The Australasian Metabolic Health Society and the Eating Disorder Alliance are calling for action against the LiveLighter toxic fat obesity campaign, which takes inspiration from a similar, decade-old campaign that ran in Western Australia.
The Australasian Metabolic Health Society (AMHS) is calling on the state’s health leaders to review the LiveLighter SA toxic fat obesity campaign, saying the advertisements contain messaging that could cause serious unintended harm.
In an open letter addressed to SA’s health leaders obtained by InDaily, the AMHS said it was concerned about the campaign’s framing and tone, and its nutritional messaging and supporting resources.
The campaign is part of a collaboration on obesity prevention which includes Preventive Health SA, Cancer Council SA and the South Australian Health and Medical Research Institute (SAHMRI).
“While well-intentioned, the campaign appears to promote outdated nutritional advice that does not reflect current evidence on metabolic health, weight management, or chronic disease prevention,” the letter said.
This comes after the Eating Disorder Alliance (EDA), which includes Australia and New Zealand’s key eating disorder organisations, called on Preventative Health SA to “immediately pull ads, social media posts and website content” relating to the “dangerous” campaign in order to prevent harm to people who are living with or at risk of developing an eating disorder.
The campaign, which hit free-to-air screens on Sunday, June 29, is described as “hard-hitting” and involves a range of TV advertisements showing everyday choices, then the toxic build-up of visceral fat on internal organs inside a body, which is due to obesity.
One TV advertisement shows a man reaching for a piece of pizza inside a fridge, grabbing onto his waist, then deciding against the pizza while dialogue plays in the background.
Version of these advertisements have also run on radio, billboards and social media.
The advertisement aims to increase awareness of the impact of toxic fat and prompt South Australians to eat well and increase physical activity to improve their health.
The campaigns aim to action people to the LiveLighter website, which shows information and tools to support eating well and being more active. These consist of recipes, meal planners, workout builders and more.
The strategy draws on elements of the LiveLighter public health campaign, which has been running in Western Australia for over a decade. This campaign has also run in the ACT and Victoria.
AMHS advisor Dr James Muecke said “persisting with 12-year-old nutrition advice while ignoring current science will not reduce chronic disease – it risks making things worse”.
“The campaign recycles long-debunked diet-heart messaging and ignores the growing international consensus that therapeutic carbohydrate restriction and healthy dietary fats play a key role in weight managing and prevention of chronic disease,” said Dr Laureen Lawlor-Smith, AMHS director and GP.
In the open letter, the AMHS raised specific points of concern such as an “overemphasis on grains and starchy carbohydrates”, a “neglect of carbohydrate reduction for metabolic health”, “bias against animal-based foods” and the “promotion of low-fat, high-carbohydrate diets”.
The letter also addresses the concern for “environment change rather than individual blame”.
“Campaigns that focus on the visual portrayal of body weight or body shape – without a broader, nuanced approach to the complex drivers of obesity – risk contributing to stigma and shame, rather than driving change,” the letter said.
“Obesity is a multifactorial condition, deeply influenced by social determinants, food environments, economic pressures, ultra-processed food marketing, and inequity – not simply individual choice.”
Butterfly Foundation CEO and EDA member Jim Hungerford, said “this sort of campaign has been proven to be problematic, and in fact to contribute to the development of weight increases, and eating disorders”.
“There is a large amount of peer-reviewed research available that demonstrates that shaming people based on their body weight, weight discrimination and weight stigma is damaging to people’s psychological and physical health,” Hungerford said.
The EDA also said research shows that messaging that frames body weight as a personal choice does not result in increased health behaviours. It instead perpetuates a harmful weight stigma.
“It is very disappointing that in 2025 we are still seeing these fear-based campaigns, when we know that they don’t work, and worse, can cause considerable harm,” said Jade Gooding, CEO of Australia & New Zealand Academy for Eating Disorders and member of the EDA.
“It is imperative that anyone planning a wide-scale health promotion campaign regarding food and exercise consult with appropriate eating disorder specialists to minimise risk and keep our communities safe.”
Butterfly ambassador and member of the EDA, April Helene Horton, said the campaign was “highly effective at shaming people”.
“Support from clinicians and health professionals doesn’t mean much if those professionals are also influenced by fatphobia. Their endorsement doesn’t replace the need for critical thinking. The comparison being made here isn’t about health outcomes – it’s about which campaign shamed people more effectively,” she said.
“An ad like this can undo years of progress for someone who’s been working hard to accept their body.
“Seeing yourself portrayed on screen in a way that suggests you’re a problem can be incredibly harmful. The stigma and graphic imagery in this campaign could completely derail someone’s body image journey and stop them from engaging in truly healthy behaviours – like nourishing themselves and moving in a way that feels good for their body.”
Preventive Health SA CEO Marina Bowshall told InDaily there was “no evidence of unintended or harmful consequences”, and that the “campaign is effective”. This is based on multiple peer-reviewed journals, together with an independent evaluation led by SAHMRI, Bowshall said.
“Evaluations of the campaign in WA have shown that LiveLighter does not exacerbate negative social stereotypes,” Bowshall said.
Bowshall said the campaign “has been developed in consultation with public health, behavioural science and clinical experts”.
“With studies looking at impact of the campaign showing it did not result in unintended consequences such as body dissatisfaction, reduced self-esteem, or maladaptive weight loss approaches (i.e. disordered eating patterns, excessive exercise),” Bowshall said.
Bowshall said the “campaign has been designed to be considerate of weight stigma, with the adverts aligning with best practice obesity prevention language and imagery guidelines”.
“We know weight is a sensitive topic, but we also can’t shy away from the very real health impacts of obesity,” Bowshall said.
“Obesity is now the biggest preventable health risk in South Australia, and around two thirds of the adult population and one third of children are living with overweight or obesity.
“As well as increasing the risk of preventable disease including cancer, heart disease and type 2 diabetes, recent modelling shows that without action, children born last year could see as much as a seven-month reduction in life expectancy as a result of obesity.
SAHMRI Health policy centre director, Professor Caroline Miller, said “the toxic fat ads are confronting”, which is “intentional”.
“Graphic campaigns like this have been proven to change behaviour. Just like with smoking and drink driving, we need strong, clear messages to shift public perception and spark positive action,” Miller said.
Bowshall also said this campaign has been “operating [in] several states and territories in Australia since 2012 and has been extensively evaluated”.
“Its development has been guided by best practice in public health campaigns through WA Health and in consultation with public health, behavioural science and clinical experts and community partners – including those with a variety of lived experiences,” she said.
The last evaluation of the campaign was in 2024, led by SAHMRI. The conclusions were that “it is an effective and evidence-based public health campaign”.
“We know this is a hard-hitting campaign, but it is supported by clear public health evidence. With two-thirds of South Australian adults living with overweight or obesity, and one-third of children – and this now being the leading cause of preventable chronic health conditions – it is important that we act,” Bowshall said.
Preventive Health SA will offer to meet with Dr Muecke and other letter signatories – along with SAHMRI and the Cancer Council SA – to provide further information on the campaign, Bowshall said.