Advertising and Obesity: A Behavioral Perspective

"Concern over the levels of obesity observed in Western countries has grown as researchers forecast a rapid growth in the medical care that a progressively more obese population will require. As health workers deal with increased incidences of diabetes and other obesity-related disorders, policymakers have examined the factors contributing to this problem. In particular, advertising that promotes high fat and high sugar products to children has come under increasing scrutiny..."

This 15-page article explores the role that advertising plays in reinforcing and normalising behaviour, presenting an analysis of how marketing contributes to obesity. According to the authors, advertisers have rejected claims that advertising contributes to this health problem by arguing that it cannot coerce people into purchasing a product, and does not affect primary demand. This reasoning, the authors claim, is deeply flawed; they use behaviour modification theory to show why. In addition to examining the "fast-food" industry's promotions, they review the New Zealand government's response to obesity and suggest policy interventions that they believe would foster healthier eating behaviours.

In the introductory sections of the piece, the authors explore the debate swirling around advertisers' rights and responsibilities, and the media attention that this debate has generated. In short, health lobby groups in New Zealand have stepped up their call for official bans on fast-food advertising during children's television programmes, among other measures. As the authors explain, advertisers have reacted strongly; their arguments against restriction of their marketing techniques are outlined here. For instance, advertisers have claimed that it is the responsibility of parents to guide their children's media use, help them interpret advertising, explain why certain food groups should be consumed in moderation, and exercise more care - and more control - when it comes to their children's consumption behaviours.

In essence, the authors argue here that advertising does not only work through persuasion, drawing on the work of theorists like Ehrenberg and his colleagues. In brief, Ehrenberg's "weak" theory suggests that advertising is a reinforcer rather than a cause of behaviour; it will support unhealthy eating behaviour, while the wide range of sales promotions employed will prompt trial and reward continued consumption. That is, by supporting the continuation of unhealthy behaviour patterns, advertising reduces the likelihood that individuals will either recognise the behaviours as unhealthy, or seek to change them. Crucially, the authors urge that removal of fast-food advertising will not eliminate obesity; however, they suggest, drawing on Ehrenberg, that advertising does create an environment in which unhealthy eating behaviours are accepted, viewed as normal, or even promoted as desirable.

In the following sections of the article, the authors stress that, to counter obesity, those responsible for health strategies need to develop programmes that change individuals' environments so that healthier lifestyles become easier to follow. They illustrate this claim through looking in depth at the New Zealand government's Healthy Eating Healthy Action Plan, and outline an alternative intervention agenda based on behaviour modification theory (BMT). In brief, this agenda would be characterised by a process that involves:

• An emphasis on regulatory and environmental change. The authors call, first, for exploring restrictions on the promotions used to support fast-food sales. (For example, the use of sporting role models by fast-food manufacturers may create the misleading impression that consumption of high-fat, high-sugar, and high-salt items is consistent with peak sporting performances). They call for more specific regulations, such as stricter regulation of school supply arrangements, which could reduce opportunities for consumption and make it easier for healthier eating habits to develop, or required modifications to manufacturing processes.
• Use of community-level social marketing interventions like the "Fruit in Schools" programme, which provide alternative food choices and set forth clear benefits or reinforcers with making these choices.
• Individual-level efforts such as "Five Plus a Day" or "VERB - It's what you do", which can, the authors say, serve as an effective concluding stage in this process of preventing obesity in New Zealand or other countries where incidence of this disease is on the rise.

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