Friday Favorites: The Role of Marketing and Food Advertisements in the Obesity Epidemic

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

I talk a lot about the power of taking personal responsibility for your own health, for your family’s health. But there are forces at play when it comes to influencing what we eat. Check it out.

In the 1970s, the U.S. government went from just subsidizing some of the worst foods to paying companies to make more of them. In the 1970s the farm bills reversed longstanding policies aimed at limiting production to protect prices and instead started giving payouts in proportion to output. Extra calories started pouring into the food supply.

Then, Jack Welch gave a speech. In 1981, the CEO of General Electric effectively launched the “shareholder value movement,” reorienting the primary goal of corporations towards maximizing short-term returns for investors. This placed extraordinary pressures on food companies from Wall Street to post increasing profit growth every quarter to boost their share price. There was already a glut of calories on the market, and now they had to sell even more.

This places food and beverage CEOs in an impossible bind. It’s not like they’re rubbing their sticky hands together at the thought of luring more Hansels and Gretels to their doom in their houses of candy. Food giants couldn’t do the right thing if they wanted. They are beholden to investors. If they stopped marketing to kids, or tried to sell healthier food, or anything that could jeopardize their quarterly profit growth, Wall Street would demand a change in management. Healthy eating is bad for business. It’s not some grand conspiracy; it’s not even anyone’s fault. It’s just how the system works.

Given the constant demands for corporate growth and rapid returns in an already oversaturated marketplace, the food industry needed to get people to eat more. Like the tobacco industry before them, they turned to the ad men. The food industry spends about $10 billion a year on advertising, and around another $20 billion on other forms of marketing, such as trade shows, incentives, consumer promotions, and supermarket “slotting fees.” Food and beverage companies purchase shelf space from supermarkets to prominently display their most profitable products. They pay supermarkets. The practice is also evidently known as “cliffing,” because companies are forced to bid against each other for eye-level shelf placement, with the loser pushed “over the cliff.” With slotting fees up to $20,000 per item, per retailer, per city, you can imagine what kind of products get the special treatment. Hint: It ain’t broccoli.

To get a sense of what kind of products merit prime shelf real estate, look no further than the checkout aisle. “Merchandising the power categories on every lane is critical,” reads a trade publication on the “best practices for superior checkout merchandising.” They were referring to candy bars and beverages. Evidently, even a one percent power category boost in sales could earn a store an extra $15,000 a year. It’s not that they necessarily don’t care about their customers’ health; publicly traded companies, like most of the leading grocery store chains, are said to have a fiduciary duty to increase profits above other considerations.

Tens of millions of dollars are spent annually advertising a single brand of candy bar. McDonald’s alone may spend billions a year. The food industry now spends more money on advertising than any other sector of the economy.

Reagan-era deregulation removed the limits placed on marketing food products on television to children. Now, the average child may see more than 10,000 TV food ads a year, and that’s on top of the marketing online, in print, at school, on their phones, at the movies, and everywhere in between. Nearly all of it is for products detrimental to their health.

Besides the massive early exposure and ubiquity, food marketing has become highly sophisticated. With the help of child psychologists, companies learn how to best influence children to manipulate their parents. Packaging is designed to best attract a child’s attention, and then placed at their eye level in the store. You know those mirrored bubbles in the ceilings of supermarkets? They’re not just for shoplifters. Closed-circuit cameras and GPS-like devices on shopping carts are used to strategize how best to guide shoppers towards their most profitable products. Behavioral psychology is widely applied to increase impulse buying. Eye movement-tracking technologies are utilized.

The unprecedented rise in the power, scope, and sophistication of food marketing starting around 1980, which aligns well with the blastoff slope of the obesity epidemic. Some of the techniques, such as product placement, in-school advertising, and event sponsorships skyrocketed from essentially zero to multibillion-dollar industries since the Eighties. This led one noted economist to conclude that “the most compelling single interpretation of the admittedly incomplete data we have is that the large increase in obesity is due to marketing.” Yes, innovations in manufacturing and political maneuvering led to a food supply bursting at the seams, with close to 4,000 calories a day for us all, but it’s the advances in marketing manipulations that are used to try to peddle that surplus into our mouths.

The opening words of the Institute of Medicine’s report on the potential threat posed by food ads were: “Marketing works.” Yeah, there are a large number of well-conducted randomized studies I could go through showing advertising exposure and other marketing methods can change your eating behavior and get you to eat more, but what do you need to know beyond the fact the industry spends tens of billions of dollars a year on it? To get people to drink their brown sugar water, do you think Coca-Cola would spend a penny more than they thought they had to? It’s like when my medical colleagues accept “drug lunches” from pharmaceutical representatives, and take offense that I would suggest it might affect their prescribing practices. Do they really think drug companies are in the business of giving away free money for nothing? They wouldn’t do it if it didn’t work.

To give you a sense of marketing’s insidious nature, though, let me share an interesting piece of research published in the world’s leading scientific journal: “In-store music affects product choice” documented an experiment in which either French accordion or German Bierkeller music was played on alternate days in the wine section of a grocery store. On the days the French music was playing in the background, people were three times more likely to buy French wine, and on German music days, shoppers were about three times more likely to buy German wine. Despite the dramatic effect—not just a few percent difference, but a complete three-fold reversal—when approached afterwards, the vast majority of shoppers denied the music had influence on their choice.

We all like to think we make important life decisions, like what to eat, consciously and rationally. However, if that were the case, we wouldn’t be in the midst of an obesity epidemic. Most of our day-to-day behavior does not appear to be dictated by careful, considered deliberations. Rather, we tend to make more automatic, impulsive decisions triggered by unconscious cues or habitual patterns, especially when we’re tired, stressed, or preoccupied. The unconscious part of our brain is thought to guide human behaviors as much as 95 percent of the time. This is the arena where marketing manipulations do most of their dirty work.

