Health first
Talking about childhood obesity

People assume that childhood obesity is inevitable. An issue of bad parenting and modern life, one that only affects ‘other people’. To change this conversation we need to stop reinforcing these beliefs – and tell a new story. Small changes to the ways that we speak and write about childhood obesity if applied consistently, could have a big impact.

If you’re in a rush, or just need a refresh, you’re in the right place.


What is framing

Framing an issue effectively means doing things a little differently to standard awareness raising or campaigning.

To frame an issue we need to:

  1. Know what we’re communicating into by understanding how people think and feel about this issue.
  2. Make deliberate choices when presenting information: what to emphasise, what to explain and what to leave unsaid.
  3. Trigger certain ways of thinking and bypass others – it’s very hard to argue against a feeling or belief once it’s activated.
  4. Show why it matters by aligning solutions with people’s ideals of what’s desirable and good.
  5. Show that change is possible, not that problems are huge and challenging.
  6. Give your audience ways to think differently instead of meeting them where they are.

Why we need it

People often make assumptions that make it harder to understand how childhood obesity happens, and how it can be ended.


  • Self-makingness: the idea that childhood obesity happens because parents make bad decisions and lack willpower – and is a sign of personal failure

  • Othering: the belief that childhood obesity happens to other people, in other places

  • Education as the only answer: people think that parents and teenagers need to be educated to make better health choices

  • Fatalism: obesity is seen as a crisis of modern life and an impending threat to our NHS

Here’s what the British public thinks about childhood obesity:

Read more about our research methodology and findings here

Key communication principles

  1. Childhood obesity is a serious and growing crisis in our country – it must be tackled.

    We must put our children’s health first – and act now to improve child health and wellbeing.

  2. Children living in this area are twice as likely to be obese.

    Every child deserves the opportunity to be healthy, no matter where they live.

  3. Caregivers and parents need to start making healthy choices for their children.

    Families are up against a flood of unhealthy food; pouring out from high streets, supermarket shelves, and our school canteens. We need to close the floodgates.

  4. Pester power is a genuine problem for busy parents. Children are drawn to sweets and it’s hard for parents to keep making healthy choices for their kids.

    With junk food in the spotlight – through TV ads and online content – it’s no wonder unhealthy foods play a starring role in children’s minds.

  5. I really struggle to keep my children fit and active. Every holiday the kids are sat in front of their screens – but I don’t know where else they could go.

    In my area, the healthy options just aren’t there. Our local playground was sold off a few years ago, we don’t have public spaces or a park, and the roads are dangerous. There’s nowhere for my – or anyone’s – kids to explore and play safely outside.

  6. In 2017/18, 9.5% of children aged 4-5 years were found to be obese, while one in five (20.1%) of those in Year 6 were obese. The prevalence of obesity in both age groups rose from 2016/17.

    We need to improve children’s health and wellbeing. An average of six ten year olds in a classroom of 30 is categorised as obese. We all need to ensure that our neighbourhoods provide affordable, healthy food options and places where children can run and play.

  7. This is a national crisis. Soaring rates of obesity, a major risk factor for many serious health problems like type 2 diabetes, heart disease and cancer could potentially bankrupt our NHS.

    We must put our children’s health first – and act now to stem the tide of unhealthy food that’s flooding our streets, schools and shops. Childhood obesity has become a national emergency – but one that, as a society, we can tackle.

  8. Children’s health is all-important. We need to make sure that all young people have opportunities to be healthy, no matter where they live. This means secure access to healthy food, and safe places to grow, explore and play. This means stemming the tide of unhealthy food, in our schools and in our high streets. This means putting our children’s health first.

When talking about childhood obesity

Avoid Do

Leading with childhood obesity

Start with children’s health and how we can and must improve it

Talking about the costs of obesity – or the strain obesity places on public resources like the NHS

Remind people that we should meet all children’s needs, no matter where they live

Reinforcing the belief that parents are to blame for children’s ill health

Explain how what surrounds us shapes our opportunities to be healthy, using the rivers metaphor

Normalising the idea that children naturally prefer unhealthy food

Explain how tastes are engineered through advertising, using the stage metaphor

Leading with complicated statistics or data

Selecting and properly explaining data

Focusing solely on the scale of the childhood obesity crisis

Show how change is not only necessary but possible and within our reach

Focusing on individual-level solutions, like cooking lessons or joining a gym

Tell a positive, consistent story about the changes to our surroundings that can improve all children’s health

How to use

We can bypass people’s assumptions on childhood obesity with a new story, one focused on improving children’s health. This means we:

  • Emphasise children’s health and the things that improve it
  • Explain how context shapes our options and opportunities to be healthy
  • Show that we can and must fix this.

