Tease Out: Being Mean Won't Solve Childhood Obesity

[youtube]http://www.youtube.com/watch?v=1t_H_DBHmGQ&

“Fat kids become fat adults” may sound like the taunt of a schoolyard bully. But if you live in Georgia, it’s an expression you might see pasted on a billboard. Or printed on a flyer. Or featured in a TV commercial.

In fact, it’s just one of many slogans used in a series of Atlanta ads featuring five overweight (actor) kids: Meet Bobby, Maritza, Tamika, Tina, and Jaden. In one uncomfortable television commercial, Bobby asks, “Mom, why am I fat?” Bobby’s mom sighs and lowers her head. The words “75 percent of Georgia parents with overweight kids don’t recognize the problem... Stop sugarcoating it, Georgia” pop up on the screen. Tina’s glum face appears in a similar print ad accompanied by the text, “It’s hard being a little girl if you’re not.” Other ads feature chubby children with sentiments like “Big bones didn’t make me this way. Big meals did.” and “Being fat takes the fun out of being a kid.”

The ads gave me flashbacks to my seventh-grade cafeteria, so I was surprised to discover that they are actually part of Children’s Healthcare of Atlanta Pediatric Hospital’s Strong4Life campaign, a $25 million, five-year initiative designed to curb childhood obesity in Georgia. The ads seek to address a real problem—Georgia is America’s second-fattest state, with nearly 1 million overweight or obese kids. But will these shock ads provide parents and kids with a wakeup call, or merely serve up a big helping of mean with a side of shame?

Rebecca Puhl, director of research at the Yale Rudd Center for Food Policy and Obesity, thinks it’s the latter. “While these kinds of campaigns may have good intentions, they’re very misguided,” Puhl says. “There’s a legitimate concern that these ads are shaming and stigmatizing children and parents. What we know from research is that this can actually make the problem worse.”

Hear that, overbearing parents everywhere? Guilting people into change can actually make undesirable behaviors worse. Puhl, who has been researching weight bias for the past 12 years, says studies show that when children or adults feel shamed, blamed, or stigmatized for being overweight, they can eat more—even binge eat—and exercise less. All that blaming and stigmatizing also creates negative thoughts, making people susceptible to anxiety, depression, suicidal behaviors, and a generally decreased quality of life.

Puhl certainly isn’t the only person panning the Strong4Life campaign. Parents, doctors, health care organizations, and public-health experts have been lambasting the ads since Children’s Healthcare of Atlanta started running them in August.

Children’s Healthcare’s representatives say the ad campaign is just the first phase of Strong4Life—the hospital plans to roll out additional educational resources later to help Georgia families actually lead healthier lives. But it’s also sticking by its assertion that shocking ads are exactly what Georgia needs to slim down.

“The goal of our very direct ad campaign is to increase awareness of this medical crisis,” says Patty Gregory, a spokes woman for Children’s Healthcare of Atlanta. “To date, the stop childhood obesity ads have done just that—they have raised awareness of childhood obesity and launched a vitally important conversation about the issue. We have not seen evidence that these ads are harming kids. Rather, our doctors tell us they are having better conversations in their offices with families.” Gregory added that Children’s Healthcare’s research shows that only 11 percent of Atlanta residents dislike the campaign.

It’s true that Strong4Life’s ads aren’t totally out of left field—some case studies claim that “shock ads” can actually work. Montana, for example, saw teenage meth use decrease by 63 percent since the 2005 launch of the Montana Meth Project, an anti-drug initiative featuring graphic, disturbing drug-use PSAs and ads. The project has been so effective that Arizona, Colorado, Hawaii, Georgia, Idaho, Illinois, and Wyoming have implemented similar programs. New York City has also seen some success with its ads depicting soda cans pouring out sticky globs of fat rather than liquid cola.

Whether or not Strong4Life’s aggressive ad campaign is effective may not be the right question, though. Instead, we should be asking why Children’s Healthcare is pursuing a method that can harm kids and potentially exacerbate the childhood obesity epidemic when there are other tactics proven to be successful.

Take New York City: The city’s Health Department took a multifaceted approach to curbing obesity, focusing on habits instead of looks and implementing programs that boost healthy foods, eliminate unhealthy ones, and increase physical activity in schools. In addition to the aforementioned soda ads (which stigmatize products rather than people), NYC officials introduced healthier school lunches, placed calorie and sugar restrictions on school vending machine items, and even limited bake sales. The city also trained more than 4,000 elementary-school teachers on how to incorporate exercise breaks into the classroom.

The result? A month ago, the city’s Health Department announced an unprecedented 5.5 percent drop in the number of obese children over the past five years. That decrease may be small, but it’s significant—it’s the first time in decades that the city’s child-obesity rates have not increased, never mind an actual decrease.

Puhl agrees that solving the childhood obesity puzzle isn’t easy, and any successful initiative must tackle the problem from all angles. “There’s no one magic bullet to effectively address or prevent obesity,” she says. Not even a heavily-marketed, aggressive ad campaign.

Whether or not Georgia’s Strong4Life campaign will make a dent in the obesity epidemic remains to be seen. But Children’s Healthcare of Atlanta would do well to take this lesson from the NYC Health Department: It’s crucial to improve kids’ physical well-being, but it shouldn’t come at the expense of their psychological health.

Screenshot via YouTube user Strong4LifeGA