Communicating about obesity

In brief

To cultivate a deeper understanding of obesity and its systemic sources, we wanted to understand how people currently perceive obesity. This report outlines findings from research conducted in Southwark and Lambeth by the FrameWorks Institute to identify the ways people in these boroughs think about obesity. It helped to inform our framing toolkit, which aims to help re-shape the narrative on children’s health.

Executive summary

In the London boroughs of Southwark and Lambeth, discussions about health and what it means to be healthy inevitably turn to the topic of obesity. People readily discuss body mass index (BMI) measures and healthy eating, argue that poverty makes people more likely to be obese and express support for the sugar tax introduced in April 2018.

Because these everyday conversations reference concepts from health science, social science and public policy, it is easy for advocates to assume that people grasp obesity as a public health issue. Yet the analysis in this report will show that there is still important work to be done to build a more accurate understanding of obesity in Southwark and Lambeth. People do see many pieces of the obesity puzzle – including some of the relevant ecological factors – but they tend to arrange them into a picture of individuals failing to overcome challenging circumstances.

This report outlines the findings of this initial stage of communications research, yielding a provisional strategy for framing obesity as a systemic issue, building public understanding of obesity and boosting support for evidence-based policies and programmes to address it.

While more research must be done to understand which specific reframing strategies can be most effective for future communicators, the following recommendations offer a provisional strategy that advocates can use now to improve their communications practice.

• Tell systems-level stories. Communicators should tell stories about obesity that position social structures and environments as protagonists and antagonists alongside individuals – rather than stories that use isolated examples of the trials and tribulations of individuals and families
• Avoid restating misperceptions or myths about obesity, and never talk about them early in a communication. One of the most important predictors of whether an idea is believed to be true is the number of times people have heard it
• Avoid crisis messaging. Rising rates of obesity in the United Kingdom are often framed as an ‘epidemic’ or a ‘pandemic’ caused by a ‘tsunami of risk factors’, and issues within the NHS are called an ‘emergency’. Crisis themed language like this is common in social change communications, often reflecting advocates’ sense of urgency for change and the assumption that ringing the alarm bell will lead people to respond with action. Social science – including studies by FrameWorks – has shown that, in fact, crisis messages often backfire, leading people to conclude that the problem is too big to solve and nothing can be done
• Avoid the terms normal and abnormal when discussing individual behaviour, weight status or environments. The concept of normality presupposes its opposite – that there is something that is abnormal
• Be careful when talking about the normalisation of obesity in Southwark and Lambeth. Currently, members of the public see the normalisation of obesity as something that happens to ‘other’ people, communities and cultures. For this reason, when discussing the risks associated with a normalisation of obesity in the boroughs, communicators should avoid linking normalisation to specific communities, because this is likely to cue stigmatising thinking
• Explain what obesity prevention means, to avoid cuing individualistic or fatalistic thinking. Without context, members of the public in Southwark and Lambeth are likely to assume that ‘obesity is preventable’ means ‘people need to behave more responsibly, earlier’
• Use step-by-step causal chains to explain how social determinants affect obesity in Southwark and Lambeth. Explaining the causal links between different social and environmental factors, and how they affect obesity rates, is critical for expanding the public’s understanding of their role. For example, communicators might explain – in a simple, step-by-step fashion – how limited access to quality education can ‘stack the odds against someone’
• Provide examples of health creation and an integrated approach to reducing obesity rates to broaden people’s view of solutions. Examples must illuminate the role that health-creating policies and community empowerment can play in reducing obesity rates in the boroughs and the United Kingdom – for the whole population

In collaboration with