Critical analysis of journalistic treatment of a public health topic

The media construct our representation of the world, but this construction is never neutral. Through the analysis of an article from Le Monde on anti-obesity medications, I question the unconscious biases that orient journalistic discourse toward a purely pharmaceutical vision of health.

Variable-geometry critical distance

We easily analyze, with critical distance, newspaper articles from past times, those from World War II, from the early 20^th century for example, mocking the subjectivity, racism, or prejudices of journalists from that era. This critical capacity comes naturally to us when we observe the past or foreign territories. Yet, we rarely apply this same vigilance to the daily messages transmitted to us by contemporary official press organs.

This asymmetry in our critical thinking is not insignificant. As Noam Chomsky already emphasized in Manufacturing Consent: The Political Economy of the Mass Media (1988), the media construct a “manufactured consensus” that seems all the more natural to us as it constitutes our immediate informational environment. The discourses and representations of the world constructed by journalists create commonality, and this commonality contributes to social bonding. It is therefore always extremely difficult to exercise critical thinking precisely on what creates bonds, and yet, this is the very definition of critical thinking.

I therefore apply to journalists of the present and of my country, France, the same analysis that I could apply to journalists from South Africa, Venezuela, Cuba, or early 20^th century France. I want no difference in treatment. Why would I? Out of fear of being excluded from the social group? If this is the price of freedom of thought, every citizen should be ready to pay this price, for freedom is our most invaluable possession, dearly acquired. Pierre Bourdieu reminded us in On Television (1996), that journalists are caught in power structures and economic logics that orient, consciously or not, their discursive production. Serge Halimi, in The New Watchdogs (1997), shows that the capitalistic concentration of media produces a homogenization of discourses. Walter Lippmann, as early as 1922 in Public Opinion, already showed how the media shape our “mental images” of the world rather than reflecting it.

And precisely, the subject of media education is therefore not to judge the information that is transmitted as if it were a fact, but to know that it is a construction, and to judge the way this information is constructed and transmitted, its political and social stakes. “Objectivity” is an illusion that all sociologists have deconstructed. If we talk about media education, we talk about a sociological or semiological approach, to be able to criticize journalistic practice. This is why media education led by journalists is necessarily counterproductive and misleading, despite good intentions, as I show in the article Media and Information Education : Rethinking the Role of Journalists, with concrete educational proposals.

Anatomy of a bias

I will take a very simple example: the cover of Le Monde from August 23, 2025. I will propose a critical analysis of the method of manufacturing a “false truth” that nevertheless presents itself as completely objective.

On the cover, the big headline in the center of the page is: “Anti-obesity medications, expanded access brings hopes and fears”. This simple sentence deserves an in-depth semiological analysis, in line with Roland Barthes’ work on contemporary mythologies.

• First, the hierarchization of information tells us something about the need to sell the newspaper. This subject is placed at the center and larger on the page, bigger than war, politics, deaths, massacres. Since obesity concerns many people and these people have a problem with their obesity, there is obviously something sensationalist in this title. This commercial logic is not neutral, it already orients the treatment of the subject toward what “sells,” as Patrick Champagne analyzed in Making Opinion (1990).
• Second, the subject is not obesity in general, but specifically anti-obesity medications. This restrictive framing excludes from the outset a whole series of approaches: non-pharmaceutical hospital treatments, nutritional approaches, the cultural history of obesity, the social determinants of obesity, etc. As Michel Foucault noted in The Birth of the Clinic (1963), the medicalization of social problems is a historical process that transforms complex questions into technical problems to be solved. There is therefore a political positioning that perhaps ignores itself.
• Third, the subtitle “expanded access, hopes and fears” presupposes that the pharmaceutical solution is THE way forward, the only questions being its accessibility and its risks. It would have sufficed to add a question mark to position the reader in a critical distance. But no. What this title tells us in subtext, perhaps unconsciously on the part of journalists, is that there exists a simple equation: obesity = necessary medications.

Thus, the subject is not obesity as a complex public health problem, but specifically “anti-obesity medications.” Why not. This initial framing, what George Lakoff would call “framing” in Don’t Think of an Elephant (2004), already orients the reader’s entire perception. The subtitle, “expanded access, hopes and fears,” confirms this orientation: it is not about questioning the very relevance of the pharmaceutical approach, but only discussing its access modalities.

