Can these Minnesota ads reduce obesity?

September 28, 2012

The ad above comes from Blue Cross Blue Shield of Minnesota's new anti-obesity campaign, which depicts obese and overweight parents setting unhealthy eating examples for their children, who are also overweight.

As anti-obesity campaigns go, its not getting the friendliest of receptions. “We’ve been shaming fat people for decades, and clearly it’s not doing anyone any good," Jezebel's Lindy West told NPR. Yale's Rebecca Puhl pointed to research suggesting that people respond better to positive messages about healthy eating rather than negative ones. 

Blue Cross Blue Shield disagrees. The health plan has spent over a decade working on prevention-related ad campaigns, and thinks these ads have a better potential to change eating behaviors than a friendly approach. I called up Blue Cross Blue Shield of Minnesota to get the back story on the campaign, which has been live for about three weeks now. 

"We have some unique resources that make us a bit different from other health plans," says Marc Manley, the insurer's chief prevention officer. "We sued the cigarette companies in the 1990s and came out of that with a $241 million settlement. We have committed investing that to work in tobacco prevention, physical activity and healthy eating."

Blue Cross Blue Shield Minnesota ran a tobacco prevention campaign in the mid-2000s, promoting a smoking quit line. With those television ads, they learned a bit about motivating behavior changes: Positive messages were okay, but more pointed advertisements worked even better to generate quit line calls. 

That does not necessarily conflict with the academic research with the research that Yale's Puhl conducted, showing that positive messages were better liked. That study only measured their intention to change behaviors, not whether they actually followed through with a change. Separate public health research - such as this study on calorie labeling in fast food restaurants - suggests that there's a disconnect between an intention to eat healthy and actually doing so. 

"We had different kinds of ads with some that were very supportive and explained what the quitline was about," Manley says. "But the ads that really made the quitline light up were much more direct, talking about the example smokers were setting for their kids."

The health plan aimed to generate a similar response with these two new ads, both of which show parents setting unhealthy eating examples that their children then follow. There's the ad above, that depicts grocery shopping, and also the one below, set in a fast food restaurant. 

Both ads use actors who are overweight, a choice that Manley says was intentional. "Our intent was to show normal people doing normal things in these ads and then suddenly having the realization that might not be the right thing, he says. "We picked the people we picked because two-thirds of Americans are either overweight or obese.

"We're not used to seeing heavy people in ads," Manley continues. "But we wanted to show normal people, and the reality is, this is what normal looks like right now." 

Manley says that the ads have received a positive reception locally and have only seen criticism on the national level. "It's gotten some attention, but I think people here were a little less surprised because they're used to Blue Cross doing things like this," he says.

And either way, the ads have launched the conversation that Blue Cross Blue Shield Minnesota hoped to begin. 

"I think many people have a sense that weight is not really a serious problem," says Manley. "We wanted people to be talking about that idea. And now they are." 

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