Opinion Piece: OB_S__Y

Are Health Campaigns Failing Us or Are We Failing Them?

Recently, two public health campaigns about obesity have come under fire for being insensitive and potentially dangerous. One of these, Change4Life, is a project of Public Health England and aims to instil a healthy lifestyle in young children, whilst educating parents on the impact their bad habits have on their family. The other was a campaign from Cancer Research UK which aimed to inform the public that obesity is a major preventable cause of cancer. Vicious arguments have lit up social media between those who have expressed their hurt and those who think people are being too sensitive. The backlash surrounding these campaigns has made me ask the question, are these campaigns failing us or are we failing them?

The Change4Life Campaign

The Change4Life campaign launched in 2009 with the aim to initially target families with children from 5-11. Due to its success, the campaign has become multifaceted with branches such as Start4Life, which is aimed at pregnant women and new parents. The 4life campaigns are all focused on providing health information to each demographic in an age-appropriate way. Their resources for children are fun, brightly coloured and explain the health risks of an unhealthy lifestyle in a non-scary but informative manner. In a clever move, they also utilise the marketing strategies that have previously used by fast food companies to appeal to children. For example, they have partnered with Disney to create fun ’10-minute shake up’ games which include much loved Disney characters. The National Social Marketing Centre reports that the Change4Life has been a monumental success and in its first year reached 99% of its target audience, 413,466 families joined Change4Life and had 1.9 million responses via the web, post, face-to-face and through phone calls.

Their most recent advert, however, has been met with angry responses from the public and from eating disorder charity Beat UK. The advert encourages children and parents to choose snacks which are a 100 calories each and to limit snacks to two a day. The advert has an accompanying jingle which sings the phrase, ‘100 calorie snacks, 2 a day max.’ Critics of the advert have argued that it equates restricting calories with being healthy and encourages behaviours which may evolve into disordered eating. The delivery of the advert has also been challenged as the jingle has been used as a Spotify advert replaying in between songs. If someone vulnerable to disordered eating were to hear this over and over it may reinforce any intrusive or compulsive thoughts that they may already be experiencing.

The Change4Life campaign as a whole has consistently delivered in providing a holistic view of nutrition which by no means champions calorie counting as the be all and end all of health, but this particular advert ignores other important factors involved in choosing snacks, such as satiety and nutritional impact. For example, A 100 calories of chocolate and a 100 calories of chicken have the same calorie count but are vastly different in terms of protein content and amounts of saturated fat. The campaign also ignores the idea of activity levels affecting calorie requirements. Eating disorder charity, Beat, released a statement which argued that ‘It is important that messages aimed at reducing obesity consider the impact they may have on individuals at risk of developing an eating disorder’ and asked that ‘Public Health England to listen to concerns about the impact this campaign could have on those at risk of developing an eating disorder and change the campaign to focus more on healthy eating rather than calorie counting.’ Beat has publicised petition against the Change4Life ‘100 calorie snacks, two a day max’ campaign and a response video made by blogger and eating disorder survivor Tallulah Self.

Cancer Research UK

The second campaign which has come under fire is Cancer Research UK’s obesity campaign, which aimed to raise awareness of obesity’s link to preventable cancers. As part of the campaign, Cancer Research UK put up billboards featuring the word obesity in a hangman style with some letters missing. Underneath the word, the advert asks readers to guess what the second largest cause of cancer is, after smoking. An online torrent of criticism was spurred by comic Sofie Hagen labelling the advert as fatshaming, saying, “Right, is anyone currently working on getting this piece of s*** CancerResearchUK advert removed from everywhere? Is there something I can sign? How the f***ing f*** is this okay?” One twitter user even suggested she would stop any support of the Cancer Research charity if they did not remove it. The angry response to the campaign has been visceral and heated and this was only furthered by those mocking those who expressed their hurt on social media.

The billboards are designed to raise awareness of an objective fact, and a fact which the UK’s public didn’t know. There is a lack of nuance and complexity to the advert, but how much nuance can you put on a billboard? If you google the campaign, the page features detailed information about the cancers linked to obesity and how to make healthy changes to reduce your risk. As the site explains, the cancers to which obesity is linked, such as oesophageal and pancreatic, are complex and difficult to treat. Not making the public aware of this for fear of backlash would be unethical. People should know the risks of obesity, just as they know the dangers of smoking.

The advert itself succinctly highlights the response to it — the word OBESITY presented with gaps in place of some letters. It is these gaps which are filled by the viewer of the advert. Those that feel that it is fat shaming are filling that space with their previous experiences. Whilst the advert itself is an objective fact (studies and data are provided on the campaign’s website), we live in a culture where those who are overweight are bullied, whether it be in the school ground or the workplace. Another fact that Cancer Research UK’s research has discovered; fat shaming is not conducive to weight loss and ‘may even exacerbate weight gain.’ Perhaps if there were less bullying be it on the playground or elsewhere, the campaign may have produced a different response.

Cancer Research UK have stood by their campaign, stating that there were no plans to change their campaign surrounding obesity’s link to cancer and that “This is not about fat shaming. It is based on scientific evidence and designed to give important information to the public. Only 15 percent of people are aware that obesity is a cause of cancer. Cancer Research UK has a duty to put that message in the public domain” (PR Weekly, 2.3.18).

What now for health campaigns?

The response to Change4Life’s campaign highlights the need to include an element of sensitivity these campaigns, especially where children are involved. One sentence highlighting other aspects of choosing healthy snacks, such as protein or vitamin content, could have made a world of difference. The mode of transmission is equally important too – to have that jingle repeating over an over through a vulnerable person’s earphones could have catastrophic consequences for their health.

The obesity campaign merely stated a fact rather than encourage a potentially dangerous dieting method and Cancer Research UK’s response to the controversy highlights the difficulty involved in creating health campaigns. The campaigns have to be short, snappy and memorable and so there is little room for nuance. A health campaign is by definition a campaign to change the public’s behaviour and so has to be somewhat shocking or motivating. Cancer Research UK’s billboard is nowhere near as graphic as the campaigns which aim to encourage people to stop smoking. Clearly, a balance needs to be struck between a scientific neutral fact and the way that fact will be received in our society. The message of the Cancer Research UK’s campaign has been completely overshadowed by the controversy over its reception. Are we heading for a situation where public health campaigns, fearing a backlash, dilute their message to the point where they are rendered completely ineffective?

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