Public Reactions to Obesity-Related Health Campaigns A Randomized Controlled Trial

Background: Despite numerous obesity-related health campaigns throughout the U.S., public perceptions of these campaigns have not been formally assessed. In addition, several recent publicized campaigns have come under criticism in the popular media for reinforcing stigmatization of obese people. Thus, research in this area is warranted. Purpose: To systematically assess public perceptions of recent obesity-related public health campaigns in the U.S. Design: RCT. Setting/participants: The data were collected online in summer 2012 from a nationally representative sample of American adults (N=1085). Intervention: Participants were randomly assigned to view 10 obesity-related health campaigns that were pretested and publicly criticized as being stigmatizing of obese people, or 10 campaigns that contained more-neutral content. Main outcome measures: Participants provided evaluations of each of the campaigns regarding the extent to which campaigns were rated to be stigmatizing of obese people, motivating for improving lifestyle behaviors, and promoting of self-efficacy for healthy behavior change. Participants additionally evaluated the appropriateness of the visual content depicted in each campaign. Analysis was completed in 2012. Results: Stigmatizing campaigns were no more likely to instill motivation for improving lifestyle behaviors among participants than campaigns that were more neutral (OR=1.095, 95% CI=0.736, 1.630). Stigmatizing campaigns were also rated as inducing less self-efficacy (adjusted mean difference = -0.171 SD, 95% CI= -0.266, -0.076) and having less-appropriate visual content compared to less stigmatizing campaigns (adjusted difference in probability = -0.092, 95% CI= -0.124, -0.059). These findings remained consistent regardless of participants' body weight, and were generally consistent across sociodemographic predictors. Conclusions: This study highlights the need for careful selection of language and visual content used in obesity-related health campaigns, and provides support for efforts to portray obese people in a nonstigmatizing manner.