Why Health Messages Fail: Lessons from the Australian Fast-Food Industry
Population health priorities in the West have been dominated by overweight and obesity since the World Health Organization’s declaration of obesity as a global “epidemic” in the 1990s. Yet despite several decades of health campaigns designed to promote healthy eating, increased scrutiny of food choices has, paradoxically, contributed to growth in markets for “unhealthy” or “extreme” food products that resist appeals to health. This poses challenges to finding effective health communication strategies to combat this significant public health problem.
Stacks of Fat
The situation in Australia offers some instructive lessons. In 2008, the Australian government formally announced obesity to be a national health priority. This resulted in a greater number of obesity-related policy and prevention initiatives, as well as increasing media coverage about the “problem” of obesity. (My research found an approximate 20-fold increase in obesity-related news between 2000 and 2008). Also during this time, major fast-food chains launched two of their most successful month-long burger promotions: Hungry Jack’s (Burger King’s) Quad Stack, a 1,080-calorie hamburger consisting of four beef patties, four slices of cheese, two slices of bacon, and 71grams of fat; and KFC’s Double Down, a sandwich that replaced a hamburger bun with two deep-fried chicken fillets, cheese, bacon, and barbeque sauce, and provided eaters with 32 grams of fat and 540 calories.
Australian fast-food outlets tend to be more conservative in their portion sizes than the United States, so both burgers were considered “extreme” in the Australian context in terms of their fat and calorie content. They generated significant media controversy, with nutritionists, dieticians, and health professionals criticizing the burgers as irresponsible food choices during an obesity epidemic. Moreover, the news and current affairs reports that featured these criticisms further emphasized the undesirability of the Quad Stack and the Double Down by featuring pictures of greasy, sloppy, misshapen burgers, and images of eaters nauseated by their encounters with such seemingly repulsive food.
Yet the burgers were a resounding success. The Double Down was so popular in the southern Australian state of Tasmania that it sold there for six weeks, rather than the four weeks that originally had been planned. How did this happen? How did two burgers that so thoroughly rejected accepted nutritional advice gain such popularity among consumers?
My research found that the success of the burgers can be, in part, attributed to the way that their marketing campaigns deliberately courted controversy. The Quad Stack was launched only a couple of months after obesity was announced as a national health priority, so Hungry Jack’s and its advertising agencies would have undoubtedly been aware of the potentially controversial timing for the release of such a nutritionally transgressive burger. But rather than explicitly engaging with issues of health and nutrition, the advertising campaign for the Quad Stack utilized Hungry Jack’s traditional marketing strategy of targeting young male consumers by using humor and appealing to their masculinity. Simply put, the Quad Stack was marketed as a challenge. The television commercial featured a circus troupe with the smallest male performer struggling to wrap his mouth around the enormous burger.
The advertising campaign for the Double Down similarly focused on the masculinity of the burger and its consumers. Print, online and television advertisements dubbed the sandwich, somewhat lightheartedly, as one of fast food’s “manliest” burgers, emphasizing male bonding and framing women as an unwelcome intrusion and “fun police” trying to restrict men’s freedom.
These advertising images of men enjoying the challenge of eating the Quad Stack and the Double Down contrasted sharply with the news and current affairs coverage of the two burgers. Disapproving women featured disproportionately in the media coverage. The men who appeared sometimes expressed positive attitudes toward the burgers, but women were negative without exception. The health professionals interviewed were mostly women, and those shown to be repulsed by the burgers also were predominantly female.
This is significant because these media representations conform to a broader set of cultural ideas in which interest in nutrition, dietary restraint, and caution about what one eats are culturally coded as feminine, while risk, rebellion, and resistance are culturally understood signifiers of masculinity. Indeed, from extreme sports to extreme music, the positive revaluing of risk and transgression is now a key characteristic of marketing strategies used to promote “extreme” products, services, and practices to men.
Consequently, if condemnation of the burgers is feminized, but these products are marketed as masculine—and, at least in the case of the Double Down, utilize ideas of women as fun police who restrict men’s freedom—some of the unintended consequences of the health-related criticisms of fast food start to become clear.
Lessons for Health Communication
Health campaigns that adopt a negative approach—telling people certain food choices are “bad” and should be avoided—can potentially sow the seeds of their own resistance. Negative messages can inadvertently feed into the factors motivating consumption of foods that resist or reject accepted dietary advice, and can assist in maintaining markets for “transgressive” or “extreme” food products that resist appeals to health. Indeed, the popularity of both the Quad Stack and the Double Down was driven in part by the controversy they generated.
The success of the two burgers offers instructive lessons for those involved in health communication and health promotion. A negative approach focused on telling people what not to eat or condemning certain foods simply doesn’t work. In fact, such an approach offers effective advertising strategies for those seeking to market “unhealthy” foods as vehicles for masculine resistance to (feminine/feminizing) authority.
With obesity rates continuing to rise in the West and rising faster in Australia than in any other OECD country, and with health-related criticisms contributing to the popularity of “unhealthy” foods like extreme fast-food burgers, anti-obesity campaigners urgently need to consider adopting more positive, less puritanical health communication strategies that have proven successful in other areas of health promotion such as sexual health. For example, kitchen garden programs promoting cooking from scratch using fresh, home-grown ingredients, or initiatives focused on encouraging local, seasonal eating—that is, initiatives focused on the pleasures of food, rather than on the negative consequences of “bad” food choices—are much more readily able to resist becoming fodder for savvy marketers seeking to use controversy to boost the desirability of “extreme” food and much more likely to result in lasting change in people’s dietary habits and their relationship to food.