Make this about health

We can have different kinds of conversations if we talk about improving children’s health first.

This issue frame avoids activating blame and judgement of individual parents.


With a story about the potential to create and improve health – rather than just tackle poor health – we activate and inspire support for solutions.

Not like this:

We need to tackle rising childhood obesity by decreasing the consumption of unhealthy foods and increasing children’s physical activity.

Like this:

We all need to improve the health of our children by making sure that every child can get affordable, healthy food and has opportunities to explore and play.

Here’s what this could look like in practice:

Use the fair places value

We can use values frames to state powerful, unarguable truths about our world. To state that we all believe that the places we live should meet our children’s needs. And to establish our common grounds for action – without lecturing, othering, or talking down.


When we frame children’s health as an issue that matters to all of us, we help our audiences to see how they have a role in creating change.

Use an inclusive ‘we’ – one that refers to everyone, not just your organisation or a specific group – to activate people’s sense of collective agency.

Use the value of fair places to remind people that the places we live shouldn’t restrict young people’s opportunities to be healthy

To use this values frame:

  • Focus on the characteristics of places and environments (not people) – and how these characteristics need to change
  • Evoke people’s sense of fairness around access to opportunities
  • Remind people that children should have a fair chance to thrive and be healthy, no matter where they live.

Not like this:

“It’s not fair that children and families find it hard to choose healthy lifestyles. Especially ones involved in a day-to-day financial struggle. We all need to make sure that the healthy choice is also the easiest one for families.”

Like this:

“All children should be treated fairly and have the same chances to thrive and be healthy, no matter where they live. Many families do not have access to the things children need to be healthy. We all need to make sure that our neighbourhoods provide affordable, healthy food options and places where children can run, explore and play.”

Here’s what this could look like in practice:

Use the right metaphor

We can use metaphor to explain how context shapes children’s health in straightforward, concrete ways. Metaphor bring abstract concepts to life without dumbing down.


When we use metaphor to explain – and not just assert – why something happens, we increase people’s understanding of and support for solutions.


Talk about options – not choices – to focus on our surroundings.

Use the rivers to explain how unhealthy food dominates our food environment.

To use this metaphor, call to mind external factors within a system that:

  • Is made of different elements that are not balanced
  • Is acting on our environment in ways that cause harm to families
  • If left unchecked, could cause even more harm
  • Can be mitigated upstream with the right action.

Not like this:

“Families are drowning in a tidal wave of unhealthy food. And in its aftermath, it’s impossible for parents and caregivers to make much-needed healthy choices for their children.”

Like this:

“We can improve all children’s health in the UK by working upstream to improve the flow of affordable, healthy food options and opportunities to run and play. Right now, the floodgates of unhealthy food options are open wide, and these options are overwhelming children and families.”

Here’s what this could look like in practice:

Use the stage metaphor to explain the influence of advertising on children’s tastes.

To use this metaphor, explicitly position children as the viewers of ad content that:

  • Influences in ways that are artificial and intentional
  • Acts without parental mediation
  • Could prioritise healthier options if different choices were made.

Not like this:

“Pester power puts parents and caregivers in an impossible position. Kids are naturally drawn to high-sugar, high-fat food in bright, shiny packaging – and pestering in stores shines a light on these products for parents.”

Like this:

“Unhealthy food options are in the spotlight. Aggressive advertising aimed at children and fun promotions in supermarkets cast unhealthy options in a starring role in young people’s minds. Healthier food options get lost in the background or are pushed entirely offstage. We need to set the stage for good health for all children.”

Here’s what this could look like in practice:

Put stories in context

We can add context to individual stories to show how surroundings help or harm our ability to be healthy. To make sure that our stories aren’t dismissed as the result of bad choices. And to explain why ending childhood obesity requires us to fix social systems and conditions – not people.

Not like this:

“It’s a real struggle for me to keep my family healthy nowadays. It’s hard to find healthy food at my local store, and I have to pick what works with our lifestyles – which usually means quick, cheap and filling. I do try to choose low-fat, low-sugar things where I can. And I know we all need to cut down on our takeaway treats – but they’re right there, every time I walk home from work!”

Like this:

“Like a lot of families in my neighbourhood, it can be a struggle to put healthy food on the table. The nearest big supermarket is two bus rides away. I work long hours, and look after my mum and my two boys. Compare that to the high street – there’s a flood of fast food places, and takeaways with gigantic portions everywhere you look. Fast food is cheap, it’s filling, and I can pick some up on my way home. Everyone is finding it harder to be healthy here – the healthy options just aren’t there.”

