Weight of the Nation, BBC1, 5 January; Fat Free, BBC1, a 6 part documentary series, from 7 January; Fat Files, BBC2, a 3 part Horizon documentary, from 7 January
This is the big one for obesity—the BBC’s largest ever health campaign, with 30 dedicated programmes in seven weeks, plugs everywhere on local and national radio and TV, and a registration scheme aimed not just at providing information but at “motivating behavioural change.” The BBC has even informed every health authority in the hope of getting health professionals across Britain “on message.” Throw away the scales. Never say diet. It’s the small but permanent changes to eating and activity that are the key to getting fit and feeling great.
The BBC has been down this way before. Terry Wogan launched a Fight the Flab radio campaign in the 1970s and admitted to miming pull ups over the microphone. In 1993 Wogan fronted The Health Show, a live, celebrity led extravaganza on BBC1 with Dr Hilary Jones. The cornerstone programme of this year’s campaign, Weight of the Nation, took a similar line, but the roles of plump presenter and thin doctor were reversed, with Dale Winton taking over from Wogan and Dr Ian Banks filling Dr Jones’s shoes—with a bit to spare.
Studio pundits confessed their fad diets (“cabbage soup—I lost three pounds and all my friends”), and a team of “fat busters” sorted out five rotund men at Longbridge social club and a working mother with 2 stone to lose. All felt much better in a few months with the help of a nutritionist and a sports scientist, although TV must take some of the credit. The Hawthorne effect is never so great as when 7 million people are watching.
This was classic “infotainment”—upbeat presentation, soundbite information transfer, and the attention on empowerment. The main message (move more, eat healthily, diets are for dodos) was reinforced in Fat Free, a series of video diaries. “The day I started dieting I’ll live to regret till the day I die,” said Tracy. She had lost 7 stone on Lipotrim, a liquidised food replacement, but was still unhappy (“I’ve gone from being morbidly obese to just clinically obese”). Whereas Weight of the Nation was entirely jolly, Fat Files acknowledged the emotional strain of obesity. Terry had an unhealthy relationship with her scales and was devastated to find that she had put on 2 lb (“basically, I eat crap food all the time .... I tried porridge but I couldn’t cook it, and bran flakes taste disgusting”). And Shaun, a Glasgow trucker with a 44 inch waist, was less than impressed with his first ever healthy meal (“cauliflower cheese and pasta—is that it?”).
In Horizon’s Fat Files, we were treated to some truly empowered fat people—and that was the way they wanted to stay. The Padded Lilies, a water ballet troupe of large American women, were adamant: “This is my natural look—what my predecessors gave me.” Dr Stephen O’Reilly confirmed that some obese people have predetermined appetites that override their will power and desire to diet: “They are not weak willed, sloth-like, or lazy. They have a genetic defect.” The slow metabolism theory is long dead, but the discovery of defects in the use and production of leptin lent strong support to a genetic cause. The Padded Lilies were unimpressed. “How dare anyone say I’ve got a defect .... I should be accepted as I am,” said one. Others agreed: “We’re spheres, we’re here, we’re fat, that’s that....”
Well, almost. This campaign has programmes pitched at every level, and the sheer volume is recognition of the fact that, if health education works at all, it’s by slow drip, with lots of repetition. On each occasion, viewers and listeners are encouraged to phone for a self help pack (0897 55 00 55). The pack costs £2 (research had shown that people don’t value what they don’t pay for—NHS, take note) and provides practical advice and reinforcement. However, what distinguishes this campaign from its predecessors is that BBC Education has linked up with University College London’s Health Behaviour Unit and been given a £30 000 grant from the British Heart Foundation to evaluate it.
In the past, programme makers have judged success by ratings and the number of information packs sent out. No objective attempts have been made to assess if the campaigns have worked, and, given that £2m of public money has gone on this one, it’s to the BBC’s credit that it is trying to find out if it is well spent. Anyone who phones the helpline is asked to register his or her eating and activity details and is followed up over at least six months. The research will look at the characteristics of those who register and stay with the programme, estimate health benefits and the factors that influence them, and assess campaign penetration by using questions in the Office for National Statistics’s omnibus survey. Weight of the Nation may not change much, but this could be a watershed in the evaluation of medicine and the media.
Figure.
Dale Winton—enjoying food