This very clear subliminal message fits into what Ivan Illich called the “medicalization of life” in Medical Nemesis (1975). He denounced how modern medicine transforms social, cultural, and political problems into individual medical problems.

Finally, the three points detailed on the cover reinforce this framing: two names of new medications, their proclaimed effectiveness, their high cost, their non-reimbursement, and the lowering of the obesity threshold that could lead to “misuse.” One could imagine a fourth point that would open onto other perspectives, for example other approaches that work on the causes of obesity, are they relevant? Or, how do doctors position themselves on these alternatives?

This absence is not insignificant. We come back to Noam Chomsky who explained very well how the media, through their editorial choices and blind spots, construct a framework of thought that limits the possibilities of questioning. Here for example, the fact that the obesity threshold has been lowered, opening immense potential gains for pharmaceutical laboratories, is not questioned in its economic impacts, even though it is precisely the work of pharmaceutical lobbies to work to increase their clients’ profits. This crucial information, which should raise questions about conflicts of interest in the very definition of the disease, is presented as a simple technical fact.

In short, this simple title, which might seem innocuous, objective, simple information, in the middle of the front page of Le Monde of August 23, 2025 already reveals its political-economic orientation, which has nothing to do with the public health issues we are led to believe is the subject. It is undoubtedly unconscious on the part of journalists, I do not attribute vile intentions to them. Sociology is there to describe and understand, not to judge.

The absent voices

Reading through the entire article, we discover an apparently serious, documented investigation, with quotes from doctors, discussions about BMI thresholds. And only three words, in passing in a sentence, buried in the four thousand words of this double page, mention that these treatments “must be associated with a diet and sports practice”. Three words, like an obligatory but unimportant stylistic clause, like the small exception that confirms the rule that the real subject is treating effects and not working on causes.

The article certainly cites Mediator, that medication sold as an appetite suppressant that had serious fatal side effects. The Servier laboratory scandal, exposed by Irène Frachon in Mediator 150 mg: How Many Deaths? (2010), which was followed by compensation trials, should have served as a lesson about the dangers of excessive and misplaced medicalization, in service of profit and not health. Yet, this reference is only used to reassure: the new medications would be different, better controlled. I know Mediator intimately, as my grandfather was a pharmaceutical sales representative at Servier laboratory, his job was to sell Mediator to doctors. I spent my childhood drawing on “Mediator” letterhead paper! His admiration and loyalty for “Monsieur Servier” were unshakeable. He died well before the scandal, but at the time he was selling it, the laboratory knew very well the danger of the medication, which was put into perspective with the immense profits it allowed them to make, and lies and manipulation were exercised on the staff itself, my grandfather being completely unaware of the reality of the dangers his work posed to the patients of the doctors he convinced.

The Le Monde article therefore remains focused on what doctors can do, what they can prescribe, thresholds, dosages, etc. It speaks in conclusion of “public health,” but we confuse health and disease. As Georges Canguilhem recalled in The Normal and the Pathological (1966), “health is the luxury of being able to fall ill and recover from it”. Being focused on the pharmaceutical treatment of a disease is not doing public health, it is managing the consequences of broader issues of lifestyle, food culture, and education. Using the term “public health” in such a naive article about the mercantile intentions of laboratories is particularly obscene.

And where are nutritionists and other naturopaths who work on causes rather than symptoms? Where are the anthropologists of food who could shed light on the cultural dimensions of obesity? Where are the sociologists who would analyze the social determinants of this “epidemic”? Where are the doctors who practice therapeutic fasting? There is no presence in this article of any contradictor to pharmaceutical logic, no opening to any broader perspective on the subject. It’s almost an advertorial that doesn’t know it. The absence of diversity in the cited sources illustrates what sociologist Éric Neveu calls the “circular circulation of information”: journalists always interview the same experts, from the same institutions, sharing the same presuppositions. This homogeneity of sources produces a homogeneity of discourse that nevertheless presents itself as exhaustive and objective.

