This article was written by Lydia Jade Turner and first published on Online Opinion.
Last week the WA state government, The Heart Foundation and The Cancer Council launched a series of anti-obesity ads in the state of WA. The ads employ scare tactics in a bid to pressure viewers into adopting a slimmer waistline. Using graphic imagery designed to provoke disgust towards fat while labelling fat ‘toxic,’ the ads inform viewers that “a grabbable gut on the outside is a sure sign there’s toxic fat on the inside.”
As an eating disorders clinician I was surprised to see such an irresponsible and harmful public health campaign. The campaign was started because previous anti-obesity campaigns have not led to desired outcomes. Nearly fifty years of research has demonstrated that approximately 95-98 percent of the population regains the weight lost after two to five years. Perhaps someone thought shouting louder was a good solution.
Yet previous research has demonstrated that harm can arise from anti-obesity campaigns, especially when young people are exposed. Unlike tobacco or alcohol which one can abstain from, food and weight issues are far more complex. Unintended consequences of slimming include binge eating, weight cycling, food and body preoccupation, reduced self-esteem, eating disorders and higher than pre-dieting starting weight .
The ads have been given a W rating, meaning they can be broadcast at any time of day, except during preschool and children’s cartoons and any programme likely to attract a child audience. While this sounds good on paper, the reality is parents will have to keep their television off at all hours of the day except during kid’s shows if they don’t want their kids receiving these fatphobic messages.
It’s not just preschoolers and children who are vulnerable. Eating disorders have increased two-fold over the past five years, and adolescents certainly fall into the high-risk category. The ads have been broadcast over a range of mediums, including landing the front page of the The West Australian. How can they not be affected?
With these concerns in mind, I started a petition on change.org, calling for the ad series to be cancelled immediately. I have since been told by some colleagues within the eating disorders field that while they agree with my views on the matter, they are unwilling to sign the petition, out of fear of losing future opportunities to collaborate with the organizations involved. I understand their views however I also feel this ad campaign is so damaging that someone must speak up.
The Heart Foundation defended the campaign in the WA Today, claiming that the advertising messages had been “thoroughly tested to ensure they are effective and unlikely to generate unintended consequences.” They also claim to have collaborated with the Eating Disorders Programme at Princess Margaret Hospital and members of the National Eating Disorders Collaboration (NEDC).
Curious as to how The Heart Foundation had tested for long term consequences, I asked Chief Officer Maurice Swanson if he could provide the methodology used to test for “unintended consequences.” Swanson suggested I meet with him to discuss “…the extensive research and informed consultation that has underpinned the development of the campaign’s messages and information resources.”
I told Swanson I was unavailable this past week as I have been moving offices, but that he should be able to provide documentation of the methodology. It has been over a week and my email has gone unanswered. Given the campaign was funded by taxpayers, surely The Heart Foundation should be transparent about the process?
I am dubious about the claim that eating disorders experts have collaborated on this campaign (with the implication that it has their approval). The resources provided to The Heart Foundation during the development of this campaign included a document titled “Evaluating the Risk of Harm of Weight-Related Public Messages” published by the NEDC – the very body The Heart Foundation claim to have collaborated with.
The NEDC’s that obesity and eating disorders share common risk factors. The researchers identified “weight bias and stigmatisation, childhood weight-related teasing, dieting and disordered eating” as shared risk factors. “Positive body image, high self-esteem, enjoying physical activity, … avoiding unhealthy dieting” were identified as shared protective factors.
The campaign’s ads hardly promote positive body image or show enjoyment of physical activity. Showing a fat man opening the fridge with the voiceover “’when you eat more than you need to and aren’t as active as you should be…” the campaign serves to stigmatize fat people by perpetuating the stereotype that all fat people are fat because they are gluttonous and sedentary.
The ad campaign runs contrary to the NEDC’s research findings, fostering negative body image and increasing risk of obesity – the very ‘condition’ The Heart Foundation claim to want to reduce. If The Heart Foundation truly collaborated with eating disorder experts, rather than taking a ‘tick-a-box’ approach and doing what they wanted to do anyway, why aren’t those eating disorder experts defending the foundation’s campaign? Who are they and why have they remained silent?
Another resource provided to The Heart Foundation states: “fear-based messages could inadvertently encourage weight and shape concerns, a simplistic view of weight and health, and weight stigma.” The same resource goes on to state: “the mass media sometimes perpetuate … prejudice, for example, by presenting obese people in a biased, stereotyped manner.”
Contrary to popular belief, research shows those who internalize stigmatization show a reluctance to exercise in public. I have had fat patients who have been verbally or physically abused while in public, because they are fat. People don’t go where they don’t feel welcome.
NEDC findings also state: “Comorbidity studies suggest … overweight and obese individuals are at higher risk of disordered eating and eating disorders than the general population .” What caution has been taken to minimize this risk? How will success be measured – will it only be contingent on the size of one’s waistline, or will disordered eating patterns be taken into account when reporting outcomes?
The claims that if your gut is grabbable on the outside, there’s toxic fat on the inside, is both untested and not based on evidence. It is very different to a campaign stating “every cigarette is doing you damage.” The public has been taught that social institutions like The Heart Foundation are trustworthy, but this is not the first time the foundation has found itself embroiled in controversy.
Fitness has been shown to be a better predictor of health than size. Healthy behaviours have been shown to mitigate many of the diseases typically associated with obesity. It’s time The Heart Foundation cancel its harmful campaign.