Is “Fat” a Four-Letter Word?

Time in the Sun

Dr. Pretlow teaches that obesity is not a matter of poor willpower or lack of exercise, rather it is an addictive brain disease involving certain highly palatable problem foods. It is substance dependency, and attributing it to a direct biochemical effect on brain chemistry seems unnecessary and overdone. As he says:

Fast sensory signals, e.g. taste and texture, acting on the brain are sufficient to induce dependence. For example, bulimic individuals immediately purge foods eaten, yet still become addicted to the foods.

When kids become dangerously obese, what they need is major support, preferably 12-step programs (PDF). And of course there is no intervention without first identifying the problem. Is “fat” a four-letter word? Sometimes, it doesn’t even need to be said. The implication is enough to upset people. Remember the big fuss about the childhood obesity billboards in Georgia? Is it really so horrible to remind people that “Fat Kids Become Fat Adults”?

Australians are, by and large, a straightforward and pragmatic people, and they have the world’s highest skin cancer rate. Presently, around two-thirds of the population will be diagnosed with it before the age of 70, if they live that long. The photo on this page is one of the government ads found on the sides of buses. The official literature describes the content:

Advertisement shows a surgical incision with six staples:

staple 1 — backyard cricket games
staple 2 — pool party
staple 3 — tennis with friends
staple 4 — outdoor concert
staple 5 — barbecue at Sam’s
staple 6 — surgery couldn’t get all the cancer

The government recommends that everyone protect themselves with hats, clothing, sunglasses, sunscreen, and by staying in the shade as much as possible. Or, as another public-service announcement puts it, “Slip-Slop-Slap”:

Slip on long-sleeved clothing.
Slop on 30+ broad-spectrum sunscreen and reapply every two hours.
Slap on a broad-brimmed hat that shades your eyes and face.

Are Australians outraged or insulted by the cancer prevention campaign? Do they feel shamed or stigmatized? The Advertising Standards Bureau registered a complaint about this particular ad, calling it an eyesore and visual pollution. This person felt that shock and scare tactics were being used, and that children should not be exposed to such graphic illustrations in public places, paid for by tax funds.

To which the government replied:

The target audience for this campaign is youth and young adults aged 13-24 years. The development of the campaign was based on current evidence and best practice in relation to reaching youth with a behavior change message… The image was reviewed by our Campaign Reference Group and two highly regarded, prominent melanoma surgeons who all agreed the image chosen was an accurate portrayal of a melanoma wound…. Advertisements using this particular image underwent significant testing with youth and this confirmed that the graphic imagery was necessary to convey the seriousness of the surgery and, therefore, skin cancer, and increase their perceptions that they are at risk.

The Board dismissed the complaint, and, anyway, something seems to be working. Sarah Marinos reported earlier this year that 12% fewer Australians are actively seeking to tan their skins. The big news is the decrease in the number of young people using solariums (tanning parlors), a practice that some scientists believe is many times more dangerous than browning in the sun. Of course, it also helps that the government has passed a law against kids under 18 being admitted to solariums.

In the area of childhood obesity, do we worry too much about hurt feelings?

Your responses and feedback are welcome!

Source: “Print advertisement: Don’t let your time in the sun catch up with you (1),”, 11/16/09
Source: “Australia becoming more sun smart,” body + soul, 01/22/12
Image of Time in the Sun is used under Fair Use: Reporting.

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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