It started with the denial of a growing health crisis.

Nearly 40% of Georgia's children are overweight or obese -- the second-highest rate in the nation -- yet 50% of Georgians don't consider child obesity a problem. What's more, 75% of parents of obese children don't think they have a problem on their hands, according to Children's Healthcare of Atlanta, the state's largest pediatric health care system.

In response, Children's Healthcare crafted an ad campaign intended to highlight the roles of parents and caregivers in the widening epidemic.

The posters and TV spots of obese children with doleful eyes were as stark as their accompanying messages: "Being fat takes the fun out of being a kid," and "It's hard to be a little girl if you're not," to name a few.

"We felt that because there was so much denial that we needed to make people aware that this is a medical crisis," Chief Administrative Officer Linda Matzigkeit said.

"We knew flowery ads don't get people's attention. We wanted to come up with something arresting and hard-hitting to grab people."

The buzz began almost as soon as the ads started appearing in September on billboards, buses and train platforms around Atlanta. Critics felt images from the Strong4Life campaign were too negative and perpetuated weight-based stereotypes without providing concrete solutions.

"There seems to be this perception that it's OK to shame children and families struggling with obesity because that will provide an incentive to lose weight," said Rebecca Puhl, director of research and weight stigma initiatives at the Rudd Center for Food Policy & Obesity at Yale University.

"However, research in weight bias shows that when individuals feel shamed or stigmatized because of weight they're actually more likely to engage in behaviors that reinforce obesity: unhealthy eating, avoidance of physical activity, increased caloric intake."

The TV spots stopped airing in Georgia in October and most of the billboards have come down. But conversations around the campaign continued online and in media coverage worldwide, raising debate over what makes an ad effective when it comes to combating obesity.

As far as Children's Healthcare is concerned, the fact that the ads sparked debate means they achieved their goal, regardless of the reaction.

"Our intention was to get people talking about childhood obesity and we did that. We can't do this alone; it's going to going take a whole community of physicians, parents and caregivers to solve problem," Matzigkeit said.

"If parents continue to be in denial we're not going to get past this crisis."

It's a crisis that has been fostered by a culture of convenience: fast food, calorie-dense meals and the car-centric cities slowly building up to national obesity rates of 33.8% among adults and 17% in children, according to the Centers for Disease Control and Prevention.

Stormy Bradley realizes now that she was one of those parents who didn't recognize her daughter had a real problem. "It's just a phase; she'll grow out of it," she told herself.

"I think I should've been more proactive earlier on," the Atlanta mother said. "I just didn't want to have a conversation that would upset her or put a rift between us, also because I knew that would mean me having to face my own issues with weight."

Then, Bradley saw an ad on Facebook in February 2011 looking for overweight children. She asked her 13-year-old daughter, Maya Watson, if she was interested and at the audition, the two learned about the substance of the ads.

They also heard about the potential backlash they could face if she accepted the part.

"I was a little bit hesitant but then when I thought about it, I was like well it'll be a good message to other kids like me," Maya said. What's the message? "Being overweight is a problem, but you're not the only one dealing with it," she said.

Feedback from her peers has been positive, she said -- most were surprised to see her on TV and billboards. She also became involved in the media blitz defending the ads, appearing on local news and Good Morning America.

Through the experience, Maya and her mother were offered the chance to utilize the hospital's Health4Life clinic, where she developed small changes to her daily routine through consultations with doctors, psychologists, nutritionists and exercise physiologists. And, she's sticking with it, she and mother attested.

Fruits are surprisingly filling, she said. She can't remember the last time she drank soda after giving up sugary beverages for water and the occasional packet of sugar-free drink mix. She typically exercises at least 30 minutes a day, either by walking the dog with her mom or going to the park or playing on the Wii her younger brother.

By the time school began last fall, she was ready to try out for the cheerleading squad and made it, which means two training sessions a week along with two to three games.

"The smaller things definitely make a change," she said in a phone interview Sunday as she and her mother drove to a "Black Girls Run" event in Lithonia, Georgia.

"It's very hilly in my neighborhood but now when I walk the dog I don't get as tired. With cheerleading, we have to run a mile at least. And before I couldn't do the whole thing but now I can."