Case study: Who Are You Calling Fat?

Interviewee: Sarah Ramsden

Executive producer Sara Ramsden speaks of the way Who Are You Calling Fat? created a forum for the obesity debate to be aired — and for science to come to the fore.

An exploration of healthy living

Who Are You Calling Fat? was first broadcast on 28 October 2019 on BBC2 and BBC iPlayer. The two-part series used reality TV motifs from shows like The Apprentice, I’m a Celebrity, Get Me Out of Here, Big Brother and Love Island to create a mainstream, accessible and televisual forum through which the range of debate around obesity and healthy living can be explored in Britain today.

Obesity is a complex and multifaceted social issue, one that requires nuanced solutions to create real progress. Yet all too often, public discourse around obesity becomes fixated on the physical and dietary aspects of the problem, ignoring the significant influence of psychological and socio-political factors.

Who Are You Calling Fat? contended with both the divisive nature of obesity debates and the simplified narratives of mainstream media. The series confronted the idea that overweight people are at personal fault and lack the will to take care of their own health adequately. It also paid attention to genetic conditions that can contribute to obesity, as well as the complicated psychological factors that can lead people towards eating disorders and unhealthy lifestyles.

At the same time, the series also acknowledged the more strident voices in the body positivity movement — those who argue, against scientific studies, that obesity has no wider health consequences and is purely born of a social stigma.

“I felt that the man in the street had very little understanding of the genetics of obesity and very little understanding of the psychological trauma that can often contribute to obesity,” says Sara Ramsden, the series’ executive producer.

“I wanted to create a show that might encourage understanding and help people to understand the complexity of weight gain, and try to reduce blame and stigma and ideological polarisation.”

Ramsden explains that the show set out to explore the science, the ideological discourse, and the socio-political realities of obesity. Yet this more complex picture of obesity was presented in an accessible, easily-understood format — one that channelled the style and visual language of reality TV.

Who Are You Calling Fat? was premised around a recognisable structure: nine people who live with obesity moved in together for a fortnight in a grand Oxfordshire home filled with cameras. Each “contestant” held a different perspective on their bodies and their health, and of the perception of overweight people in the UK.

Over the course of nine days, the contestants discussed and explored the issues around being overweight. They also received a genetic test to discover whether they were physically destined to gain weight.

Who Are You Calling Fat? was created by Love Productions — a British production company and Sky Group subsidiary best known for creating The Great British Bake Off. Prior to Who Are You Calling Fat?, Love Productions also created the social impact entertainment shows Benefits Street and Tower Block of Commons.

Ramsden began her career at the BBC in 1981, during which she worked on the production team for Newsnight and Panorama. She had a brief stint as controller of Sky One before becoming creative director of factual programming at Endemol. Here, she oversaw the production of Fat Men Can’t Hunt — a health-orientated series that was arguably the precursor to Who Are You Calling Fat?

She subsequently spent 15 years as a commissioning editor at Channel 4, in two stints as a specialist factual commissioner and Head of Popular Factual. In these roles, Ramsden was responsible for hundreds of hours of social impact screen-media entertainment. She joined Love Productions as a creative director in 2017.

The psychology of obesity

Who Are You Calling Fat? had been long in the making for Ramsden.

“When I was at Channel Four, I kept trying to push for a series about the psychology of weight loss,” she says. “I wanted to create a show about a group of people, all living in a house together, who could share the experiences of what led them to become overweight.”

Among other inspirations for the show, Ramsden cites the widespread, heated opposition to a billboard campaign that Cancer Research ran in the UK. The campaign’s key message asked: Guess what is the biggest preventable cause of cancer, after smoking?

“It’s scientifically proven that obesity can lead to cancer,” says Ramsden. “Yet those criticising the campaign didn’t seem to pay heed to this.”

Ramsden also recalls the decision made by Cosmopolitan magazine to feature plus-size model Tess Holliday on a front cover — a move that led to accusations from media figures that the magazine was “celebrating morbid obesity”.

Farrah Storr, the magazine’s editor, defended the decision on the breakfast TV show, Good Morning Britain. “The reason she is on my cover is to show that there is a different way to look,” said Storr.

Ramsden found the potential ramifications of the cover to be troubling.

“It was extraordinary to see a glossy magazine profiling a model whose body was clearly in the morbidly obese category,” she says. “It felt like a watershed moment.”

The premise of Who Are You Calling Fat? was cemented by clear, insistent public health data about rising obesity in the UK and the associated health risks.

But Ramsden also concurrently wanted the show to progress the public discourse around obesity — and, in particular, to move beyond the typical fixation on physicality.

“I was aware that other recent television programmes about health and weight only ever focused on diet and all weight loss and exercise,” Ramsden says. "No one was ever talking about psychology. And it's quite clearly a really substantial issue when it comes to discussing obesity.”

Pushing the public conversation

Who Are You Calling Fat? had a budget in the region of £200,000 per hour of broadcasting and garnered more than two million viewers — receiving far higher than usual ratings for a show of its type and budget.

From the earliest stages of production, Ramsden wanted the series to spark a reaction.

“I wanted the show to be controversial,” she says. “I wanted it to get noticed. I wanted people to talk about it. But primarily I wanted the audience to understand that obesity is more complicated than it seems — that it's not just a matter of personal, moral decrepitude that someone has become fat. I wanted people to understand both the science and the societal side of obesity. I wanted the show to contribute to a more informed national conversation.”

Ramsden’s science training contributed to her outlook on TV production. And, in fact, she sees parallels between the two disciplines.

“‘I studied science originally,” she says. “My degree was in human science, so I've always really been aware of wanting to discuss social problems in the round and as a whole. The show was made in the knowledge that the issue of obesity is not clear-cut, but full of very complex factors.

“Throughout my career, from my background in science onwards, I’ve felt a duty to try and educate the electorate in a democracy — to help them be able to ask the right questions and be more informed about science.”

How did the series rely on the power of lived experience?

As they searched for Who Are You Calling Fat?’s central cast, the production team had to assemble a representative cross-section of society. Ramsden believes that the effort here was a crucial element in the show’s success.

“The most important part of the production process was finding, casting, vetting, and readying the contestants so they were positioned to articulate different sides of the debate without reading from a script,” she says.

“We spent a lot of time discussing how to appropriately cast a group of diverse people living with obesity,” she says. “We wanted people with different attitudes, opinions and lifestyles who could all come together.”

Among those cast was Sarah, a former director of the UK charity Obesity UK, who herself had struggled throughout her life with weight gain. While in this role, Sarah campaigned for obesity to be treated like a disease.

On the other side of the debate was Victoria — a fat-positive advocate who considers the terms “overweight” and “obese” to carry unnecessary moral implications and who considers health to be a “social construct”.

Between them were more conflicted voices like that of Babs, a civil servant who, while acknowledging the problems of being overweight, yearns to feel more accepted by society and less scared by public health messaging.

Tropes as a tool for engagement at scale

Who Are You Calling Fat? was actively designed to reach and appeal to an audience who were “leaning back on their sofa”, as Ramsden puts it.

“It’s harder to make a subject accessible to a broad audience than it is just to make straight, conventional television that only a small number of people would be interested in watching,” she says.

Consequently, Ramsden calls for the need for more “tabloid TV” in the arena of SIE.

“I've always loved tabloid telly,” Ramsden says. “But I want to find new ways of using the tools that are employed so well in tabloid telly to grab people’s attention. Elements of soap opera, of emotions and human connections — you need to use all these dramatic tools in order to illustrate and educate people in big, complex, hard-to-access subjects.”

While the series was intended to be educational in its messaging, it actively referenced other successful reality TV programmes through visual motifs and tropes in order to engage viewers that might disconnect from the topic in a more formal setting.

“We were careful to employ that classic drone shot when the contestants arrived at the house in a people carrier, so that the series looked like The Apprentice,” Ramsden says.

“The house was made to feel familiar to viewers of Big Brother. The swimming pool was sometimes used to imitate scenes in Love Island. When viewers recognise these little references, they hopefully think: ‘OK, this is going to be interesting. I'm not going to get lectured about the statistics about obesity and the pressure that diabetes puts on the NHS.’ But, actually we did lecture them about the specifics of the issue.

“I'm very proud of the fact that the show borrowed from all those shows and made use of those tropes.”

The value of understanding the medium

For any creators of SIE, two questions invariably arise: how can we capture the attention of the audience? And then, once we have it, how can we use that attention responsibly?

Who Are You Calling Fat? can be seen as a definitive response to these questions — a leading example of how to showcase the complexities of a social issue and to do so via a format and aesthetic that succeeds in entertaining and engaging a wide, mainstream audience.

“If you want to use this medium to win hearts and minds and change national debate and drive impact, then you have to understand the medium,” says Ramsden.

In her view, this means analysing best practice in the sector.

“To understand this medium, you need to watch Strictly Come Dancing, you need to watch Love Island, and you need to watch I’m a Celebrity Get Me Out Of Here. Because these shows are extremely adept at telling stories and using real people to construct storylines and raise issues in a very non-pointed way.”

She continues: “To create serious, in-depth analyses of difficult social problems, the first thing you must do is work out how to take people with you. That’s the lesson of my career in educational state-powered broadcasting.”

Who Are You Calling Fat? underlines a point that might seem like a truism, but can sometimes be forgotten in the production process: that above all else, SIE must remain entertaining to reach a wide audience.

To create genuinely entertaining content, Ramsden says, a producer must understand the formula of popular and widely-seen shows. If SIE practitioners can appreciate why successful examples of popular culture are so successful, then they can use this insight to deepen and drive the impact of their own creations.