Posted by: ezzakazhall | August 2, 2012

Baby, it’s toxic inside…

Last time, we talked about the Victoria State Government removing obese children from their families. Now, it appears that the Western Australia Government has invited itself to the anti-obesity party, with the launch of this advertising campaign, supported by the Heart Foundation and the Cancer Council.

As you’ll see from the above link, the advertisement follow in the footsteps of anti-smoking ads (such as the Every Cigarette Is Doing You Damage), actually take the viewer inside an obese human body to view a build-up of “toxic fat” around the internal organs.” The print ads use the tagline “a grabbable gut on the outside means toxic fat on the outside”. The TV ads feature an overweight gentlemen grabbing his stomach while taking a piece of pizza from the fridge, and also a woman about to grab two bags of chips from a supermarket shelf (note: the woman with the chippies isn’t actually fat. But, obviously she will be if she buys the chips. Obviously).

As this ABC news broadcast mentions, the ads have had a “mixed response”. In particular, Australian eating disorder specialist Lydia Jade Turner has created an online petition to have the ad campaign pulled, stating that the tactics used will trigger obsessive behaviours and disordered eating, particularly in young Australians. Said Ms Turner in the ABC article:

“With this subjective hand grab of the gut, we can imagine young people imagining a layer of fat there that perhaps isn’t there, and engaging in harmful weight loss behaviours in a bid to appear healthy…

“I treat people with eating disorders, and that’s why I speak out about this campaign.”

However, ABC also interviewed Professor Amanda Sainsbury-Salis, an expert on obesity at Sydney University, says she finds the ads “sensible”, they are “just telling it like it is” and that the ads depict healthy behaviours that can contribute to a healthier body weight. These include, says Prof. Sainsbury-Salis:

“…don’t stand in front of the fridge eating pizza. Another message in the ads is if you can walk to the shops, do so, instead of driving. Another message is don’t pick up two big bags of chips in the supermarket and buy them because they’re two for the price of one.

“These are behaviours that are very healthful and which will promote healthy body weight, healthy metabolic profile in all people.

“So there’s nothing in the ads in terms of weight management behaviour that would promote or which is known to promote or which is known to promote eating disorders.”

A couple of the ads are featured on Lydia Jade Turner’s Body Matters Australia blog. I wouldn’t watch them with any food nearby, but that’s just me.

As far as the eating disorders issue goes, Ms Turner makes some decent arguments in the above blog post against the ad campaign. Some of the salient points she mentions in her post are:

1) Research has shown that from anti-obesity campaigns can cause harm more harm than good, to children and young people in particular.  The article Ms Turner cited from the Oxford Health Education Research Journal states that, “The vast majority of overweight children and adolescents know that they are fat and subsequently develop a poor body image and a fear of food, as do many normal weight youth who incorrectly perceive themselves to be ‘too fat’… Health education messages about overweight and weight control are likely to make young people feel worse about their bodies and themselves in general.”

Given that the ads in Western Australia will be shown at any time of the day, including in the middle of the kid’s cartoon shows, the ads will almost certainly be getting a younger audience. And, if the Oxford journal is to be believed, this campaign has the potential to trigger body image issues and a fear of fat in young people. As Ms Turner also stated in her post, eating disorder rates have doubled in the past five years, and children and adolescents are most vulnerable.

2) The Australian National Eating Disorders Collaboration provided information to the Heart Foundation during its consultation phase, which stated that obesity and eating disorders share common risk factors, including “weight bias and stigmatisation, childhood weight-related teasing, dieting and disordered eating”. The NEDC stated that shared positive factors were “positive body image, high self-esteem, enjoying physical activity, and avoiding unhealthy dieting”. Problem is…there are no incidences of positive body image in the ads, and Ms Turner states that the ad featuring the man eating pizza “serves to stigmatize fat people by perpetuating the stereotype that all fat people are fat because they are gluttonous and sedentary.” Given the NEDC has identified weight-bias and stigmatisation as a risk factor for eating disorders, stereotyping the overweight may not be the best advertising tactic in this case.

3) She goes on to mention another resource provided to The Heart Foundation, which states that, “fear-based messages could inadvertently encourage weight and shape concerns, a simplistic view of weight and health, and weight stigma.”  On this note, she mentions research which shows those who internalise weight-related stigma are reluctant to exercise in public.

Prof Sainsbury-Salis stated that the ads promote healthier behaviours, such as walking to the shops, rather than driving. However, if the shock tactics used result in internalised stigma for those targeted, then they’re not going to want to be seen walking anywhere. In addition, as I mentioned  in this post, studies by the University of Columbia in NYC show that those who are unhappy with their size (regardless of weight) are more likely to experience poorer health outcomes than those who are not. So, internalised stigma may not only result in a lack of exercise, but also in reduced overall health.

4) Finally, Ms Turner mentions that NEDC research into the risks of anti-obesity campaign’s also states that: “Comorbidity studies suggest … overweight and obese individuals are at higher risk of disordered eating and eating disorders than the general population.”  As stated above, the Oxford journal research has shown that anti-obesity campaigns can lead to disordered eating in children- and eating disorders can certainly stretch on into adulthood.

Prof Sainsbury-Salis did acknowledge that the importance of researching the link between anti-obesity campaigns and eating disorders, particularly in young people. However, as Ms Turner stated on her online petition, the impact of the ads on teenagers (one of the most at risk groups) was not tested before the ads went to air. Also, she alleges the Heart Foundation claimed it has “collaborated” with the NEDC in making the ads- when, in fact, the NEDC never endorsed the ads.

I will say (and I have stated this before) that I fully support the endorsement of healthful behaviours. Here in NZ, for example, we have the Push Play campaign, which encourages kiwis to do at least 30 minutes of exercise a day, and had a series of ads displaying ways people can be more active (eg, taking the stairs at work, or playing with your kids outside). We also ran a series of ads, endorsed by our Ministry of Health, which encouraged families to adopt a healthy lifestyle- such as providing healthy snacks for kids, eating meals together as a family and encouraging kids to help with meal preparation. I personally would rather see these kind of adverts, which actually encourage small but sustainable changes, than ads for weight management companies, such as Jenny Craig (with whom Dame Edna has not jumped on board).

As far as the ads in Western Australia go- while Prof Sainsbury-Salis insists they promote healthy behaviours, they seem to be promoting a lot more “donts” than “dos”. Don’t stand in front of the fridge eating pizza. Don’t let your kids sit around playing video games. Don’t buy chips just cos they’re on sale. But what to do instead? Do cook up a nutritious and tasty dinner for your family, and eat it around the table together? Do take the kids out to kick a ball around the park? Do buy a giant bag of apples on special in place of the chips? At least that’s one thing the other major Australian public health campaign, Swap It, Don’t Stop It, has it in its favour: it actively promotes healthy choices, rather than all-out banning less healthy ones (that, and it uses cute balloon people and animals on its website).

Something I’d like to see is a lot more promotion of healthy choices ahead of supposed obesity prevention. In fact, a study by the American Board of Family Medicine has found that healthy habits lead to healthy bodies, regardless of body size. So, if this study is correct, the focus needs to be on endorsing greater health and wellbeing, not weight loss. And less of a focus on shock tactics and inspiring fear in larger people- which may, if all Lydia Jade Turner’s research is to be believed, may encourage less than healthy behaviours in the long run.

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