Well, this probably seems uncharitable, but here are my reasons why I will never again be donating to Cancer Research UK (CRUK).
Don’t get me wrong, if you’re a friend of mine, and you’re planning on running, swimming, knitting in a bath of custard etc in future and need sponsorship, I will happily donate to a charity in recognition of your efforts. But not to CRUK. You can pick another charity. You can choose one doing great work in cancer treatment or care or awareness or research; Macmillan, Marie Curie, Breast Cancer Now, there are hundreds! Just not Cancer Research UK/Race For Life/Stand Up To Cancer, which are many faces of the same charity.
Why? What’s wrong with Cancer Research UK?
Maybe it’s just me, but I’d hope that a charity which puts research at the forefront of its identity (it’s in the name, for heavens’ sake!) would understand the need to not make wild claims. I’d hope they understood the difference between causation and correlation – it’s usually taught in secondary schools! Here’s a really useful TED talk explaining the danger of mixing correlation with causation:
So we can see from the example given in the video (if you’re reading this on mobile data and don’t want to watch it!) is that just because the incidence of drownings increases when the sales of ice creams increase (a correlation), does not mean that we can infer ice creams are responsible for drownings (causation). Or conversely, decide that drownings are responsible for ice-cream sales!
We can suspect one leads to the other. We can theorise what might cause this, but without further evidence it is merely a theory. It may be difficult to prove. That doesn’t mean you can ignore the lack of proof and state it as fact for the sake of convenience. Furthermore we must not forget to look for other influencing factors which might explain both results, like the weather, in the TED example.
So, where does Cancer Research UK come into this?
When CRUK released their ad campaign last year stating, quite categorically, that obesity causes cancer, I was a bit concerned. I knew of the link between being of higher weight and increased risk of certain cancers (and decreased risk of others that we rarely hear about!), but there has never been proven causation. Yet CRUK were happy to state it.
Wait, obesity isn’t a cause of cancer?
No one (and there’s been plenty of research!) has yet proven that obesity causes cancer. It is possible that there is a causal link, of course. The theories may be spot on. I don’t deny that. But you’d hope a charity spending hard-won donations, and with ‘research’ in their name, would be a bit more responsible and careful not to overstate a theory as fact? It’s an important distinction.
As with the TED analogy, research has suggested that common factors could be responsible for the connection. Genetics are particularly suspect. Did you know tall people are more likely to get cancer than short people? Don’t see them putting that on a bus shelter, or claiming that height causes cancer. It’s an accepted correlation. Strangely CRUK don’t feel the need to make anyone feel crap about being tall…
But being fat’s not the same as being tall!
“But people can’t help their height!” I hear the virtue-signallers cry! “It’s not the same! Fat people can lose weight!” (with a in implied side-order of “they’re just lazy/stupid/lack willpower!”).
Except if you’re overweight, and have always been overweight, come from a line of people who are and have always been overweight, and have repeatedly watch them try and fail to lose weight, you know that while the maxims of ‘just lose weight’, ‘just eat less’, ‘just exercise more’ sound so deceptively simple in theory, they’re incredibly difficult in practice.
Of course, there’s always surgery, the one reliable intervention to lose weight – but if that’s so desirable, why wouldn’t we suggest tall people lop off a couple of inches to reduce their cancer risk? (I’m not suggesting that either!) There are significant risks associated with surgery, and significant downsides. It is not a one-size-fits-all solution. Yes. Pun intended. Let’s not lose sight of the fact that there’s a lot more to being healthy than merely a BMI.
But obesity IS preventable! You just don’t want to hear the truth!
Many overweight people struggle with their weight their entire life. Many lose weight, only to put it all back on again and more, often over and over, getting bigger with every cycle. We know this, and we don’t fully understand why. But we’re beginning to understand that willpower and behaviour are probably only a small part of the puzzle, maybe as little as 5%, with many other factors coming into play .
If it was so easy, Slimming World and Weight Watchers would have gone out of business years ago. The fact of the matter is that their business model works precisely because most people don’t and can’t lose the weight and keep it off long term in our modern society. We know this. It’s a problem we’ve been trying to solve for years, and CRUK campaigning that obesity is a ‘preventable’ cause of cancer completely ignores this.
Every time I drove past one of the CRUK adverts last year it irritated me. I knew it was inaccurate, felt it was irresponsible, and I was frustrated that they were choosing to oversimplify a complex problem as a personal failing. I, and many others felt it insidiously feeds the narrative of blame and shame that is so common with obesity.
It allows those who don’t have a high BMI to feel just that bit more smug, just that bit more superior; safe in the knowledge that their predominantly genetic disposition to not be overweight is saving them from cancer, with the added implication that us fat people should really do something about it for the sake of our health…
Maybe they didn’t realise…?