There lies the serious bias of this article. There lies the evidence that this newspaper belongs to shareholders who are also shareholders of pharmaceutical laboratories. As documented by the Basta! collective in its investigations on the links between media and the pharmaceutical industry, it is difficult in a newspaper owned by such people to be able to even suggest that there might be other ways to fight obesity than medications. The denial of certain aspects of reality is mandatory integrated, hidden behind a pretended seriousness, a pretended objectivity.

One could object that the subject of this article from Monde is not obesity, but anti-obesity medications, therefore that my criticism is off-topic, because the journalists did their documentation work well on the subject they are covering. One could tell me that I’m actually talking about another article, the one I would have liked to read in line with my own preconceptions. Here is why I refute this objection: what I’m talking about is the orientation of this article, that is to say the choice not to question at all the legitimacy of the medications and not to mention that there are non-pharmaceutical approaches in the fight against obesity. I’m not saying that the subject of the article should be changed, it would suffice to put a question mark here or there and add two or three words, out of four thousand, that would change everything.

The manufacture of consent

The article functions, whether we like it or not, as sophisticated advertising. The chosen words - “despair,” “deemed very effective,” “lowering of the threshold,” create a sense of urgency and opportunity. Readers will wonder: “Maybe I’m eligible?” This is exactly the effect sought by what Edward Bernays called “the manufacture of consent” in Propaganda (1928). This construction of pharmaceutical desire participates in what Philippe Pignarre calls in The Great Secret of the Pharmaceutical Industry (2003) the “manufacture of patients”.

These journalists have genuinely investigated, questioned people, sought information. It’s serious work, but devoid of any critical spirit about the very framework of the subject treated. Journalists are caught in what Pierre Bourdieu called the “journalistic illusio”: they believe in their own game, in their objectivity, without seeing the structural determinants that orient their work.

The Novo Nordisk and Lilly laboratories are mentioned as having “launched awareness campaigns in the metro”. This information, presented neutrally, normalizes the fact that private companies directly shape public perception of a health problem. No critical analysis of this commercial grip on the very definition of the disease and its treatment.

As Michel Foucault also noted in The Birth of the Clinic (1963), modern medical power is exercised not so much through constraint as through the production of knowledge and norms that define the normal and the pathological. The lowering of the obesity threshold mentioned in the article perfectly illustrates this process: the category of sick people is broadened, thus creating new markets for the pharmaceutical industry.

Media education as an act of citizen resistance

My objective, through this analysis, is not to individually discredit the journalists who worked seriously on this article. Rather, it is to reveal the structural mechanisms that orient, often without their knowledge, their discursive production. As Antonio Gramsci wrote, cultural hegemony is exercised precisely through these unquestioned evidences.

Media education then becomes an act of citizen resistance. It is not about falling into sterile and naive conspiracy theories, but on the contrary about developing what Paulo Freire called “conscientization”: the ability to critically read the representations of the world that are proposed to us. For accepting media framing without questioning is to renounce an essential part of our intellectual freedom.

If we believe that the only answer to obesity lies in medications, what autonomy are we building? What capacity for action on our own health are we developing? As Hippocrates said 2500 years ago, and this wisdom remains strangely absent from the article, “Let food be thy medicine.” This holistic approach to health, which works on causes rather than symptoms, is systematically obscured by the dominant biomedical prism, of which this article is one of the very many signs. And yet all doctors must, before practicing, pronounce the traditional Hippocratic oath. Where is it in the present reality? It’s as if it doesn’t exist.

For genuine public health information

This Le Monde article, presented as informative and balanced, actually reveals the deep biases that structure contemporary journalism when it deals with health. The total absence of alternative perspectives, the exclusively pharmaceutical framing, the normalization of pharmaceutical intervention as the only possible response: all this constructs a worldview in service of industrial interests rather than authentic public health.

Freedom begins with the ability to question the evidences presented to us. I hope to have shown that what presents itself as objective never totally is, and that our duty as enlightened citizens is to keep this critical spirit alive, particularly in the face of discourses that claim to inform us for our own good. For as Kant wrote in What Is Enlightenment? (1784): “Sapere aude!”: Have the courage to use your own understanding.