The extent to which the public health ‘war on obesity’ reﬂects the ethical values and principles of critical health promotion: a multimedia critical discourse analysis
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Issue addressed: The discipline of health promotion is responsible for implementing strategies within weight-related public health initiatives (WR-PHI). It is imperative that such initiatives be subjected to critical analysis through a health promotion ethics lens to help ensure ethical health promotion practice. Methods: Multimedia critical discourse analysis was used to examine the claims, values, assumptions, power relationships and ideologies within Australian WR-PHI. The Health Promotion Values and Principles Continuum was used as a heuristic to evaluate the extent to which the WR-PHI reﬂected the ethical values of critical health promotion: active participation of people in the initiative; respect for personal autonomy; beneﬁcence; non-maleﬁcence; and strong evidential and theoretical basis for practice. Results: Ten initiatives were analysed. There was some discourse about the need for participation of people in the WR-PHI, but people were routinely labelled as ‘target groups’ requiring ‘intervention’. Strong evidence of a coercive and paternalistic discourse about choice was identiﬁed, with minimal attention to respect for personal autonomy. There was signiﬁcant emphasis on the beneﬁciaries of the WR-PHI but minimal attention to the health beneﬁts, and nothing about the potential for harm. Discourse about the evidence of need was objectivist, and there was no discussion about the theoretical foundations of the WR-PHI.