Not everyone reacted as mildly as I did, of course…
Right, is anyone currently working on getting this piece of shit CancerResearchUK advert removed from everywhere? Is there something I can sign? How the fucking fuck is this okay? pic.twitter.com/b7eU7lulms— Sofie Hagen (@SofieHagen) February 28, 2018
But those ads didn’t quite push me to the point of saying never again will I be donating to Cancer Research UK. That only happened this week…
I decided to give them the benefit of the doubt last year. Maybe they didn’t realise? Perhaps they felt the shock factor they wanted to use outweighed the risks of that approach and misjudged it? Maybe in wanting to keep the message simple they went further than they should have in overstating the point, but have learned from it?
So, what happened next?
Firstly, don’t be tempted to read the responses Sofie Hagen received on Twitter. Let’s just say plenty of people decided to tell her she was wrong. Haters gonna hate and all that… We don’t need that kind of negativity!
The campaign garnered lots of attention, was widely accused of fat-shaming and stigmatising obesity, and lauded by others for ‘telling it like it is’ (or as we know, isn’t, but hey-ho). These comments mainly came from smug-thins who think it’s simple to solve the ‘obesity problem’; just regularly tell fat people how crap they are and they’re sure to take it on board…
It also prompted amusing but entirely predictable responses implying the only reason people are overweight is because they eat fast food… yawn. Never saw that one coming. Oh, wait. Yes we did. It’s exactly these kinds of lazy tropes and attitudes that such a campaign fuels and that we’re entirely sick of.
That should alleviate your anger pic.twitter.com/uFP2v0YOlw— Tony (@danditoni) March 7, 2018
Didn’t anyone explain to CRUK where they’d gone wrong?
Of course! Aside from the discussions on Twitter and in the media, various organisations and experts connected to the study of obesity contacted CRUK to offer their services.
They told CRUK how the adverts were stigmatising and misleading. They explained how simply telling people with obesity that they’re at increased risk of cancer does nothing to help, but does everything to make people feel more marginalised. Experts met with CRUK to explain how a more useful and sensitive campaign could be launched in future…
So, what happened this week?
This week, CRUK went one further with this ad campaign.
Cigarette packets branded with “Obesity is a cause of cancer too”. Eyecatching and emotive, certainly. Accurate and helpful? Not so much.
Marvellous. They’ve taken on board precisely …erm… nothing at all from last year’s campaign feedback!?
Or perhaps they enjoyed the publicity last time?
Good grief, I feel sorry for the people who gave up smoking and gained weight as a result. They must feel like they can’t do right for doing wrong! They’re probably having their nicotine addiction triggered by the enormous images of cigarette packets, all while wanting a cigarette to deal with the stress of finding out that they’re doomed to get cancer…
Of course, the media reported the release like this:
With the word ’cause’ prominently repeated, with images of fast food and headless fat bodies galore – despite organisations such as the European Association for the Study of Obesity and The World Obesity Federation campaigning widely against such reporting and providing and free usable non-stigmatising images… Here we go again. Entirely predictable. Blame and shame. Emotive stuff.
There was a swift backlash. The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (what a title!) wrote this great article:
Only this time there’s no room for the benefit of doubt; CRUK know these campaigns are hurtful, and they clearly don’t care.
@OliWilliamsPhD @DrStuartFlint @BrocqSarah @zoetw and I met with CRUK last winter to talk about their previous campaign, and how it stigmatises against people with obesity. We talked at length about how they could create a better campaign. No change in focus. Agree this is worse.— James Nobles (@JNHealth) June 29, 2019
And then, despite the complaints, CRUK continued the narrative this morning by tweeting this:
What, are we just pointing out random statistics we observe now? No. Clearly CRUK has decided this is the hill they want to die on; might as well be hung for a sheep as a lamb. If you don’t like it, go chew some obesity gum or puff on your obesity inhaler… Oh, wait…
Cancer Research UK Budget
It’s a lot. A sizeable amount is spent on research. So far so good. But when £43 million pounds in 2017/18 was spent on ‘information and policy’ (admittedly, it’s only half of what they spend on raising the cash in the first place…), and when that information and policy is based around misrepresenting that research, enough is enough.
What does CRUKs CEO have to say?
Luckily not all media outlets have responded to CRUKs latest campaign by parroting it blindly… Sky News at least have responded by reporting some of the criticisms the new campaign has received:
They even quote CRUK chief executive Michelle Mitchell:
“We have a responsibility to tell people about what might increase the risk of cancer.”
Yes, Michelle. Might. So why are you so ready to be certain that it does cause cancer when you’re plastering it on a poster?
I might never again donate to Cancer Research UK. Oh, actually sorry, no. I’m never again donating to Cancer Research UK. Put that on a poster, Michelle.