Why the ‘Change4Life’ campaign is an anti-obesity ‘nudge’ that glosses over social inequality
The rise of populist politics, evidenced in Brexit and the election of Trump, is sending shockwaves through advanced liberal democracies. Some commentators have diagnosed these developments as a protest at governments’ failure to address the deep social problems which exist in society. In particular, neoliberalism has led to a failure to address social inequality and its corollaries, partly because of fiscal austerity and partly because a creed of free market competition which fears regulatory interventions (even to curb industrial practices that are demonstrably harmful, like the over-production of cheap fat and sugar-laden foods). Unwilling or unable to pay for the spiralling (health and other) costs resulting (directly and indirectly) from these social inequalities, governments eschew social investment in favour of social blame. It is in this context that the concept of ‘nudge’ has gained currency among political elites in the UK and elsewhere. In this commentary I critically examine its use in anti-obesity policy and question the efficacy and morality of an approach which subtly reinforces lines of social inequality through its policy messages.
‘Nudge’ draws on the theory of behavioural economics developed by psychologists Amos Tversky and Daniel Kahneman in order to shape civic behaviours towards more desirable ends while retaining individual freedoms. Rejecting the idea of the citizen-consumer as ‘rational utility maximser’, behavioural economics argues that irrationality, bias, and just plain laziness play a key role in shaping our decision-making behaviours. Chicago academics Richard Thaler and Cass Sunstein propose its application to public policy as the ‘real third way’, designed to ‘help the less sophisticated people in society while imposing the smallest possible costs on the most sophisticated’. In effect, this approach diagnoses widespread social problems (obesity, ill-health, poverty, criminality) as being in large measure a matter of individuals’ irrationality and inability to make decisions which are in their own and society’s best interests, thereby effectively posing a risk to the (social and economic) security of nations. As political strategy Nudge seeks to persuasively articulate this diagnosis of the problem and to then exhort (certain) individuals to wrest control back from the clutches of their ‘inner lizard’. Meanwhile the UK government’s ‘Nudge Unit’ develops policy interventions designed to enable people to make the ‘right’ choices. Such interventions range from changing default options (e.g. pension enrolments or organ donations) to the use of carefully crafted messages with ‘government acting as a more effective ‘persuader’ [in the context of] an agenda of enhanced personal responsibility’. This type of message-management has been the nudge of choice in relation to obesity policy in the UK.
In light of increasing population-level obesity, the context for this policy field is one in which obesity is seen as a social problem which is ‘on the move’ and must be stopped before it reaches ‘epidemic’ proportions. This is the politics of futurity, of pre-emption. The prime policy targets, therefore, are future potentially obese adults – today’s children. Anti-obesity policy in effect construes children as a disease risk. More specifically, in the case of the ‘Change4Life’ social marketing campaign, it is northern working class children who are construed as the threat, whose risky lifestyle behaviours should be recalibrated (to match those of the middle classes?). This targeting of a specific social demographic is accomplished very subtly, through voice and language style in a long-running TV campaign comprising short cartoon adverts. They offer the viewer a window into the lifeworld of the ‘typical family’ whose unhealthy lifestyles are acted out by colourful plasticine cartoon characters (courtesy of Aardman Animations, creators of Wallace and Grommit). The formula is repeated throughout the twenty-three adverts that have been broadcast since 2009: a disembodied voiceover delivers a confessional narrative about their unhealthy lifestyle involving too little exercise and too much (junk) food. This is then diagnosed as a policy problem by drawing on a biomedical discourse about the disease risks of such a lifestyle (Type 2 diabetes, cancer, heart disease). The policy solution in each case constitutes a suggested behaviour change (eating less and exercising more) accompanied by various incentivising merchandise (branded stickers, charts, recipes, vouchers) available if viewers sign up to the Change4Life website. It is noteworthy that a key index used by the government to measure the success of this campaign is numbers signing up to the website.
Change4Life claims to be a collective, national movement, but subtly targets an already disadvantaged social demographic. The first person narrator in the adverts, delivering their ‘unhealthy’ confessional and self-diagnosed behaviour-change is one or more children (or adults in the case of alcohol consumption). The accent is in most cases typically Lancashire (in one case closer to Yorkshire); the language informal and colloquial. Both regions are among the highest for obesity prevalence by local authority in England. The cartoon world is ostensibly anonymous and generic, but through subtle language choices certain viewers are invited to identify more than others. In a typical advertising technique, the ads end with a different voice (the symbolic ‘voice of government’) marking the transition back to the ‘real’ world of the viewer through direct address, exhorting us to ‘(sign up to) Change for life, now’. Throughout these adverts the use of personal pronouns ‘we’ (whose reference, semantically, often includes the viewer) encourages identification with the narrative, drawing the listener into the problematised lifestyles, while direct address (‘you’) invites active engagement with this ‘collective movement’ in a discourse which belies what is actually a decidedly individualistic framing of obesity.
