Liverpool, like many UK cities, has seen a significant rise in obesity in recent years. In the city, an estimated 40 per cent of the adult population is overweight and 20 per cent 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 go 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 primary care trust 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. They needed support – not only in practical terms but in feeling that they were not alone. They needed help to buoy them through difficult patches. There was strong support for a campaign that would bring the city together, as had the recent Capital of Culture year.

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 strapline ‘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 an estimated £1m broadcast coverage, creating high levels of awareness and a sense of something ‘big’ happening in the city.

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.

Each community event was run by people from within the community such as health trainers and community food workers, and featuring a wide range of performances by local community groups from armchair exercises to free-running and yoga.

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 Liverpool Echo ran 10 full pages featuring campaign events and two front page solus features during the launch week. Radio City/City Talk provided sponsorship of its Drive Time programme, with frequent mentions and celebrity endorsements. There was a weekly mention on the ‘diary’ feature, regular 30-second trailers, interviews, live broadcasts which saw presenters pledging and a day-long focus on the Challenge. 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 photocalls. The launch event saw figures such as Jamie Carragher from Liverpool FC; Beth Tweddle, Team GB gymnast; Paul Clough and Mike Bennett of St Helen’s Rugby League Football Club; David Price, Olympic bronze medalist; Rachel Brown, Everton Women’s Football Club; 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 Johny Vegas.

The campaign has used 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 pledgers, 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. Front-line 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.

The campaign is ongoing and will be fully evaluated in early 2010, but interim evaluation shows that at the halfway point it has exceeded its interim targets, with more than half a million pounds pledged by February 2009. Research shows high levels of local awareness, with 13 per cent spontaneous awareness in January 2009 (compared with Weight Watchers 3 per cent), 72 per cent visually-prompted awareness and 58 per cent of participants claiming to have lost weight in December 2009.