A few phrases that bring in context:

Like a lot of [working parents / people in [city] / etc], I…This support system should be for everyone who needs it[Problem] is widespread
So many parents in this community are affected by [x]…restricted my optionsWe shouldn’t be up against a tide of unhealthy food
…cut down on my / our optionsWe can all act to make sure this doesn’t happen againNot everyone in [location] has access to this support
I have support from [x]This affects / affected more than just me and my childrenI didn’t have any options
In [location], it’s harder for young people to be healthyIn my community…My options were taken away / given back when…

Put stats in context

Stats don’t speak for themselves. We can help people make sense of facts and figures by putting them in context; with values, metaphor and systems stories.

Without this context, data is often interpreted in predictable ways – and to confirm people’s existing beliefs.

Use data only to support – or bridge to – your existing content

Like this:

“Improving children’s health matters to all of us. Right now, an average of six ten years olds in a classroom of 30 has obesity. Families are up against a flood of unhealthy food options. We all need to ensure that all our neighbourhoods provide affordable, healthy food options and places where children can run and play.”


Place numbers in a social context that provides meaning – like a classroom, or playground. This brings them to life and keeps our focus on the environment. Where possible, use figures to highlight barriers (or opportunities) within our environment – like the number of public park closures or changing portion sizes.

Talk about what’s possible

Childhood obesity can seem like a problem too overwhelming to be solved. We can combat fatalism by talking about the things we can do to improve children’s health – and explaining how these solutions work.

Not like this:

“We need to act now to combat the child health emergency in the UK. There’s a tidal wave of unhealthy food options and families are drowning. Our society is already damaged – and it will be irreparably damaged for generations unless something changes.”

Like this:

“We need to act now to improve children’s health in the UK. The floodgates of unhealthy food options are open wide and our children don’t have enough healthy options and opportunities. Childhood obesity is a national emergency in the UK, but we can tackle this and help all children to be healthy with concrete steps that – if we work together – are within our reach.”


Use the 2:1 ratio – for every dose of urgency and crisis in our communications, we need to include at least two doses of “can-do”. This includes tone, as well as content.

Specific solutions are better than general ones – as long as they are proportionate to how we’ve explained the problem.

Harness power of repetition

The more people hear a frame, the more powerful it becomes.

Certain words and ideas work better than others when talking about childhood obesity. We need to keep using these words and ideas to tell a new story about improving children’s health – and avoid the ones that cause harm.

Instead of Try

Physical activity

Explore, run and play, get moving

Food environment

Options, barriers – and explain these using the rivers metaphor

Choices, lifestyles

Options, opportunities

Inequality/disparities in low income areas

The fair places value to bring these to life – e.g ‘It shouldn’t be harder for people in [area] to be healthy’

‘We need to take a public health approach to this issue’

‘This issue affects all of us – we all need opportunities to be healthy. By [doing specific action] we can…’

Preventative approach, moderation

Work upstream, balance the flow – and extend the rivers metaphor to give specific details

Encourage, inspire

Support, help, enable

Not enough physical activity/exercise

Not enough opportunities to exercise and be healthy

Framing in practice

Changing public and political understanding takes time. We need a constant drip-feed of well-framed messages and content to change hearts and minds. Here are a few ways to tailor your frames to aim, audience, and channel.

Universal policy asks

  • Make this a collective and inclusive issue that affects us all, especially young people, with a focus on improving health
  • Use the rivers metaphor to help people see that this is an issue that needs policy attention and avoid fatalism
  • Use the stage metaphor to advocate for changes to marketing and promotion
  • Avoid focusing in on individual families – this encourages people to see childhood obesity as an individual-level problem, requiring individual-level solutions.


As a society, we must tackle childhood obesity. We all have the ability to be healthy – and every day, we need to make the right choices that make this possible. Like the Thompson family in Fenton West, who signed our ‘Healthy Choices’ pledge – and made a daily commitment to eat healthily and stay active.


As a society, we must put our children’s health first. We all need healthy options and opportunities to flourish and to thrive – and yet every day, we’re flooded with unhealthy food. Vending machines piled high, fast-food shops everywhere you look, buy-one-get-one free deals in every supermarket… it’s overwhelming for families. Our politicians can and must act to stem this flood.

See how Caroline Cerny of the Obesity Health Alliance put this into practice, with a media response

Targeted policy asks

  • Focus on what all children need to be healthier; and what some places and contexts are failing to provide
  • Avoid focusing on the characteristics of individuals or aspects that could be seen as individual failings.


