Fighting Obesity or Obese Persons? Public Perceptions of Obesity-Related Health Messages

Rudd Center for Food Policy and Obesity, Yale University, New Haven, CT, USA.
International journal of obesity (2005) (Impact Factor: 5). 09/2012; 37(6). DOI: 10.1038/ijo.2012.156
Source: PubMed


This study examined public perceptions of obesity-related public health media campaigns with specific emphasis on the extent to which campaign messages are perceived to be motivating or stigmatizing.

In summer 2011, data were collected online from a nationally representative sample of 1014 adults. Participants viewed a random selection of 10 (from a total of 30) messages from major obesity public health campaigns from the United States, the United Kingdom and Australia, and rated each campaign message according to positive and negative descriptors, including whether it was stigmatizing or motivating. Participants also reported their familiarity with each message and their intentions to comply with the message content.

Participants responded most favorably to messages involving themes of increased fruit and vegetable consumption, and general messages involving multiple health behaviors. Messages that have been publicly criticized for their stigmatizing content received the most negative ratings and the lowest intentions to comply with message content. Furthermore, messages that were perceived to be most positive and motivating made no mention of the word 'obesity' at all, and instead focused on making healthy behavioral changes without reference to body weight.

These findings have important implications for framing messages in public health campaigns to address obesity, and suggest that certain types of messages may lead to increased motivation for behavior change among the public, whereas others may be perceived as stigmatizing and instill less motivation to improve health.

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Available from: Rebecca M Puhl, Nov 24, 2014
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    • " Weight stigma is harmful and counterproductive in efforts at weight loss. Puhl et al. (2013) showed that stigmatizing campaigns designed to promote public health were no more effective than neutral campaigns in terms of instilling motivation for lifestyle change. Further, stigmatizing campaigns were rated as inducing less self-efficacy in a large sample of adults, regardless of BMI. Even well-meaning motivational approaches, su"
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    ABSTRACT: Because body weight is largely seen as controllable, weight stigma—the social devaluation of those who are overweight—is not subject to the social norms that condemn open expression of racism and sexism. Indeed, rejection of peers based on perceptions of excess weight is normative. Since weight stigma is internalized, popular views (and often the views of physicians) have suggested that increasing the salience of weight stigma might produce a reduction in overeating and/or an increase in physical activity. However, that perspective is not rooted in scientific evidence. Recent randomized controlled designs demonstrate that stigma may promote overeating. Correlational evidence suggests that self-reported stigma experience is associated with risk for binge eating and decreased interest in physical exercise and dieting, for children and adults. In addition to reviewing these research studies, this paper examines the potential for intersectionality of stigma across multiple social identities and considers alternatives to stigmatizing weight loss interventions.
    Full-text · Article · Jan 2016 · Appetite
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    • "There were gender preferences for ToV and message content for alcohol and weight control components. This finding is consistent with previous work that found obesity-related health messages may be perceived as stigmatizing and instilling less motivation to take action[22]. "
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    ABSTRACT: Background: Young adults are a particularly hard to reach group using conventional health promotion practices as they do not see nutrition messages as personally relevant to them. Text messaging (short message service, SMS) offers an innovative approach to reaching young adults to support and promote dietary behavior change. Objective: The aim of this study was to develop and test tonal preferences for nutrition text messages among young adults using focus groups. Methods: A total of 39 young adults aged 18-30 years residing in Perth, Western Australia participated in four focus groups. Participants briefly discussed their perception of healthy eating and their responses to messages about increasing fruit and vegetables, and reducing "junk food" and alcohol intake. They ranked their preference for 15 nutrition messages across 3 dietary behaviors (fruit and vegetables, junk food, and alcohol) with 5 different message tones (authoritative, empathetic, generation Y, solutions, and substitutions) and identified the messages most likely to persuade young adults to change their diet. A 5-point ranking of the nutrition messages was from the most likely to least likely to persuade (1-5). The focus groups were conducted by a trained facilitator and observer and were recorded. Data driven content analysis was used to explore themes. Tonal preferences and potential motivators were collated and frequencies presented. Results: Participants ranked offering substitutes (29%, 11/39) and using empathy (22%, 9/39) as the most persuasive message techniques in improving diets of young adults, with low responses for Generation Y (17%, 7/39), solutions (17%, 7/39), and authoritative (15%, 6/39) tones. Females were more likely to consider substitution messages persuasive (35%, 7/20) compared with males (22%, 4/19). A greater proportion of males compared with females considered authoritative messages persuasive: (22%, 4/19) compared with (7%, 1/20). There is a strong preference for a substitution tone for fruit and vegetable messages (52%, 20/39), and no overall message tone preference for junk food and alcohol messages. Substitutions were viewed as helpful and practical. Empathy was liked as it acknowledged previous efforts. Responses to authoritative tone were mixed with some feeling guilt while others found them informative. Acceptability of the solutions depended on the behavioral change and acceptability of the solution proposed. Generation Y tone had some support for junk food and alcohol messages, and if favored, was considered casual, humorous, catchy, and motivational. Conclusions: Substitutions and tone of empathy were favored as the most likely execution styles to motivate nutrition behavior change across all participants. There is no "one size fits all" with different tones preferred by individuals for different dietary behaviors. Although text messaging provides instant message delivery direct to the individual, these results demonstrate the complexity of developing motivational nutrition message for young adults. These findings reveal the importance of considering the tone and content and pretesting messages for health promotion text message interventions.
    Full-text · Article · Jan 2016
    • "In tobacco control research, 'why to quit' ads (showing graphic health effects) have been found to be more persuasive than 'how to quit ads' (supportive/encouraging messages) [18]. In contrast, obesity prevention Public health ads: weight and lifestyle campaign slogans focussed on diet and/or physical activity (with no mention of obesity) were shown to be most positive and motivating among a nationally representative sample of US adults [24] . Further research is needed to test which types of messaging for obesity prevention television ads are most motivating to audiences, or whether using a combination of these messages across different ads for a single campaign maximizes persuasive potential. "
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    ABSTRACT: This study aimed to identify and analyse the content of previously produced and aired adult-targeted public health advertisements (ads) addressing weight, nutrition or physical activity internationally. Ads were identified via keyword searches of Google, YouTube and websites of relevant government agencies and health organizations, and were eligible for inclusion if they were: in English; produced between 2007 and 2012; targeted at adults; ≤60 s; not promoting a particular commercial brand of food, fitness or weight loss product. Of the 99 ads coded, 59% featured supportive/encouraging messages, 36% presented information about health consequences and 17% focussed on social norms/acceptability issues. Supportive/encouraging messages were more frequently used in physical activity ads, while there were a higher proportion of messages about health consequences in weight ads. Execution style differed across lifestyle topics, with simulation/animation more common in nutrition ads and graphic images and negative personal testimonials in weight ads. Ads addressing weight were more likely to evoke high negative emotion and include potentially stigmatizing content. Understanding how weight and lifestyle issues have been addressed in recent public health advertising will help guide future efforts to test the effectiveness of different message types in facilitating positive behaviour changes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email:
    No preview · Article · Jul 2015 · Health Education Research
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