Change4Life contributes to the persistence of an ‘individual blame’ approach to public health by distorting and simplifying scientific evidence on the ‘systemic’ nature of increased obesity prevalence. The adverts reframe in simplified, emotionally manipulative language, the obesity health risks proposed by the epidemiologists who authored the 2008 ‘Foresight’ report. The report uses an ‘obesity systems map’ to explain the diverse environmental, biological and socioeconomic factors that coalesce in producing increased obesity prevalence. Nevertheless it places the individual victim of ‘passive obesity’ at the centre of this system, locking her into psychologically entrenched behaviours. This opens wide the policy door for a lifestyle nudge and limits governmental responsibility for addressing the socioeconomic causes of obesity to the realms of individual behaviour change. Foresight also uses statistical modelling to predict the health consequences among the adult population, while acknowledging uncertainties about the implications of childhood obesity for later life. Change4Life nevertheless places children centre stage in its framing of obesity as a threat to society and is accompanied by a national child measurement programme. The adverts deliberately avoid discussing ‘obesity’, as this was considered to be potentially alienating, and instead talk about ‘fat in the body’. This permits the distortion of scientific claims. The primary category of calculation in the Foresight report is ‘obesity’ and future prevalence (by 2050) is cautiously predicted at 25% of those under 20. By contrast the adverts claim that ‘9 out of 10 kids today would grow up with dangerous amounts of fat in their bodies’. Despite the acknowledged uncertainties about future trends, this claim is forceful in its epistemic certainty – no ‘could’ or ‘might’ here; rather ‘we woke up and realised that’. This is a much more shocking claim and is possible because it does not specify the age range involved and expands the category of calculation from the (relatively) well-defined ‘obesity’ to the ill-defined ‘dangerous levels of fat’. Distortions of this kind are interwoven with emotionally manipulative language about ‘horrid diseases’ and ‘loving our kids’, thereby invoking parental fears and guilt and feeding into wider societal anxieties about the most fundamental and intimate aspects of daily life: parenting, eating, health and wellbeing.
The ‘Obesity Systems Map’
‘Nudge’ is the popular name given to libertarian paternalism; the self-styled ‘real third way’ which sets out to address the social problems arising from laissez-faire neoliberalism by reclaiming a role for governments as ‘effective persuaders’, educating individuals into making better and healthier (in every sense) life choices. Change4Life represents one such educational campaign. It attempts to pre-empt future problems by acting upon present behaviours, treating children as future, potentially obese adults. In subtly targeting a northern (poorer and statistically more obese) demographic it implicitly acknowledges the social inequalities reflected in obesity prevalence, while retaining a focus on individualised, rather than systemic, policy solutions. At the same time the government continues to view regulatory mechanisms on the food and drinks industry as a ‘last resort’, and shows even less interest in programmes of public investment (e.g. in urban planning, regional development, transport) to address the social inequalities which underlie the uneven distribution of obesity.
Change4Life is the government’s flagship policy Nudge. Notwithstanding the involvement of commercial sponsors (including Mars, Kelloggs, Pepsi, Unilever), the taxpayer has poured millions into the coffers of M&C Saatchi in order to produce this glossy marketing campaign. Behind this policy lies a considerable weight of scientific research into the complex societal causes of obesity, providing government with an opportunity to embrace a more collective view of social responsibility for the problem of obesity. In Change4Life this opportunity is not taken, favouring instead a paternalistic intervention into the (putatively isolated) lifestyle decisions of individual consumer-citizens. With its emphasis on individual psychology, nudge effectively offers governments licence to reject fiscally expensive policy solutions to this systemic social problem in favour of individualised solutions. Through colourful cartoons, inclusive, simplified, and emotionally manipulative language, it enlists children as the ‘instigators’ of family lifestyle changes. Meanwhile the health, diet, fitness, counselling and therapy industries make billions from our malaise, anxiety, stress, low self-esteem, and (physically and psychologically) ‘unhealthy’ behaviours.
For a more detailed treatment of this subject: Jane Mulderrig (2016) ‘Reframing Obesity: a Critical Discourse Analysis of the UK’s first Social Marketing Campaign’, Journal of Critical Policy Studies