As the obesity epidemic continues to gain weight, Liverpool tackles the problem head on.

Liverpool, like many UK cities, has seen a significant rise in obesity in recent years. In the city, an estimated 40% of the adult population is overweight and 20% obese. It is estimated that obesity results in over 130,000 sick days every year in Liverpool. The NHS in Liverpool spends £5m a year on treating obesity-related problems, which goes on to cost the city’s wider economy an additional £15m a year. If current trends continue, up to half of all children and one third of adults will be overweight or obese by 2020.

Liverpool PCT launched its ‘Healthy Weight: Healthy Liverpool’ strategy in April 2008, with the objective of stopping the rise in obesity by 2010 and ultimately reducing the level of obesity in the city from 2010. ‘Liverpool’s Challenge’, devised and managed by Liverpool PCT’s social marketing team, is a strand of that long term strategy.

The team commissioned extensive qualitative research into the target audience in order to develop an insight into their everyday lives and understand the motivations and barriers to adopting healthy eating and exercise practices. The insights developed from analysis and interpretation of the research showed that people wanted to lose weight and become more active but struggled to change their habits.

And so Liverpool’s Challenge was created – an innovative challenge to residents to pledge to lose one million pounds of weight. An ATL teaser campaign with the strap line ‘We’ve got one million pounds to lose’ generated curiosity prior to the launch and saw local radio stations holding on-air discussions to guess what the advertisements meant.

In September 2008 all was revealed and Liverpool’s Challenge launched with a media campaign that to date has generated over £560,000 worth of press and estimated £1m broadcast coverage.

The ‘Million Pound Tanker’, a converted milk tanker, provided the focus for the launch event and was a mainstay of the campaign, taking the message out to local people as it toured the city. Inside the tanker, visitors were met by a receptionist and given a goodie bag before meeting with a health professional to have their BMI measured and receive free, confidential lifestyle advice.

Outside the tanker in the ‘Active Zone’, ‘Live Zone’ and ‘Food Zone’, community food workers gave cookery demonstrations and handed out food samples and cookery books, while fitness instructors showed how to use fitness equipment and handed out vouchers for free gym or swim sessions.

Liverpool PCT’s social marketing team negotiated media partnerships with the Liverpool Echo and Radio City, the two largest media outlets in Liverpool, chosen because of their extensive reach and fit with the target audience. The challenge was kept high on the news agenda, with regular stories appearing in the media. The radio partnership also extended online, with banners, features and a sign-up button.

Local celebrities lent their support throughout, attending ‘tanker’ events, providing quotes for the press and attending photo calls. The launch event saw figures such as Jamie Carragher from Liverpool FC; Beth Tweddle, Team GB gymnast and Steve Johnson, Captain of England’s amputee football team.

There was also a live performance from Britain’s Got Talent football freestyler Jeremy Lynch, which helped to engage the young men in the crowds. Other celebrities have provided ongoing endorsement of the campaign, including actress Claire Sweeney and comedian Johnny Vegas.

The campaign has used 48-sheets, six sheets, street liners, street banners, press and ‘community’ advertising in Boots stores, GPs, job centres, community centres, cafes and other public venues to keep the challenge at the front of the public’s minds. The frequency of the campaign was increased in areas of the city with high prevalence of obesity.

The collective nature of the challenge helped people to feel that they were joining a club of like-minded people. Residents signed up in their thousands, with 1,500 pledging in the first week and the website receiving 50,000 hits. People pledging entered a community in which they were supported at every turn – from one-to-ones with health professionals to receiving CRM packs containing informative and motivational material – stories from other pledges, easy recipes and low cost activities.

 Each person had a personal challenge account on which they could record their progress and people could see the overall campaign progress on a ‘Blue Peter style’ counter on the website, a Challenge tower in the city centre and the side of the tanker. Challenge teams toured the city, signing people up at work and on the street, with additional staff in areas of high obesity.

Staff throughout Liverpool PCT were involved in the delivery of the campaign, in particular those working on the existing award winning ‘Liverpool Active City’ and ‘Taste for Health’ initiatives. Frontline staff such as dietitians, health trainers and practice nurses signed people up to the challenge. Staff were consulted on producing newsletters and other information, providing exercise advice, recipes and editorial feedback.

The social marketing team worked closely with local partners to promote the campaign, with organisations such as Liverpool City Council, Merseyside Fire and Rescue Service, Merseyside Police, MerseyRail and Arriva organising staff ‘sign up’ sessions, publishing articles in staff magazines and featuring the campaign on payslips and intranet pages.

Liverpool’s Challenge is running until January 2010 and has so far had 720,000lbs pledged. The campaign will be fully evaluated in early 2010, but interim evaluation shows high levels of local awareness, with 39% spontaneous awareness of the challenge and the tanker (compared with Weight Watchers 5%), 71% visually-prompted awareness of the challenge.

There is also evidence of behavioural change, with an increase (self reported) in the percentage of participants classed as a healthy weight (BMI 18.5-25.0). 8% of tracked participants have moved into the healthy weight BMI category whilst the number of people in the morbidly obese BMI category (BMI 35.01 plus) has fallen from 38% to 23%. Attempts to eat more healthily have risen from 55% to 85%, with more people consuming fruit and vegetables on top of which 47% have started exercising and 26% have joined a gym or bought exercise equipment.