Rebecca Shenkman

Director of the MacDonald Center for Nutrition Education and Research | M. Louise Fitzpatrick College of Nursing Villanova University

  • Villanova PA

Rebecca Shenkman, MPH, RD, LDN, is an expert in nutrition, weight management and using food to help prevent and control disease.

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3 min

Playing "Ketchup": Kraft Heinz, Food Industry Work to Meet Evolving Consumer Trends

In September, the Kraft Heinz Company revealed its intention to split into two smaller entities—one focused on in-demand products, like shelf-stable meals, spreads and sauces, and the other on slower-growth businesses, such as the Oscar Mayer, Kraft Singles and Lunchables brands. The move is among the latest in a series of breakups and spinoffs announced by major "Big Food" conglomerates, including Kellogg's, Keurig Dr Pepper Inc. and Unilever, and experts speculate more divvying and downsizing are bound to follow. Beth Vallen, PhD, a professor in the Villanova School of Business who studies consumer behavior and food marketing, contends these demergers and restructurings are the direct result of a recent yet significant shift in shoppers' spending habits. "It is certainly a possibility that we are moving away from 'Big Food,'" says Dr. Vallen. "The companies are likely to be more agile as smaller entities, and the more targeted businesses will allow them to focus on their different market segments as we face increasingly complex consumer and macro trends in the food industry." Among the more noteworthy factors the professor cites are changes in how shoppers evaluate products and how often they make purchases, particularly amid rising costs, economic pressures and increased competition in the marketplace. When it comes to groceries, a LendingTree survey from earlier this year found that nearly nine in 10 Americans are reassessing what items they cart to the checkout lane. "Inflation and uncertainty have driven consumers to look for more value when they shop," says Dr. Vallen. "This might result in behaviors like switching to lower-cost alternatives, and along these lines, consumers are seeking out retailers with high-quality store brand offerings that might replace their typical, branded items. "Consumers are also shopping less frequently. This could be due to reliance on technology, like online grocery purchases, which requires more planning, as well as a desire to make groceries stretch between purchases to save money." Another development affecting the industry is a broader drive across the population toward health-conscious options and low-calorie meals, heightened to a degree by the rise of GLP-1 drugs like Ozempic. A recent KFF Health Tracking Poll evidences that these medications, which have been shown to promote weight loss, are taken by roughly one in eight American adults; and households with users are expected to account for more than a third of food and beverage sales by 2030. According to Rebecca Shenkman, MPH, RDN, LDN, the director of the MacDonald Center for Nutrition Education and Research at Villanova's M. Louise Fitzpatrick College of Nursing, the impact of these drugs' usage on consumers' eating habits should not be underestimated. "GLP-1 receptor agonists reduce appetite and food intake through multiple mechanisms, and evidence suggests both a reduction in snacking frequency and a shift toward healthier choices among users," shares Shenkman. "They report fewer cravings for sweet, salty and fatty snacks, particularly during the first 12 to 24 weeks of treatment. In addition, consumer surveys and clinical trials indicate increased intake of fruits, vegetables and water, and decreased consumption of processed foods and sugary beverages. "With millions of users and average daily reductions of 700 to 900 calories, demand for calorie-dense snacks could decline significantly." Among the brands and businesses at greatest risk, in Dr. Vallen and Shenkman's respective estimations, are "packaged and processed foods" as well as "sugary beverages and high-fat treats." In turn, with shoppers increasingly moving away from these "unhealthy" options and expressing an openness to dispensing with long-term staples, companies in the sector will need to emphasize adaptability in the coming years, making a conscious effort to understand customers' distinct preferences and needs. "Altogether, there are numerous trends that are seemingly pulling consumers in different directions—between health, taste, value and convenience," concludes Dr. Vallen. "Looking ahead, it will be important for firms to understand how these trends impact different consumers—and in different categories. Health likely means something different to Gen X and Gen Z and may vary further based on whether we are talking about a family dinner or a late-night treat. Taking efforts to understand consumer motivations will be crucial for companies to appropriately respond to current trends."

Rebecca ShenkmanBeth Vallen, PhD

5 min

As Popularity of Weight Loss Medicine Soars, Professionals Caution Against “Magic Pill” Mindset

