January 2, 2012— -- "Being fat takes the fun out of being a kid," read graphics of a TV ad in which a young girl tells of how she doesn't like going to school because she's bullied over her weight.
It is part of a video and print campaign to combat childhood obesity in Georgia, which has one of the highest childhood obesity rates in the nation.
But could the ads end up stigmatizing overweight kids instead of solving the problem?
"Blaming the victim rarely helps," said Dr. Miriam Labbok, director of the Carolina Global Breastfeeding Institute at the University of North Carolina at Chapel Hill. "These children know they are fat and that they are ostracized already."
Some public health experts fear Children's Healthcare of Atlanta's Strong4Life campaign is too blunt to cultivate action. Still, the group is standing by its decision to feature the ads to raise awareness about childhood obesity.
"We needed something that was more arresting and in your face than some of the flowery campaigns out there," said Linda Matzigkeit, senior vice president of Children's Healthcare of Atlanta.
An estimated 1 million children in Georgia are considered overweight, ranking the state second in the nation for childhood obesity.
Children's Healthcare of Atlanta chose the straightforward approach after its survey of two towns in Georgia found that 50 percent of parents did not know childhood obesity was a problem and 75 percent of parents with obese children did not think their child was overweight.
"If we do not wake up, this will be disastrous for our state," said Matzigkeit.
She said the health system often sees children come in with adult health issues like heart disease and joint pain that can be attributed to their weight.
"We are hearing parents say that it's time we do something about it," she said.
Sedentary lifestyles and the availability of processed foods over fresh foods are contributing to weight issues in children. In Georgia, cutbacks on school nutrition programs, physical education classes and recess could also be contributing factors, Matzigkeit said.
But certain variations of the ad may not be doing much to fix the problem, some experts argued. They pointed to one print ad, in particular, that says, "It's hard to be a little girl if you're not."
"While guilt and fear are motivators, they have to be meted out with the answer to the situation," Labbok said. "The ads with the children do not offer help to them."
According to health communication experts, successful public health campaigns offer a clear call to action. Labbok says the Georgia ads address the problem, but don't give viewers a clear solution.
More physical activity, breastfeeding, consuming fresh foods, limiting television viewing and decreasing consumption of sugar beverages are all actions that could potentially turn the tide on childhood obesity, according to the U.S. Centers for Disease Control and Prevention.
"There is no mention about what a parent can do other than to say 'stop sugarcoating the problem,'" said Dr. Lori Feldman-Winter, professor of pediatrics at the Robert Wood Johnson Medical School.
But Dr. John Morton, director of bariatric surgery and surgical quality at Stanford University School of Medicine, said the ads are a crucial first step in addressing the issue of childhood obesity.
"To change deep-seated social and physiologic behavior like eating will require enormous work, and these ads will help the family start thinking about prevention," said Morton.
The current ads are the first in a series of phases estimated to be a total $50 million project. The campaign is geared toward parents and caregivers of children who have control over their diet and physical activity.
Stormy Bradley's 14-year-old daughter, Maya, was one of the young girls featured in the ads. Bradley, 40, of Atlanta, said she's had discussions with her daughter about weight and about healthier eating.
Maya wanted to take part in the ad to draw awareness to the issue, Bradley said.
"We knew they were going to be controversial," Bradley added. "But from my point of view, it was necessary to spark a conversation."
But there is another aspect of the campaign raising questions: One of the television ads portrays Maya as having diabetes when, in reality, she does not.
"I don't think it takes away from the credibility of the ad because the emotions and the things she says are similar to what someone who could have the health issue would have," said Bradley, adding that her daughter had high blood sugar levels. "I think she's a face they can relate to."
But the situation may cross an ethical line, according to Timothy Edgar, graduate program director in health communication at Emerson College.
"I would be concerned that if somebody finds out that she doesn't have diabetes, that it could undermine the campaign," said Edgar.
Public health campaigns that have been successful often portray real people with real problems. While the current ad implies a real public health issue, the dramatization by an actor could weaken the message, Edgar said.
Weight issues are among the top reasons why some children are bullied, and some critics said the campaign also singles out the overweight child and could potentially exacerbate the bullying.
"At what point should looking out for their health mean losing the fun of being innocent and young?" one person wrote on the campaign's Facebook page.
Matzigkeit said the children featured in the ads have all been offered nutritional counseling. Maya was paid for her contribution and also took advantage of the counseling.
"This is not about how somebody looks, it's a serious medical issues," said Matzigkeit. "And if they don't believe me, I offer them to come see our clinic."
Bradley knows that discussions about weight can be uncomfortable because she, herself, is battling weight issues.
"This has made her more conscientious about the actions we choose," said Bradley. "You can hate it or love it, but you're still talking about it."