Obesity is a significant issue for Indigenous populations around the world , with many countries reporting higher obesity rates amongst Indigenous populations than overall population rates [2–5]. Obesity is a major contributor to Indigenous morbidity and mortality in Australia [6–8], and is a significant risk factor for a range of illnesses such as Type II diabetes, osteoarthritis, cardiovascular disease and some cancers . Excessive weight was the second highest contributor to the total burden of disease and injury amongst Indigenous Australians in 2003 [9, 10], and obesity is a major contributor to the lower life expectancy experienced by Indigenous Australians .
In news media coverage and public discourse, obesity is often purported to be a ‘lifestyle’ issue [12, 13], however there are a number of structural determinants such as social, economic, political, environmental and technological factors that influence an individual’s likelihood of becoming obese . Disadvantaged socioeconomic status (SES), a lack of post-school qualifications, ethnicity and geographic location are some of the structural determinants of obesity . Indigenous obesity is influenced by a range of external factors including colonisation, low SES, and difficulties in accessing healthy food [7, 9, 14], some of which are unique to this population. Indigenous heritage is itself a risk factor of obesity [7, 9, 14] and the greater burden of disease experienced by this population exists throughout the lifecycle . This is further exacerbated by the presence of other structural determinants such as low SES [7, 9], a group in which Indigenous Australians are disproportionately represented . Accessing nutritious foods can be challenging for Indigenous Australians in low income groups and/or living in rural and remote locations [7, 9, 14], or where government regulations limit access to traditional foods . The effects of colonisation is a determinant of health uniquely faced by Indigenous populations worldwide [7, 14], with Indigenous Australians experiencing a dramatic change in lifestyle after European settlement and ongoing adverse impacts on health and wellbeing .
The media can play a significant role in shaping public opinion and even government policy [15–21], using language devices and visual imagery to represent issues in a way that subtly supports a particular perspective [22–25]. This is especially relevant to obesity where excessive media focus on individual responsibility or causes and solutions can reinforce weight stigma, and distract attention away from structural determinants, governmental and societal responsibility, and societal-level solutions [19, 20]. The representation of obesity in the media is a topical issue in Australia and many countries around the world [15, 19, 20, 23, 26–29]. In a large-scale study in the United Kingdom, Hilton et al.  observed increasing coverage of the ‘obesity epidemic’ and a shift from individualistic frames to more structural frames, perhaps indicating an inclination towards regulatory change in the public discourse. Gollust et al.  found an increase in representation of non-white individuals and a decrease in depictions of stereotypical behaviours over time in media images of obesity printed alongside articles in US news magazines. The authors also noted that an underrepresentation of Latinos, African Americans and elderly obese still remained, and that a variety of reasons ranging from pushing policy change to journalistic values could be responsible for the patterns observed . McClure et al.  and Puhl et al.  also investigated media representation of obesity in US news coverage, specifically focussing on images  and video content , respectively. In contrast to Gollust et al.’s  findings, both Puhl et al.’s  and McClure et al.’s  studies observed stigmatising imagery of obesity, raising concerns regarding negative public opinion and general treatment of obese individuals, internalising of negative stereotypes by obese individuals, and the resulting physical and psychological harm. De Brun et al.’s  study observed increasing coverage of obesity in an Irish newspaper, which was predominantly framed as a ‘lifestyle’ issue although structural frames did increase during the study period. Similarly, Lawrence  observed a shift in news media representation of obesity from that of individual causes and personal responsibility, to one of environmental causes. However, Lawrence  also noted that the increasing citation of environmental causes was being met with an increase in personal responsibility frames in response. In contrast, Holmes  observed an unusual trend in Canada where the ‘obesity epidemic’ was not framed as an individual problem but rather as a collective challenge for the nation to overcome. Obesity was found to be framed as an individual ‘lifestyle’ issue in Australian media [12, 15]; and in the case of childhood obesity, the responsibility was often assigned to parents [12, 15], and one study found it to be solely attributed to mothers .
Recent research has identified the significant influences of media framing of Indigenous issues on the Australian political and public spheres [16, 25, 32–36], however McCallum has also noted that literature exploring media representation of Indigenous health is limited . Hollinsworth  argues that media framing of Indigenous Australians is particularly influential, as many people have little other involvement with the Indigenous community. There is evidence that Indigenous Australians are portrayed negatively in media representations and the framing of Indigenous issues “is a form of racist discourse” [16, p336]. Racial frames are commonly employed by media sources when reporting on Indigenous people, and can be used to link racial identity with negative, anti-social or criminal behaviours . Negative coverage of Indigenous Australians including regarding health [16, 25] has been found to have significant consequences for Indigenous people [34, 36], for example by influencing government policy  and social attitudes . McCallum’s [16, 32] studies of the shift in news media reporting of Indigenous health over time found that government policies changed dramatically in response to shifts in ‘alarmist’ media framing. McCallum [16, 32] provided the Northern Territory Emergency Response (the ‘Intervention’) in 2007 as an example of the profound interconnectedness between media representation and government policy. This example saw the introduction of “radical policy solutions” , (p332) involving the engagement of the military to enforce a range of coercive measures in remote Northern Territorian communities , (p333), in response to an overemphasised ‘Indigenous health crisis’ frame represented in media reporting .
A review of current literature highlights the scarcity of research studying media representations of Indigenous health. Extensive searching failed to identify any papers investigating media and Indigenous obesity, despite obesity being known to significantly impact on Indigenous health and wellbeing [9–11], and strong evidence that both obesity and the influence of media are important issues facing our society today. The following media analysis aims to shed light on the issue of media representations of Indigenous obesity in Australia and contribute to filling this gap in the literature.
Content analysis is a method that uses clearly defined criteria to analyse news media material, providing useful insights into the content and context of news media articles by exploring underlying meanings and framing of content, and the broader implications of the representation of an issue . Framing is a strategy whereby communicators, consciously or subconsciously, select and promote certain facts or points of view, with the aim of increasing the salience of the content to the audience [15, 18, 23, 28, 35]. It is often utilised as a means of defining problems, diagnosing causes, identifying solutions and making moral judgements . Media outlets employ common ideological constructions to provide a context with which to frame news stories in a manner that is easily understood by their audiences [28, 35]. Although audiences are able to choose their own constructs or opinions of issues, framing is particularly influential to audience perceptions of issues where the audience is not as well-informed or active participants of the issue being reported [17, 18, 21]. Image framing is an often overlooked but important component of news media framing that can assist in conveying ideas, eliciting strong emotional responses from audiences, reinforcing stereotypes and guiding audience perceptions and understandings of an issue [26, 29]. This can even be the case where a biased image is accompanying otherwise neutral content [19, 20]. Images can also be used to frame issues in a manner which may be deemed too controversial or may not be expressed in textual form, for example racial, gender or demographic profiling . Image framing can be particularly influential on public opinion as images are often accepted as reflective of reality, and news is reportedly better understood by the public through images and videos rather than written or audio content . The framing of an issue lends itself to subtly pushing particular viewpoints especially when widespread across various media outlets and media (e.g. print, television, online, radio, etc.) which, unless actively countered or highlighted, can influence how the issue plays out in the public discourse [15, 23, 29].
In this paper we utilise content and framing analysis to explore how obesity in Australia’s Indigenous population is represented in both general and Indigenous-focussed news media coverage, and potential implications for the public discourse of Indigenous obesity. The investigative questions include:
What is the extent of media coverage of this issue?
How is this coverage distributed over time and across media sources?
How is Indigenous obesity represented by the media, particularly the causes/origins of and solutions to obesity?
How is this issue framed in both text and image content?