Slimming America’s waistline: Are we fighting obesity or obese people?

With over two thirds of Americans now overweight or obese, public health campaigns have emerged across the country to promote behavior that can help reduce America’s waistline. But do the messages communicated by these campaigns help reduce obesity or potentially make the problem worse?

According to a new study by the Rudd Center for Food Policy & Obesity at Yale, the public responds more favorably to obesity-related health campaigns that emphasize specific health behaviors and personal empowerment for health, rather than messages that imply personal blame and stigmatize those who are obese. The study, which appears in the International Journal of Obesity, is the first to systematically assess public perceptions of anti-obesity public health campaigns, and suggests that certain types of messages may lead to increased motivation for behavior change while others do not. 

Researchers conducted an online experimental study with a national sample of 1041 Americans. Participants viewed campaign messages from national and highly publicized public health campaigns to address obesity. They were asked to rate characteristics of each campaign as positive or negative and state whether they felt motivated to improve their health or stigmatized by the campaign’s message. 

Campaigns rated most favorable and motivating were messages that promoted specific health behaviors, such as increased fruit and vegetable consumption promoted by the national “5-A-Day” campaign; more general health messages such as the First Lady’s “Let’s Move” campaign which encourages Americans to “Learn the facts, eat healthy, get active, take action”; and campaigns that attempted to instill confidence and personal empowerment regarding one’s health. Interestingly, note the researchers, campaign messages rated most positive and motivating made no mention of obesity at all.

In contrast, anti-obesity campaigns that already have been publicly criticized for promoting shame, blame, and stigmatization toward individuals struggling with obesity were rated most negatively by the study participants, who rated them as the least motivating for behavior change. Participants expressed less of an intention to act upon the messages’ content. Among those campaigns rated, the worst was the Children’s Health Care of Atlanta Campaign to address childhood obesity, which featured billboards portraying obese youth with captions such as “Being fat takes the fun out of being a kid,” and, “Chubby kids may not outlive their parents.”The authors assert that messages intended to motivate individuals to lose weight may be more effective if framed in ways that promote specific health behaviors and confidence to engage in those behaviors, rather than messages that imply personal blame.

“By stigmatizing obesity or individuals struggling with their weight, campaigns can alienate the audience they intend to motivate and hinder the behaviors they intend to encourage,” said lead author Rebecca Puhl, the Rudd Center’s director of research. “Public health campaigns that are designed to address obesity should carefully consider the kinds of messages that are disseminated, so that those who are struggling with obesity can be supported in their efforts to become healthier, rather than shamed and stigmatized.”