NEW YORK - Photos of morbidly obese people alongside a news story about the health threat from being overweight may cause moderately heavy people to think they're not at risk, a new study suggests.
"I don't know if we can realistically influence media choices," said coauthor Fiona Gillison. "But people should be aware that the more exaggerated image is making the message get through differently."
Gillison, of the Department for Health of the University of Bath in the UK, and her colleagues recruited 563 people, about half of whom were overweight or obese, for their study.
The participants were randomly assigned to read a health story about the link between excess weight and heart disease. Some stories included an image of an overweight model, others had a morbidly obese model and some had no image.
Excess weight is usually categorized according to body mass index (BMI), a measure of weight relative to height. BMIs considered to be normal, healthy weights for adults range from 18.5 to 24.9, which would include, for example, a 5-foot 5-inch person who weighs no more than 149 pounds.
BMIs considered overweight range from 25 to 29.9, representing weights between 150 and 178 pounds for a person of the same height. A BMI of 30 or greater is considered obese and a BMI over 40 is severely or morbidly obese.
Considerable research shows that health risks ranging from diabetes and heart disease to cancer increase when a person is overweight and only worsen with obesity.
For the study, the photographs were framed similarly to average media images or stock photos, which are usually a shot of the body - not including the head - of an overweight or obese person in tight fitting clothing walking toward the camera on a city street.
Among those who read the articles accompanied by photos of a morbidly obese person, both overweight and obese participants interpreted the risk described to relate to a larger person than did similar readers who saw no image.
Image choice did not seem to affect whether the readers thought the message was relevant to themselves, however.
For healthy-weight readers, image choice did not make a difference either way, the study authors report in the European Journal of Public Health.
The study was conducted entirely online, with participants recruited via newspapers, online health forums and social media. Researchers relied on them to self-report their own body size.
"Research has long acknowledged the powerful influence of message framing on audience understanding of an issue and more recently has turned to the images and video content in online and traditional news media and the effect visual portrayals of various body sizes can have on beliefs and attitudes," Dr. Aoife De Brun, research associate at the Institute of Health & Society at Newcastle University, told Reuters Health by email.
Image choices in the media can promote stereotypes that are not necessarily helpful for combating obesity, Gillison said.
"Very often the images are quite stigmatizing, the person is often sitting down with a donut or with fried food," she told Reuters Health by phone. "That's portraying an image of people who are fat because they have no self control."
She and her team used images of people walking, not eating, to try to combat that in a way, she said.
"Promoting more modestly overweight people may have more impact, you think 'oh this person is like me,' which is what you're trying to achieve," she said.
Just reading one article with one image was a very low-level intervention, and it didn't seem to change how readers perceived their own risk, but that could change with more stories and more images, she added.
"I think the media needs to be more sensitive about their portrayals of all people in the images they use, including individuals considered 'obese,'" said Nicole M. Glenn, who was not involved in the study.
"They de-value particular embodied ways of being, marking them as 'abnormal,' deviant and unacceptable and these are then taken up within our everyday understandings and filter through to our individual, societal and cultural practices," she told Reuters Health in an email.
Glenn is a postdoctoral fellow in the Department of Social and Preventive Medicine at the School of Public Health at the University of Montreal.
"Obesity is a societal problem that needs a broader approach than solely focusing on the individuals - so we know now that extreme images may be a barrier to adequate risk estimation and we will need to consider consequences on a societal level," Claudia Sikorski told Reuters Health in an email.
"Less extreme, less stigmatizing images are desirable in general," said Sikorski, a researcher at the IFB Adiposity Diseases at Leipzig University in Germany, who was not part of the new study.
"We're all exposed to these images every day," Gillison said.