“Underwareness": When Corporate Ad Campaigns Trump Education

Have you seen the "Underwareness" print ad campaign for Depends?  It features models fully dressed on top while wearing nought but Depends adult diapers (and for the ladies, high heels) on the bottom, with the slogan "I dropped my pants for Underwareness."

It is accompanied by a flashy website detailing events such as their launch party and fashion show (featuring Depends) and encouraging people to share the campaign on social media outlets, with the incentive that for each post, tweet, or link they will donate a dollar to charity (United Way and the Simon Foundation for Continence.)

I am so cynical about this.


NOWHERE on the site does it say that incontinence is treatable. Instead there are links to pages where you can purchase Depends or get a free sample.

Always the optimist, I hope that the effects of the campaign are not all bad. It will perhaps assist in de-stigmatizing a common health problem (incontinence affects 25% of the American population, according to Depends.)

Another point in it's defense is that the purpose of corporations is to make money - why shouldn't their marketing campaign dollars go to marketing their products? 

And yet it is frustrating that our knowledge of health and anatomy is so limited in our country that most people don't know incontinence is preventable and treatable, which allows an ad campaign like this to thrive.

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Consider just one contributor to incontinence: pregnancy and delivery. I couldn't easily find statistics on the rate of postpartum incontinence in the United States* - an indicator of how little we value women's pelvic health here - but anecdotally it is common for women to chalk up incontinence as an unavoidable and untreatable result of carrying and birthing the next generation.

Just yesterday I was eating brunch at a kitschy restaurant with various witty sayings on the wall ("Tis better to have loved and lost than to live with a psycho the rest of your life!"), including one that read "I laughed so hard tears ran down my leg!" That wouldn't be viewed as funny if stress incontinence was known to be curable.

Another common cause of stress incontinence is athletic pursuits. In a YouTube video from 2013 made at the CrossFit Games, athletes laugh about how they pee during workouts and competition, and brag that it is a sign of intensity. The video even feature a gynecologist who claims that "In my professional opinion it is okay to pee during double-unders." (Double-unders are when you jump rope, but swing the rope under your feet twice before landing.)  

Yikes. This is a disturbing example of miseducation regarding pelvic health. When even doctors don't know the facts, how can we expect people to know that continence is an attainable goal?  

Thankfully various physical therapists wrote in response to this video, to educate people that incontinence is indeed a dysfunction. You can find some of the many responses on MoveForwardPt.com, PhysioDetective.com, and PelvicGuru.com.

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I understand that the Depends promos are advertising and not a public health PSA, but I am angry that they take on the veneer of an educational campaign when they are not. This is a blatant example of a company putting the bottom line ahead of the wellbeing of their customers, made even more insulting by putting forward a calculated image of "do-goodery."


It is frustrating that this supposed do-goodery (Spread the word! We'll donate when you do so!) encourages people to share the ad campaign by making them feel like they are promoting health when they are not.

Another gripe: the ad campaign is, like many ad campaigns, sexy and fun. While humor can go a long way in making people comfortable with taboo subjects, since when are health problems sexy and fun??!! 

"Hey baby, let's make love, and don't mind if I unintentionally urinate on you - it's hot."

How on earth is that reasonable? By framing a health problem this way it ignores the very real suffering of the people struggling with it, and makes it seem that help is not available, necessary, or desirable.

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So the Depends campaign is out there, but surely there must be substantial alternative resources where the public can find accurate and complete information on treatment options?

There's a long list of possible treatments listed on the Simon Foundation's website which may be worth a gander. I'm not a medical professional and can't speak to their efficacy, but I'm wary since not only is the website pretty shoddy and not appear to represent a robust organization, this Foundation is apparently willing to take loads of money from a corporation who will benefit from them not doing their job. 

Is there perhaps a better place to direct you to? Interestingly enough, the Google searches "incontinence research," "incontinence education," and "patient education incontinence," turn up not a single first page result for an American organization dedicated to incontinence research and education. (There was an Australian one, sponsored by the Australian government - they have nationalized health care.)

While there are results from reputable resources as the Mayo Clinic and the National Institutes of Health, there are also plenty of sketchy ones.

It is disturbing that such basic health research and information is not prioritized, funded, and made easily available to the public.

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What to do?

  • If you or a loved one is suffering from incontinence, check out the Women's Health Section of the American Physical Therapy Association's website. They have a PT Locator where you can find a local PT who specializes in either urinary and/or bowel incontinence. Again, I am not a medical professional, but it's a start.
  • Tell me if you are aware of any other reputable resources for continence treatment; I'd love to share them.

And... tell your friends not to drop their pants for "Underwareness," but rather to

Drop your pants for a solidly trained PT.


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*FYI I did find one small study from Norway that was published in the International Urogynecological Journal of Pelvic Floor Dysfunction in 1999 that showed 48% of women had symptoms of incontinence during their pregnancy, and 38% after delivery. The abstract concludes not that pregnant women should start wearing adult diapers, but that "This documents the needs for a strategy to prevent and treat urinary incontinence during these periods."