A growing weight-loss fad has been dominating headlines this summer. No, it isn't a new type of trendy diet, exercise regimen or social media influencer-touted superfood. It's two medications—Ozempic and Wegovy—that have skyrocketed in popularity as more Americans turn to these once-weekly injections to aid in their weight loss efforts. But, while acknowledging the drugs' effectiveness, their intended patient populations and appropriate usage has become far more nuanced and situational, and the intended outcome of long-term weight loss and health is dependent on more than just taking either of these medications once a week. "While these medications can be helpful for some people who struggle with weight loss, it's important to remember that they are not a magic solution," said Rebecca Shenkman, MPH, RDN, LDN, director of the MacDonald Center for Nutrition Education and Research at Villanova University's M. Louise Fitzpatrick College of Nursing. First, it's important to understand the components and histories of both Ozempic and Wegovy. They are prescription medications of the same drug, semaglutide, which belong "to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed to treat type 2 diabetes," per Shenkman. It was discovered by researchers that significant weight loss was a side effect of semaglutide. Ozempic is the 2017 FDA-approved drug used to help treat diabetes. Currently, it is not FDA approved for weight loss and typically not covered by health insurance when used for that purpose, per Shenkman, but is often prescribed off label for "weight management in certain individuals who do not have diabetes, but struggle with obesity or [are] overweight." Wegovy was approved by the FDA in 2021 as an anti-obesity drug used for individuals living with obesity or individuals with excess weight, but not classified as living with obesity, who also have other associated health problems. "When used correctly, the drugs can have many benefits," Shenkman said. "[Semaglutide] is shown to improve diabetes and body weight in addition to seeing improvements in cardiovascular health and risk factors." However, "correct use" is what concerns Shenkman and other health and nutrition professionals. "Anti-obesity drugs are a valuable tool for people who have not experienced adequate benefit from self-directed or professionally directed lifestyle treatment," she said. "However, what we are seeing more and more of now is that people are requesting anti-obesity medications without meeting eligibility criteria for drug use, [such as] body mass index and weight criteria, [or] having the foundational knowledge and application of healthy lifestyle behaviors prior to medication use." To Shenkman's first point, there are several factors, especially in American society, driving those who may not meet the criteria for these medicines or even truly need them to request and ultimately receive the drugs. The media's portrayal of ideal body image is an enormous influence, which can lead to "body dissatisfaction and a desire for quick weight loss solutions," said Shenkman. Advertisements for these drugs often promote those ideas, and even downplay side effects, making them more appealing. Intrinsically tied to body image is the struggle many individuals have with psychological issues related to food, such as emotional or binge eating. "They feel that their self-worth is tied to their weight, and they will do almost anything to lose weight, whether it be five or 50 pounds." Shenkman said. "These individuals might believe that medication will help them control their eating habits more effectively." Identification of such issues prior to prescription approval is something that providers need to be aware of and screen for, Shenkman said. "It is so important for providers to complete a comprehensive pre-treatment assessment of their patients who start on weight loss medications. Unsupervised or improper use can lead to malnutrition, unhealthy weight loss or even a worsening of an undiagnosed or undertreated eating disorder or mental health condition." But even users who meet all pre-treatment criteria may be turning to the drugs in haste, or believe that they alone will solve their problems, and do so quickly. "Americans are known for having that 'quick-fix mentality' where people often seek quick solutions to their problems, including weight loss," Shenkman said. "Weight loss medications might promise faster results compared to lifestyle changes, which can take time and dedication." Compounding this "quick-fix mentality" is the frustration many feel when they fail to see results after multiple unsuccessful attempts at weight management. "The abundance of information on diets, exercise routines and weight loss programs can be overwhelming… Some may turn to medications as they seem more straightforward and require less effort to understand," explained Shenkman. But, as health care providers know, they are far from straightforward. All drugs, including Ozempic and Wegovy, come with the potential for side effects, which can vary with the individual. Headlines this summer focused on reports of users experiencing gastroparesis, described by Shenkman as the "the slowing down or 'paralysis' of the digestive system and gastric (or stomach) emptying." Though most often reported to cause nausea and vomiting, complications of gastroparesis can be quite serious. "If someone continues the medication and experiences chronic gastroparesis, complications to be aware of include malnutrition, dehydration, acid reflux, blood sugar control and even bowel obstruction," Shenkman said. The American Society of Anesthesiology also recently issued guidance on the use of such drugs prior to surgery, given potential life-threatening complications. "When prescribing anti-obesity medication, it is the responsibility of healthcare providers to inform patients about potential side effects and risks associated with the medication," Shenkman said. "It is also the right of the patient/consumer to ask questions and understand what they are putting in their body. A thorough discussion about benefits and possible adverse effects can help patients make informed decisions about their treatment." Many users may also not fully understand that these drugs are usually taken long-term, even after reaching a desired weight. Stopping without the knowledge of how to keep the weight off may lead to its return. Considering the pros and cons of the drugs, Shenkman's advice is simple. "Weight loss medications should always be used as part of a comprehensive weight management plan, which includes a balanced diet, regular physical activity and lifestyle changes. Relying solely on medications without addressing other aspects of weight management is not likely to lead to long-term success no matter how long you stay on a medication."

