Krispy Kreme had thought of the freebie campaign as a kindly nudge to those slow to get vaccinated and a way to help the country as it trudges toward herd immunity. But within days of the announcement, some doctors had taken to social media to blast the Winston-Salem, N.C.-based company, which was founded in 1937 and has approximately 12,000 locations in stand-alone shops and within grocery and convenience stores across the country.
“Hey @krispykreme, I love that you want to thank people for getting the #covid19 #vaccine,” tweeted Leana Wen, an emergency physician who previously served as Baltimore’s health commissioner. “However, donuts are a treat that’s not good for health if eaten every day.” She added that having a daily Original Glazed, without otherwise adjusting diet or exercise habits, would lead to about 15 pounds of weight gain by the end of the year. (The same day Krispy Kreme made its announcement, a small study was published suggesting those quarantining at home had gained nearly two pounds per month. In an Axios-Ipsos poll conducted in February, 32 percent of Americans said they had recently gained weight.)
Krispy Kreme, which operates a fundraising program for nonprofits and said it also has conducted covid-related giveaways for health-care workers, teachers and others, is standing by its offer. “Like many sweet treats, Krispy Kreme doughnuts are an occasional indulgence best enjoyed in moderation,” the company said in a statement to The Washington Post. “And we know that’s how most of our guests enjoy our doughnuts. We’re certainly not asking people to get a free Original Glazed doughnut every day, we’re just making it available through the end of the year — especially given that not every group is eligible to get vaccinated yet — to show support to those doing their part to make the country safe by getting vaccinated as soon as the vaccine is available to them.”
The doctors’ critiques of Krispy Kreme’s doughnut deal sparked an outraged response from dietitians and others who decried the country’s attitude toward overweight people and how doctors talk to patients with obesity.
“I’m horrified,” said Elyse Resch, a nutrition therapist based in Beverly Hills, Calif., and the co-author of “Intuitive Eating.” “It’s an oppression. Weight stigma, fat-shaming, fatphobia — it’s oppressive, like every other oppression in the world. And it’s so wrong. We all deserve to have satisfaction in our eating, and having a doughnut is a delicious thing.”
Resch described the physicians’ pushback against free doughnuts as “ridiculous and useless.” She believes that body-shaming and weight discrimination have ballooned during the pandemic, spurred in part by research indicating that a higher weight is linked with an increased risk of severe covid-19 illness. (Those findings have been widely debated, and another recent study found that a high body mass index was not associated with different outcomes for covid-19 patients on ventilators.) As millions of Americans become eligible to be vaccinated because they’re classified as obese — prompting public shaming over the perceived advantage — it’s a particularly fraught topic.
“I think it’s really sad that health professionals are putting out the message that eating foods just because you enjoy them is a bad thing,” said Lindo Bacon, a professor and researcher at the University of California at Davis and author of the book “Health at Every Size.” “We’re seeing the message much more intensely that Americans are eating badly and that this is harmful to us, and we’re seeing very strong messages that we’re supposed to be eating differently. Doughnuts can be part of a healthy diet, and they can be part of keeping people happy.”
Vaccination issues aside, weight stigma isn’t new. And, both Resch and Bacon said, fat-shaming often comes directly from health-care professionals. As one Twitter user put it in the wake of the Krispy Kreme controversy, “I’m glad all of Twitter has now had a taste of how doctors speak to fat people.”
“I’ve had clients tell me how they’ve walked out of offices sobbing because doctors made negative comments about them,” Resch said. She added that she recently had a similar experience with a doctor she was seeing for the first time. “We’re DNA-programmed for size and shape, and people are going to be what they’re meant to be. Truly the biggest harm to health is weight stigma.”
Research suggests that weight bias in medicine is prevalent and harmful. One review noted that patients with obesity “experienced contemptuous, patronizing and/or disrespectful treatment from health professionals,” including verbal insults and inappropriate humor. Such experiences can reduce the quality of care patients get, lead to poor trust and communication, and dissuade patients from seeking treatment when they need it. In addition, according to the National Eating Disorders Association, weight stigma can lead to depression and poor body image, as well as increased likelihood of binge eating and disordered eating.
Yoni Freedhoff, an obesity medicine specialist in Ottawa, said that weight bias among doctors is common. “It’s a problem among every community,” he said. “None are spared.”
In his opinion, Krispy Kreme’s campaign is nothing more than a food company doing its job and trying to sell more food. The fact that it became a story at all is “shameful,” he said. “It perpetuates a narrative that is long-standing but really harmful and not based in fact. This whole controversy has been framed around obesity because people like to look down on people with obesity.”
While she believes “fat-shaming is unacceptable,” Marion Nestle, professor emerita of nutrition, food studies and public health at New York University, understands the sentiment behind the concerns from doctors such as Wen. “The thing about foods like doughnuts is that they encourage people to eat more of them and more in general,” she said. “[The promotion] is adorable, but it sends the wrong message. Not gaining weight is a really good idea.”
If you’re going to indulge, she said, a small doughnut is better than a big one, and best to do it as occasionally as possible.
One expert said that in this situation, a doughnut’s nutritional merits, or lack thereof, are almost a moot point. “Doughnuts aren’t really healthy, obviously,” said Eric Topol, a professor of molecular medicine at the Scripps Research Institute in San Diego. “But we have a bigger issue, which is that we don’t want people getting covid, and we want to get out of this pandemic. Anything that helps people take vaccines when they’re reluctant is a good thing. So some extra doughnuts during the course of the year? I think it’s worth it, and I’m a cardiologist.”
Danielle Ofri, a primary care doctor and author of “What Doctors Feel: How Emotions Affect the Practice of Medicine,” summed up the controversy this way. “I do think a lot of what doctors say comes across as fat-shaming — even without intent,” she said. “Everyone is just generally trying their best, but often we miscommunicate. And Twitter and social media lack the space for nuance. You have this toxic brew of exponential amplification and lack of nuance together, and that’s really a combination for disaster.”
Angela Haupt is a writer and editor based in the District. Follow her on Twitter @angelahaupt.