It started with the denial of a growing health crisis.
Nearly 40% of Georgia's children are overweight or obese -- the second-highest rate in the nation -- yet 50% of Georgians don't consider child obesity a problem. What's more, 75% of parents of obese children don't think they have a problem on their hands, according to Children's Healthcare of Atlanta, the state's largest pediatric health care system.
In response, Children's Healthcare crafted an ad campaign intended to highlight the roles of parents and caregivers in the widening epidemic.
The posters and TV spots of obese children with doleful eyes were as stark as their accompanying messages: "Being fat takes the fun out of being a kid," and "It's hard to be a little girl if you're not," to name a few.
"We felt that because there was so much denial that we needed to make people aware that this is a medical crisis," Chief Administrative Officer Linda Matzigkeit said.
"We knew flowery ads don't get people's attention. We wanted to come up with something arresting and hard-hitting to grab people."
The buzz began almost as soon as the ads started appearing in September on billboards, buses and train platforms around Atlanta. Critics felt images from the Strong4Life campaign were too negative and perpetuated weight-based stereotypes without providing concrete solutions.
"There seems to be this perception that it's OK to shame children and families struggling with obesity because that will provide an incentive to lose weight," said Rebecca Puhl, director of research and weight stigma initiatives at the Rudd Center for Food Policy & Obesity at Yale University.