Kids in Hackney are more than twice as likely to have obesity as kids in Maidenhead. High levels of consumption for high-sugar, high-fat food combines with some of the lowest levels of physical activity in the UK. Our politicians can put this right by…


The place that you’re born in shouldn’t hold you back. But kids in Hackney are more than twice as likely to have obesity as kids in Maidenhead. It’s harder for them to access the opportunities all kids need to be healthy – an unfairness our politicians can put right by….

Pitching programmes and initiatives

  • Use the rivers metaphor to show how different initiatives can play a part without presenting them as the solution
  • Avoid reinforcing the harmful beliefs that people hold about childhood obesity.


It can be so hard for busy parents to make healthy choices for their families. Parent support programmes are bringing down childhood obesity rates by helping parents to set boundaries for their children and say no to sweets and junk food.


Parents often feel like they are swimming against a powerful flood of unhealthy food. Programmes that support families can work as a lifeboat and help improve children’s health. But we need to address the causes of the flood and work upstream to keep all children healthy.

Guidances for schools and families

  • Normalise the support, not the struggle. Put solutions centre-stage
  • Extend the rivers metaphor to talk about solutions and support – like lifeboats, rafts, floodgates
  • Avoid language that triggers judgement and individual blame – like lifestyles, ‘better decisions,’ and ‘better choices’
  • Avoid language that implies education or willpower is the only solution to poor health.


Modern life makes it hard to stay healthy. Our ‘Active Lives’ programme helps busy parents prioritise staying active to fight childhood obesity. Amy joined this programme in 2019: “‘Active Lives’ helped me make the right decisions for me and my family. I’ve made small changes to our lives that have made a big difference.”


Every child deserves the opportunity to be healthy, no matter where they live. Our ‘Active Neighbourhoods’ programme breaks down barriers to health for families – and works to improve every child’s health. Amy joined this programme in 2019: “‘Active Neighbourhoods’ has given us more opportunities to be healthy – like weekly park runs, supervised outdoor play for the kids, and safer bike routes. These small changes to our environment have made a big difference.”

Writing long-form content

  • Extend the rivers or stage metaphor throughout your piece – but don’t mix them unless you have to
  • Check the balance between articulating problems and solutions. For every dose of crisis, you need at least 2 doses of “can do.”
  • Sharpen focus on context and surroundings with images that show barriers to (or opportunities for) health in our environment.

See how former Chief Medical Officer Sally Davies put this into practice, with an independent report

Writing in different tones

We can adapt tone to purpose by changing our levels of stridency and force. These can be dialled up or down as needed.

Like this, using the fair places value


Make sure talk of crisis is focused on a crisis of environment, not of individual behaviour. Use the stage and rivers metaphor to keep focus on people’s surroundings and context.


We can also dial up or down the scale of an identified problem: “We urgently need to close the floodgates” indicates a bigger challenge than calls to “balance the flow.”

See how BiteBack 2030 have put this into practice with an open letter from young people

Media Interviews

Interviewers can activate harmful assumptions with the questions they ask. We can disrupt these assumptions with ‘spot, bridge and move.’

  • Spot the harmful beliefs that might be activated by a question
  • Bridge away from those beliefs – with a bridging phrase, or by picking up on an aspect of the question that’s helpful
  • Move with a reframed answer that responds to those harmful beliefs.

We can also incorporate framing recommendations into spokespeople briefings and key messages.

Here’s what this could look like in practice:

Q: Kids like sweet foods – and eating too many sweets make you obese. Some parents just don’t care enough to step up and stop kids from eating junk. Isn’t that right


Spot – this question ignores the role of advertising in engineering tastes, others, and blames parents for individual, personal failings.


Everyone likes sweet food! But there’s no way that parents can control everything their kids do. Kids can order fast food online from their phones, delivered straight to their doors… It’s too hard, and it’s asking too much. That’s why we need to support parents – not criticise them.


We all need to put children’s health first. And when unhealthy options are in the spotlight – with TV and online advertising targeted directly at children – it’s not surprising that junk food has a starring role in kids minds. It’s past time to close the curtain on junk food ads aimed at children – for every child’s health.


Metaphor trigger strong mental images – so journalists will often pull them into article headlines.

Social media

Incorporate the framing recommendations into social media strategies and across channels. We can also use default public thinking to inform audience personas.

Here’s what this could look like in practice:

Harness existing conventions on instagram with framed images, stories and inspiring quotes:

Drive site visits and tap into existing conversations:

Share thematic stories that tie into policy and programme needs:

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Drive site visits for specific landing pages: