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A hospital in Atlanta is trying to shock people into doing something about childhood obesity. Georgia has more obese children than any other state except Mississippi. And hospital officials are hoping to reverse the trend with help from some harsh new billboards and TV commercials that feature overweight kids.

As NPR's Kathy Lohr reports, the ads are making an impact but the tactics are raising questions.

(SOUNDBITE OF FOOTSTEPS)

KATHY LOHR, BYLINE: One ad filmed in black and white that's tough to watch, features a little boy and his mom entering a room with two folding chairs. They're both clearly overweight. They sit and look at each other.

(SOUNDBITE OF AN ANTI-OBESITY AD)

UNIDENTIFIED CHILD #1: Mom, why am I fat?

LOHR: The mother bows her head and the tagline appears. It reads: 75 percent of Georgia parents with overweight kids don't recognize the problem.

In another spot, a young girl speaks directly to the camera about a disease she says she has.

(SOUNDBITE OF AN ANTI-OBESITY AD)

UNIDENTIFIED CHILD #2: My doctor says I have something called hypertension.

(SOUNDBITE OF A GONG)

UNIDENTIFIED CHILD #2: I'm really scared.

LOHR: The ads are modeled after anti-smoking and anti-methamphetamine campaigns intended to shock the audience.

LINDA MATZIGKEIT: It has to be harsh. If it's not, nobody's going to listen.

LOHR: Linda Matzigkeit is a vice president with Children's Healthcare of Atlanta, the pediatric hospital running the campaign. She says parents are in denial. Nearly one million Georgia kids are overweight or obese.

MATZIGKEIT: This is a medical crisis and I say, if you don't believe me, come visit our hospital and see the kids that we are now taking care of that, more and more, have Type II Diabetes, have hypertension, need knee replacements. And it's breaking our heart to see these adult-type diseases in the children that we serve.

LOHR: But some question the strategy. Rodney Lyn is a professor at Georgia State University's Public Health Institute.

RODNEY LYN: This campaign is more negative than positive.

LOHR: Based on his research, Lyn says the ads can hurt the very market they're targeting.

LYN: We know that, you know, stigmatization leads to lower self-esteem, potential depression. We know that kids will engage in physical activity less because they feel like they're going to be embarrassed. So there are all of these other negative effects.

LOHR: The ads are part of a five-year, $25 million anti-obesity effort. It includes training pediatricians, getting programs in schools and setting up a clinic to treat the medical and psychological issues related to obesity.

South of Atlanta, Gayla Grubbs owns a sandwich shop in Griffin, Georgia. One of the employees makes a turkey sandwich for Grubb's 15-year-old son, Sam, with some special instructions from mom.

UNIDENTIFIED WOMAN: Light on the mayo - I mean, no mayo, just no mayonnaise.

LOHR: Sam is obese and Grubb says she realized he needed help, so she took him to the children's clinic last year.

GAYLA GRUBBS: I wanted to give Sam every opportunity to feel good about himself and to get healthy. That was the main thing.

LOHR: In fact, Gayla said she didn't tell Sam he was going to the clinic until they started driving there. Sam says he didn't really mind.

SAM GRUBBS: I was being bullied a lot because of my weight. And after I started losing it, it cut down quite a lot. They don't call me names or anything like that anymore.

GRUBBS: It's a self-esteem issue and, you know, if you feel better about yourself, you're going to carry yourself differently and so that has helped.

LOHR: Sam has lost 20 pounds so far and wants to lose another 50 by the end of the year.

GRUBBS: I've been cutting back on my portion sizes a whole lot. Instead of, like, four or so pieces of pizza, I only have about two.

LOHR: And Sam says he doesn't eat pizza or fast food much anymore. This kind of family intervention is exactly what health officials hope to see more of. For the record, Gayla Grubbs says she's not upset by the anti-obesity ads that have raised controversy here.

GRUBBS: It plants a seed and what we do with that is our responsibility.

LOHR: The second phase of the children's health care ad campaign is about to begin and officials say it will focus on encouraging adults, parents, teachers and grandparents, to take action.

Kathy Lohr, NPR News, Atlanta.

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