Children’s Healthcare of Atlanta, a pediatric medical group, recently launched a highly controversial ad campaign intended to reverse Georgia’s alarming rate of childhood obesity. Second only to Mississipi, one million of Georgia’s children (40%) are overweight or obese and the pediatricians behind the campaign report seeing kids in need of knee replacements due to their obesity, as well as children with Type 2 diabetes and hypertension.
Called “Strong 4 Life,” the campaign’s television ads feature overweight children addressing the camera to discuss the negative effects of obesity on their lives. The ads end with a visual stating that 75% of Georgia parents with overweight or obese children don’t recognize the problem, followed by the tag line, “Stop sugarcoating it, Georgia.”
Here’s one such ad:
These campaign also employs billboards and bus signs like this one:
Other print slogans include “Big bones didn’t make me this way. Big meals did.” and “Fat prevention begins at home. And the buffet line.”
The Atlanta Journal-Constitution reports that the campaign will be rolled out over five years at a cost of $50 million, of which half is to be raised from third parties. The Blue Cross and Blue Shield of Georgia Foundation has already contributed $95,000 toward the campaign.
Reactions have been heated, with some experts worried that ads will result in even greater stigmatization of obese children. There’s also the concern that guilt and shame are relatively ineffective tools to encourage behavioral change. As Rebecca Puhl, director of research at Yale University’s Rudd Center for Food Policy and Obesity, said on yesterday’s Time magazine’s Healthland blog:
Childhood obesity is absolutely a public health problem, but this really just makes the problem worse . . . . When people feel stigma or shame, it only reinforces behavior that leads to obesity.
Interestingly, though, Dr. David Katz, editor-in-chief of the journal Childhood Obesity, took a somewhat more positive view of the campaign. Quoted in the same Time blog post, Katz said:
Getting this out of the shadows is potentially healthy . . . . Sometimes you’ve got to be a lightning rod if you want sparks to fly.
When I first saw the billboards with their provocative slogans I was, like most people, truly appalled. The tone struck me as ranging from snarky to cruel, the photos seemed to be overtly shaming overweight kids, and I was prepared to write a uniformly negative post about the entire campaign.
But I confess I had a slightly different reaction when I watched the television ads. Two of them focus on the bullying experienced by overweight kids and I agree with Salon writer Mary Elizabeth Williams that this angle, while addressing a real problem, is in its own way troubling:
. . . change so you won’t get picked on? That’s a terrible philosophy, especially for the less ectomorphically inclined. Some kids will always be big, even if they’re perfectly healthy. As a Facebook commenter beautifully explained, “Just wanted you to know that you’re doing a horrible thing. Fat kids shouldn’t stop being fat because they get bullied. It’s the bullies that should be stopped.”
But I was surprised to actually tear up while watching some of the other ads. I’m referring to one titled “Tina” in which a young girl discusses her hypertension and a second one (“Martiza”) in which we hear a mother’s voice explaining why she never thought her “thick” daughter had a problem until she developed diabetes.
Studies support the central concern of the Strong 4 Life campaign, which is that parents do tend to overlook or ignore unhealthy weight gain in their own children. (And they can overlook their own obesity as well. For more on obesity-denial, read this NPR story from Mississippi.) And while parents are certainly not solely responsible for their children’s weight gain (there are a multitude of factors at play, as we learned earlier this week discussing “The Fat Trap”), parents are indeed responsible for getting their children the medical attention and intervention they may need.
So while I would never condone the aspects of this campaign which could be seen as hurtful or shaming, I do understand and support the underlying motivation for it. There are many reasons why parents might not seek help for an obese child, from negligence to guilt to a belief that the extra weight is actually “healthy” (a not uncommon view in some communities), but these children are at risk, physically and often psychologically. If a parent won’t advocate on their behalf, isn’t a wake-up call needed?
Here’s my question to you: if the campaign could be tweaked to remove the shaming or potentially stigmatizing elements, would you be in favor of it? Or is the use of images of overweight children in this way never OK? Let me know what you think.
[Ads aside, I was a little disappointed in the quality of information provided to parents who are motivated by the ads to visit Strong 4 Life's website. Under each discussion topic, from exercise to fast food, there are only a few rather superficial "quick tips" and no additional links (e.g., to local public health organizations or food and cooking sites) for parents seeking more concrete guidance.]
[Corrected on 1/5/12 to remove the description of Dr. David Katz as "former FDA commissioner." In my haste to post I mixed up my Katz with my Kessler!]