On billboards in Mexico City and other cities, the campaign against childhood obesity draws attention by showing a girl with a single-scoop ice cream cone and, in a digitally modified image making her more corpulent, the same girl with a three-scoop cone. The slogan reads: “Between overweight and obesity, there is only one step.” The same dynamic is replicated with a young man and a hamburger. Other illustrations feature bulging bellies with tacos al pastor painted on them, asking: “How many (tacos) are you going to eat?”
Meanwhile, the IMSS released an image on social media, where, in a cartoonish style, two individuals with visibly high BMI are depicted—one eating a hot dog with devotion, and the other kissing his biceps. The message is: “Megarexia: Denial of obesity.” Among the symptoms listed: people with overweight or obesity who perceive themselves at their ideal weight, feeling thin and healthy despite being obese. As for causes, it is stated that there is no specific cause, but it affects men and women equally. Prevention strategies include: “From childhood, with educational measures: combat denial of overweight and promote the importance of having an ideal weight.”
It is evident that the problem of overweight and obesity in children and adults has gotten out of hand. It is clear that the strategies implemented so far have had little or no effectiveness. What is not evident is that we have yet to learn the appropriate risk communication strategies. What is problematic about these campaigns?
First, in the case of the IMSS campaign, people with these conditions are portrayed in a ridiculing manner. Having obesity is anything but something to be mocked. The stigmatization of obese individuals is a serious issue in our society. More and more children are bullied at school because of their overweight or obesity. The point about the importance of fighting obesity should not be to reinforce stigmatization.
Second, in both campaigns, obesity is treated as if it were merely a matter of “overeating” and “weight.” Overeating is only the tip of the iceberg. Focusing campaigns solely on weight reduction leads to erroneous perceptions about the importance of weight as just one indicator (among many others) of body composition. Suggesting as a prevention strategy to combat denial of overweight and highlight the importance of ideal weight has fundamental and formal problems. Formally, because there is no single “ideal weight,” but rather a range that varies according to different conditions. Fundamentally, it seems that the prevention strategy is about the what, not the how. How can I promote in a child the absence of denial about overweight, if this is always experienced through school bullying?
Focusing campaigns on the number of tacos or ice cream scoops a child eats shows that we still do not understand that the problem is not reduced to consumption. Honestly, tacos al pastor are not to blame. To top it off, the term “megarexia” does not yet have a scientific basis with extensive publications truly characterizing the so-called condition, disease, disorder, or however one wishes to classify it. It is a term coined by a Spanish nutritionist who promotes a miracle diet for weight loss. That is the seriousness of the term. In this era where society wants to medicalize everything, it turns out that now it is a quasi-psychiatric disorder. Medicalizing everything makes us lose perspective. An example of medicalization is including homosexuality as a psychiatric disorder in the Manual of Mental Disorders that governs psychiatric practice in the US. Until 1973, it was considered a disease. This is an example of how a social fact with cultural implications finds justification for discrimination in medicine.
It is not that I am against science. The problem of obesity is real. But just as efforts are devoted to running campaigns, we should dedicate efforts to the way messages are transmitted, so that they effectively fulfill their purpose, and do not misinform by perpetuating dysfunctional roles—especially remembering that obesity is, above all, a multifactorial problem.
Originally published in El Economista on August 16, 2017, in its print edition.
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— This article was originally published in Spanish by Liliana Martínez Lomelí. Translation generated with AI from the original text.