Rebecca Shenkman

3 min

The Rise of "Don't Weigh Me" Cards

Stepping on the scale is an inherent part of the American healthcare experience. But does it have to be? Healthcare professionals and patients say not necessarily. For patients struggling with mental health, eating disorders, or other body-related concerns, being forced to step on the scale may cause significant distress. Because of this, the "don't weigh me" card has become increasingly popular. Born from the desire to make a trip to the doctor a more inclusive, less stressful experience, the cards sit in waiting rooms across the country and allow patients to discreetly make a choice: Would I like to be weighed today? Similar in size and shape to a business card, patients may grab a card and hand it to the provider before the start of the appointment, indicating the patient should not be weighed and that any discussion around weight should only occur if permission is given. According to Rebecca Shenkman, MPH, RDN, LDN, director of the MacDonald Center for Obesity Prevention and Education at Villanova University, "to be effective and emphatic providers, it is important to ensure a safe and comfortable environment and for the patient to feel seen and heard—and one such way is asking permission to be weighed (if the medical situation does not require a weight)." "This shows patients that their provider respects their voice and choice” Shenkman says. "'Don't weigh me" cards are a tool that providers should recognize as a good 'pause button' that allows them to re-center patient care on the individual and not have a conversation guided by a scale number or attribute certain symptoms or conditions to weight." Healthcare providers may express weight biases that prevent patients from receiving effective care. The provider may correctly or incorrectly attribute a patient's health concerns to weight and overlook additional factors not correlated with obesity. And while obesity is certainly a chronic and progressive medical disease that should not be ignored, there is more to a patient than a number on a scale. "A barrier to effective healthcare utilization is the prevalence of weight bias towards individuals with obesity. A first step to reducing bias is to acknowledge the issue exists and to recognize one's own biases, which may intentionally or unintentionally result in unfavorable behaviors and attitudes towards individuals with obesity," says Shenkman. While communication about weight-related health is important and many times necessary, to center the dialogue on weight alone means missing out on other potential issues. "By letting patients lead the conversation, having an open dialogue and practicing shared decision-making, and approaching the discussion around eating habits and weight-related behaviors within the broader context of health, patients are likely to be more receptive to medical advice given and seek future care." When patients are allowed to choose to be weighed, they are empowered to make their own decisions surrounding their care. "Don't weigh me" cards help provide peace of mind and a comfortable environment for all people, allowing providers to act more effectively and patients to seek out effective care more often.

Rebecca Shenkman
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Areas of Expertise

Childhood Obesity
Diet and Behaviors
Nutrition & Disease Prevention
Nutrition & Lifestyle Changes
Weight Management

Biography

Rebecca Shenkman, MPH, RD, LDN, is an excellent quotable source on healthy eating and how to use food to help prevent and control disease. She can speak to how men, women and children can tackle these problems by planning ahead for meals, incorporating new foods into one’s diet and increasing physical activity to live improved, healthier lives.

Education

Aramark Dietetic Internship

RDN

New York University

MPH

University of Pennsylvania

BA

Affiliations

  • Member of the Academy of Nutrition and Dietetics
  • Member of the Weight Management Dietetic Practice Group of the Academy of Nutrition and Dietetics

Select Media Appearances

Medical Phenomenon: Ozempic's Impact on Fertility Issues Leading to Unexpected Pregnancies

MDLinx  online

2024-03-28

The connection between weight and fertility is an established one. Obesity affects hormonal levels and can cause excess estrogen, leading to irregular menstrual cycles. “Obesity can have a significant impact on fertility,” says Rebecca Shenkman, MPH, RDN, LDN, Director of the MacDonald Center for Nutrition Education and Research at Villanova University. “Evidence shows that the risk of infertility has been shown to be threefold higher in women with obesity than in women without obesity. Overweight women and women with obesity need a longer time to conceive. The impact of obesity on reproductive function is highly attributable to dysregulation of hormone mechanisms such as lower production and circulation of hormones needed for optimal fertility potential.”

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From Meds to Mindset, Tips on Dieting and Nutrition

KYW Newsradio "In Depth" Podcast  online

2024-01-18

Guilty pleasures, genetics, and access to quality food are just some of the factors that make maintaining a healthful diet so challenging. Two nutrition experts - Rebecca Shenkman and Tracy Oliver, both from Villanova University’s M. Louise Fitzpatrick College of Nursing - share insights on how to combat and contextualize diet and nutrition-related issues like obesity, while offering strategies about how to improve your lifestyle.

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No One Likes the Flu, but These 25 Foods Might Just Help Your Body Recover Faster

Parade  online

2020-08-01

Rebecca Shenkman, director of the MacDonald Center for Obesity Prevention and Education at Villanova University says to “try putting a few slices of raw ginger root in boiling water if you experience nausea or vomiting when you have the flu.”

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Select Academic Articles

Psychological safety and perspectives of standardized patients living with obesity

Clinical Simulation in Nursing

Tracy L. Oliver, Rebecca Shenkman, Lisa K. Diewald, Maggie Ahlfeld, Gail E. Furman, Bette Mariani

2025

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Unveiling Lived Experiences: Exploring the Health and Lifestyle Effects of COVID-19 on Healthcare Workers.

Nutrients

Shenkman, R.; Diewald, L.; Murray, M.B.; Oliver, T.L.

2023

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Weight bias reduction intervention among nurse practitioner students using simulation-based experiences.

Journal of the American Association of Nurse Practitioners

Oliver, T. L., Burrell, S. A., Furman, G. E., Diewald, L. K., Mariani, B., Starck, M. R., & Shenkman, R.

2023

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