The face of a smiling, chubby little girl is appearing in ads all around California, but the little girl is actually much thinner and healthier.

The public service ad by First 5 California features an overweight girl drinking sugar with a straw, but the ad has been criticized because the child model's weight was digitally altered to make her look fatter.

"They are taking a perfectly healthy little girl and Photoshopping her to make her look unhealthily obese," Adweek media reporter Emma Bazilian told ABC News. "It's no surprise that people are outraged at that."

People like Marilyn Wann, author and an activist in the fat acceptance movement, took her outrage straight to the Internet, asking on her Facebook page, "How creepy is it to Photoshop this child in this manner? If public health messages lie like this, why should people trust them?"

The agency behind the ad says the goal is to start a dialogue about healthy eating.

"This campaign serves to educate parents … on the realities and dangers of childhood obesity and get them to change their behaviors," First 5 spokeswoman Lindsay VanLaningham said in a statement to ABC News.

But it's hardly the first childhood obesity ad to turn into a giant controversy.

Children's Healthcare of Atlanta used real overweight kids in a campaign designed to attack Georgia's childhood obesity epidemic, a tactic some people called downright mean.

"If you use real kids, you're going to be called fat-shamers," reporter Bazilian said. "On the other hand, if you take this kid and you Photoshop them, it's really a no-win situation."

But the latest ad, with its enhanced chubbiness and all, shows one thing is clear: People are talking about childhood obesity, which appears to be the point.