The Unintended Consequences of Anti-Obesity Public Health Campaigns

The Unintended Consequences of Anti-Obesity Public Health Campaigns

by Felicia Sanders | Edited by Chloe Park

Over 13% of adults are now categorized as obese andnearly 40% as overweight, with the prevalence of obesity having tripled since 1975. Being overweight or obese is a risk factor for several serious health concerns, including heart disease, Type 2 Diabetes, and osteoarthritis. As a result, encouraging habits that promote healthy weights among adults (exercising, eating a balanced diet, etc.) is one of the largest public health efforts today. Promoting these habits takes a number of forms, perhaps most notably media campaigns, such as the now-out-of-print campaign led by CancerResearch UK comparing french fries to cigarettes and the advertisements published by the New York City Department of Health and Mental Hygiene, telling viewers: “Don’t Drink Yourself Fat: Choose Water Instead.” 

The ethics of widespread, fear-based public health campaigns (like the anti-obesity posters from CancerResearch UK and the NYC Department of Health) have recently come under scrutiny due to their potential to harm viewers’ mental health and incite unwarranted fear in populations that are not the campaigns’ target audience. 

Though these implications on mental health have received relatively little attention from researchers, a paper recently published in the European Eating Disorders Review, “‘It makes you not want to eat’: Perceptions of anti-obesity public health campaigns in individuals diagnosed with an eating disorder,” seeks to add credibility to these claims by qualitatively  determining the potentially harmful effects of anti-obesity public health campaigns on vulnerable populations, such as those who have EDs or are at a high risk of developing one.

Although being overweight or obese is more common globally and receives more public health attention than being diagnosed with an ED, eating disorders affect at least 9% of the population worldwide, and frequently affect more vulnerable populations that are less likely to be taken seriously by medical professionals, such as people of colorLGBTQ+ patients, and youth. Biases against these groups often results in a lower likelihood that their health concerns, such as EDs, will be identified or treated.

The paper’s lead author, epidemiologist Claire Bristow of Monash University, proposes that the prevalence of eating disorders may be influenced by a combination of inadequate medical attention and media that may be upsetting, such as anti-obesity campaigns. 

Bristow and a group of researchers asked 12 participants in the study—who were either currently or in the past diagnosed with an ED—to consider how images from four anti-obesity campaigns—including those from CancerResearch UK and the NYC Department of Health—had affected them personally and how they think they may affect others.

All participants agreed that the anti-obesity media has the ability to reinforce or trigger ED thinking, and many believed that frequent exposure to the advertising could trigger EDs in new people, particularly in youth. 

In response to the CancerResearch UK image, one of the participants, Kate, described regular exposure to anti-obesity campaigns as a “slippery slope that starts promoting [the] idea in their heads, especially for younger people that are more susceptible… that… you should associate this as being bad, and that just can… over time fester and then become an eating disorder.”

The other primary concern the participants had with such campaigns was the emphasis they placed on food having a moral dimension. In response to the NYC Department of Health poster (“Don’t Drink Yourself Fat”), Anna, another participant, argued that the image “moraliz[es] the drink she’s got in her hands, and that kind of thinking is really harmful, particularly [among] people with eating disorders, [since] there is no such thing as a good food or a bad food.”

While these two concerns (triggering/promoting EDs and the moralization of food) are significant, the participants generally agreed that campaigns addressing overweight and obesity are important. Many acknowledged that the campaigns are most likely created with good intentions and could have a beneficial effect on large portions of the population.

The paper concludes with the clarification that the participants and authors are not arguing for the elimination of such campaigns but are instead  asking “government and health authorities to reflect on their current practices and create sustainable change” that will “highlight the benefits of healthy behaviors as opposed to shaming undesirable ones”, thereby “minimiz[ing] the negative and potentially detrimental impacts [obesity campaigns can have] on vulnerable audiences.”

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