where a tremor happens. These are called structural factors, and they affect how sticky the fault is and how easily it slips.

But this new study introduces a twist: dynamic factors, like the stress waves from small earthquakes nearby, may also shape when and where tremor happens—and whether it occurs in a smooth, predictable way or in a scattered, messy fashion.

“These findings go beyond tremors. By showing how small earthquakes can affect the timing and behavior of slow fault movements, this discovery opens up new ways to understand the buildup to large, damaging earthquakes,” said Brodsky, a leading earthquake physicist. “If we can track how a tremor responds to these small stress nudges, it may be possible to read the stress landscape of a fault—offering clues about where and when it might rupture in a big way.”

Quake magnitude isn’t everything

This study shifts our understanding of a common assumption: that only large forces shape the behavior of major earthquake faults. In fact, tiny, nearby quakes—usually considered too small to matter—may play an outsized role in defining where and how the Earth’s plates slip past one another. That means that by listening to the Earth’s quietest rumbles, we may be able to learn how to better anticipate its loudest ones.

“Ultimately,” Brodsky said, “this study proposes a way to measure the elusive dynamic factors that influence how fault slips—the stress landscape that informs how stress is built up on these dangerous faults.”

“The fact that we can measure and understand the effects of earthquakes’ perturbation on slow fault ruptures gives us hope that we could use the same logic to understand where earthquakes should be expected to be regular, and where not,” Farge concludes.

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Journal

Science Advances

Method of Research

Meta-analysis

Article Publication Date

14-May-2025