What are some of the problems with obesity-related public health campaigns?
Anti-obesity messages are everywhere – in news, in entertainment, and in public health campaigns. We are constantly being told that fat is bad for us, and we need to lose weight in order to be healthy. Obesity-reduction strategies in the form of community-based interventions and social marketing campaigns often emphasise the desirability of an ideal body weight through dieting and physical exercise. However these messages don’t necessarily improve our health, and they certainly don’t appear to result in weight loss. Instead, popular ideas about fatness and health may inadvertently stigmatise the individuals they intend to help, and may be a risk factor in the development of eating disorders (Schwartz & Henderson, 2009).
A well recognised potential downside of the community-based programmes and social marketing campaigns targeting obesity is their promotion of the social desirability of thinness, and the undesirability of being overweight. These messages may be harmful to some people, particularly adolescents who face the strongest social pressure to be thin.
By focusing on weight as the problem and weight loss as the solution, social and economic inequalities are made invisible. Health disparities between groups are blamed on individuals for not making “healthy” choices. Furthermore, the emphasis on individual responsibility amounts to a form of victim blaming that allows structural inequalities to remain unaddressed. Individuals who don’t or aren’t able to lose weight are branded as non-compliant. Overweight people are seen as having a “bad” attitude, with little thought given to genetic or environmental factors, or the presence of an eating disorder. As a result, they are perceived as undeserving of respect, dignity, or even access to medical treatment since they apparently have only themselves to blame (Sikorski, et al., 2011).
These attitudes have the opposite effect to that intended, and a cycle can develop whereby perceived stigmatisation and discrimination can increase risk of unhealthy behaviours (e.g. higher calorie intake, binge eating, less physical activity) that contribute to obesity and eating disorders. This may result in adverse psychological and health outcomes for obese individuals, and worsen negative societal attitudes toward obese persons (Puhl, Peterson, & Luedicke, 2012).
How can messages be framed to motivate rather than alienate and stigmatise those the messages are intended for?
Messages intended to motivate individuals to be healthier can be more effective if framed in ways that foster confidence and self-efficacy to engage in healthy behaviours, rather than in ways that employ personal blame or solitary effort.
This suggests that people may react more positively and feel more motivated to improve their lifestyle behaviours in response to messages that focus on the public health benefits of healthy eating and regular physical activity, rather than messages that focus on the undesirable features of obesity. Given that increased nutrition and exercise are important for all segments of the population, this approach could have a broad reach. Furthermore, these interventions have a better established evidence base and a stronger prospect of benefit (Walls, Peeters, Proietto, & McNeil, 2011).
For a better understanding of the type of weight-related public messages that should be promoted, please take a look at the NEDC publication Evaluating the Risk of Harm of Weight-Related Public Messages.
Puhl, R., Peterson, J. L., & Luedicke, J. (2012). Fighting obesity or obese persons? Public perceptions of obesity-related health messages. International Journal of Obesity
Schwartz, M. B., & Henderson, K. E. (2009). Does obesity prevention cause eating disorders? [Editorial]. Journal of the American Academy of Child & Adolescent Psychiatry, 48(8), 784-786.
Sikorski, C., Luppa, M., Kaiser, M., Glaesmer, H., Schomerus, G., Konig, H.-H., & Riedel-Heller, S. (2011). The stigma of obesity in the general public and its implications for public health - a systematic review. BMC Public Health, 11(1), 661.
Walls, H., Peeters, A., Proietto, J., & McNeil, J. (2011). Public health campaigns and obesity - a critique. BMC Public Health, 11(1), 136.
Back to top