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In the fight against obesity, even framing the right message can be challenging | Column
As obesity rates continue to rise rapidly in the United States and many other countries, health experts wonder how to convey more effectively the seriousness of the crisis to the public. While many seem to be resigned to the fact that the world population is getting heavier, the growing numbers of obese people are burdening health care systems in unprecedented ways.
Societies around the world are woefully unprepared for the changing realities and lack the resources to meet the coming challenges. Insurers and healthcare providers warn that the additional costs of treating millions upon millions of overweight patients are unsustainable.
Yet, despite the flood of obesity-related health messages in recent years, it has been proven difficult to create a sense of urgency in the public’s perception of the issue. One study found that obesity-related media campaigns can be perceived as motivating but also as discouraging and even stigmatizing.
When participants in this study were asked to view obesity awareness programs from the U.S., England and Australia and rate them based on their responses, most favored positive messages that recommended making small improvements over negative ones that laid blame squarely on the lack of personal responsibility.
But not everyone agrees with taking a soft approach. “A shock of recognition” is in order because we “need to understand that obesity is a national health problem, one that causes lethal diseases, shortens lives and contributes substantially to rising health care costs,” warns Dr. Daniel Callahan, a bioethicist and cofounder of the Hastings Center, a think tank specializing in bioethics in the public interest.
A report he authored recently, titled “Obesity: Chasing an Elusive Epidemic,” has quickly evoked fierce protests from obesity acceptance and antidiscrimination advocates, mainly because of his suggestion that social stigmatization and shaming could be a useful tool in the fight against the obesity epidemic. Similar measures, he points out, have been highly successful during the anti-smoking campaigns a few decades ago.
Trying to get the obesity crisis under control has turned out to be “the most difficult and elusive health problem this country has ever encountered” Callahan laments. Addressing it effectively requires profound changes in our personal behavior but also in the ways we allow food and beverage commerce to operate. The respective industries spend billions of dollars on marketing less-than-healthy products, often aimed at children, and on lobbying to prevent much needed regulations from being enacted.
There are limits to how much government can do to influence people’s behavior. But government can impose regulations and taxes to coerce both industry and consumers into making changes that can produce desirable results over time.
And here we can indeed take cues from the anti-smoking crusades. For instance, we don’t allow smoking in most public areas and means of transportation any more. We certainly don’t allow cigarettes to be sold to minors. We no longer have cigarette advertisements on television. Placing warning signs and sometimes deterring images on cigarette packages is mandatory. High taxes on tobacco products have made them less affordable.
Considering how dramatically smoking has declined in this country, these measures have turned out largely successful.
The question is whether there will be enough political will to take similar steps towards the causes of obesity. For instance, can we agree to ban fast food outlets from residential areas? Can we forbid the sale of junk food to minors unaccompanied by adults? Can we outlaw TV ads for snacks and sodas, at least during daytime hours? Can we impose high taxes not only on sodas but also on unhealthy foods and snacks to curb consumption? Can we require warning signs on packaged foods containing unhealthy ingredients?
Proposals like these may sound radical and outlandish now. But the same was said about the smoking restrictions we take for granted today. Some of the measures mentioned here are in fact already being experimented with. What’s most important is that we finally convey a consistent message that doesn’t confuse us any longer about what we should and what we shouldn’t do.
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book "The Healthy Diner – How to Eat Right and Still Have Fun"®, which is available on her blog and at amazon.com. For more articles on nutrition, health and lifestyle, visit her blog, "Food and Health with Timi Gustafson R.D." (www.timigustafson.com). You can follow Timi on Twitter, on Facebook, Google+ and on Pinterest.