The part of our brain that governs conscious awareness may only be able to process about 50 bits of information per second, which is roughly equivalent to a short tweet. Our entire cognitive capacity, on the other hand, is estimated to process in excess of 10 million bits per second. Because we’re only able to purposefully process a limited amount of information at a time, if we’re distracted or otherwise unable to concentrate, our decisions can become even more impulsive. An elegant illustration of this “cognitive overload” effect was provided from an experiment involving fruit salad and chocolate cake.

Before calls could be made at a touch of a button or the sound of our voice, the seven-digit span of phone numbers was based in part on the longest sequence most people can recall on the fly. We only seem able to hold about seven chunks of information (plus or minus two) in our immediate short-term memory. Okay, so here’s the setup: randomize people to memorize either a seven-digit number or a two-digit number, to be recalled in another room down the hall. On the way, offer them the choice of a fruit salad or a piece of chocolate cake. Memorizing a two-digit number is easy, and presumably takes few cognitive resources. Under the two-digit condition, most chose the fruit salad. Faced with the same decision, most of those trying to keep the seven digits in their heads just went for the cake.

This can play out in the real world by potentiating the effect of advertising. Have people watch a TV show with commercials for unhealthy snacks, and, no surprise, they eat more unhealthy snacks (compared to those exposed to non-food ads). Or, maybe that is a surprise. We all like to think that we’re in control and not so easily manipulatable. The kicker, though, is that we may be even more susceptible the less we pay attention. Randomize people to the same two-digit or seven-digit memorization task during the show, and the snack attack effect was magnified among those who were more preoccupied. How many of us have the TV on in the background, or multi-task during commercial breaks? This research suggests that it may make us even more impressionable to the subversion of our better judgement.

There’s an irony in all this. Calls for restrictions on marketing are often resisted by invoking the banner of freedom. What does that even mean in this context, when research shows our how easily our free choices can be influenced without our conscious control? A senior policy researcher at the RAND Corporation even went as far as to suggest that given the dire health consequences of our unhealthy eating habits, insidious marketing manipulations “should be considered in the same light as the invisible carcinogens and toxins in the air and water that can poison us without our awareness.”

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• Nestle M. Utopian dream: a new farm bill. Dissent. 2012;59(2):15-9.
• Nestle M. Interview with Marion Nestle. Health Promot Pract. 2008;9(1):16-8.
• Nestle M, Jacobson MF. Halting the obesity epidemic: a public health policy approach. Public Health Rep. 2000;115(1):12-24.
• Stanton RA. Food retailers and obesity. Curr Obes Rep. 2015;4(1):54-9.
• Muris TJ, Thompson MW, Swindle O, Leary TB, Jones HP. Slotting allowances in the retail grocery industry: select case studies in five product categories. Federal Trade Commission. Published November 2003.
• Collier R. Call to reduce junk food at checkouts. CMAJ. 2015;187(1):E14.
• Cohen DA, Lesser LI. Obesity prevention at the point of purchase. Obes Rev. 2016;17(5):389-96.
• Vranica S. McDonald’s to review its $2 billion global media buying account. Wall Street Journal. Published October 26, 2017.
• Winson A. Bringing political economy into the debate on the obesity epidemic. Agric Human Values. 2004;21(4):299-312.
• Lapierre MA, Fleming-Milici F, Rozendaal E, McAlister AR, Castonguay J. The effect of advertising on children and adolescents. Pediatrics. 2017;140(Suppl 2):S152-6.
• Harris JL, Pomeranz JL, Lobstein T, Brownell KD. A crisis in the marketplace: how food marketing contributes to childhood obesity and what can be done. Annu Rev Public Health. 2009;30:211-25.
• James P. All-of-government approach needed to tackle obesity. Interview by Fiona Fleck. Bull World Health Organ. 2013;91(8):551-2.
• Bond ME, Crammond BR, Loff B. It’s not about choice: the supermarket and obesity. Med J Aust. 2012;197(7):371.
• Cohen DA. Neurophysiological pathways to obesity: below awareness and beyond individual control. Diabetes. 2008;57(7):1768-73.
• Zimmerman FJ. Using marketing muscle to sell fat: the rise of obesity in the modern economy. Annu Rev Public Health. 2011;32:285-306.
• Katz D. Obesity . . . be dammed!: what it will take to turn the tide. Harvard Health Policy Rev. 2006;7(2):135-51.
• Institute of Medicine. Food marketing to children and youth: threat or opportunity? National Academies Press. 2006.
• Zimmerman FJ. Using marketing muscle to sell fat: the rise of obesity in the modern economy. Annu Rev Public Health. 2011;32:285-306.
• Nestle M, Jacobson MF. Halting the obesity epidemic: a public health policy approach. Public Health Rep. 2000;115(1):12-24.
• North AC, Hargreaves DJ, McKendrick J. In-store music affects product choice. Nature. 1997;390(132):132.
• Cohen DA. Neurophysiological pathways to obesity: below awareness and beyond individual control. Diabetes. 2008;57(7):1768-73.
• Miller GA. The magical number seven plus or minus two: some limits on our capacity for processing information. Psychol Rev. 1956;63(2):81-97.
• Shiv B, Fedorikhin A. Heart and mind in conflict: the interplay of affect and cognition in consumer decision-making. J Consum Res. 1999;26(3):278-92.
• Zimmerman FJ, Shimoga SV. The effects of food advertising and cognitive load on food choices. BMC Public Health. 2014;14:342.

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Motion graphics by Avocado Video