How to Avoid the Boomerang Effect of Remedy Messaging

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How can mandating healthy eating messaging on fast-food ads ironically make things worse?

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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.

Denmark ended up canceling its saturated fat tax on meat and dairy, and shelving their sugar tax because the farming and food company interests claimed too many jobs would be lost if people ate healthier. Apparently, a healthy economy was more important than a healthy citizenry. Ironically, the fat tax was abolished just when evidence of the effects started to appear. The intake of saturated fat among Danish consumers from some meat and dairy products was declining, but not from sour cream. The public ended up eating so much more low-fat sour cream that it ended up outweighing the smaller reduction in high-fat sour cream. So, you always have to think about the unintended consequences.

If incentives have people swapping out sugary cookies for salty chips, for example, it might not be doing the public’s health many favors. One field study of a tax on soda found that you can drop soft drink purchases, but households may just end up buying more beer. Another study found that calorie labeling of sugary drinks ironically led to an increase in consumption, presumed to be because the consumers may have previously overestimated their caloric content.

Stark warnings about the risks of unintended negative consequences of obesity-targeted health policies are trumpeted by those with ties to the likes of Coca-Cola, Kraft, PepsiCo, Wrigley, Red Bull, the World Sugar Research Organization, the National Cattlemen’s Association, Mars, and corn syrup giant Archer Daniels Midland (and that’s just a single scientist). The concern about unintended consequences shouldn’t paralyze our efforts, but should serve up a healthy dose of humility when considering policy proposals.

How about releasing a video game for kids that promotes fruit? Sounds good, right? Well, what do you think happened when kids were sat down in front of bowls of fruit and candy, and randomized to play one of three different computer “advergames” (advertising-game hybrids incorporating product placements) promoting either candy, fruit, or toys? The pro-candy game group ate more candy, but disappointingly the pro-fruit group didn’t eat more fruit. But then it gets interesting. They ate more candy in the fruit game, too. Compared to the toy promotion control group, having a kid play a video game promoting fruit led them to eat more candy. Presumably, both the candy and fruit games just made them think about food, and they naturally gravitated to their preferred snack.

One of the most fascinating phenomena I came across was the boomerang effect of “remedy messaging.” One might presume that the advertising of smoking cessation aids like nicotine gum would help make quitting easier. After all, the vast majority of smokers want to quit, and so availing them of helpful options couldn’t help but help, right?

Instead, such remedy marketing can create a vicarious “get out of jail free card” that ends up reinforcing risky behavior. Exposure to nicotine replacement product advertising was found to undermine quitting intentions––especially among the heaviest smokers, the very ones who needed it the most. The thought is that smokers may subconsciously interpret the remedy as evidence that the hazards of smoking are more manageable, hence less risky, and thereby help to justify their habit.

You can see how easily this would translate to the weight loss arena. Previously, I explored how self-licensing could cause those taking slimming supplements to inadvertently eat more, but just exposure to a “fat-fighting pill” advertisement appeared to have a similar type of effect. So, even when companies are ostensibly selling health rather than disease, they still may be inadvertently making the problem worse. In the marketplace, there’s just no incentive for risk-avoidance messaging. Nobody makes money selling “just say no,” unless it can be somehow linked to saleable products and services.

A policy in France—where burgers now outsell baguettes—may represent an interesting real-world example of this counterintuitive remedy messaging effect. Industry lobbyists morphed a valiant effort to ban the advertising of junk into a mandate for preventive health messaging on junk food advertisements. So now, on products like “Lay’s Chips Saveur Poulet Rôti” (chicken-flavored potato chips), you’ll see messages like “Pour votre santé, pratiquez une activité physique régulière”––“For your health, practice regular physical activity.” Sounds good, right? But any time an industry agrees to a regulation, one should get skeptical as to its effectiveness.

To see if such messaging might lead to a boomerang effect, research subjects were randomized to view a Big Mac advertisement with or without the preventive health message “Eat five fruits and vegetables per day.” I mean, wouldn’t it be great if McDonald’s was forced to advertise healthy food? The participants then filled out some BS questionnaire, and before they left were allowed to choose one of two McDonald’s coupons as a reward for their participation: a free sundae or a free bag of fruit. Guess who was more likely to pick the fruit?

Only one in three of those who just saw the straight burger advertisement chose the fruit over the sundae. But that number fell to only one in six among those who’d been prompted to eat healthier. Let that sink in for a second. Isn’t that crazy? The absence of the healthy message doubled the choice of the healthy snack. The health message made things worse. This may be the remedy messaging boomerang effect in action. By simultaneously offering a temptation with a reminder about how they can dig themselves out later justifies the excuse to indulge. Subconsciously, it may give the chicken-y chip eater the rationalization that they can just work it off the next day––even if the next day at the gym never comes.

The advised antidote to avoid justification effects is to instead use negative framing. Instead of offering a way out to compensate for indulging “just this one time,” cautionary messages may be more effective. For example, on your next ham and cheese, or chocolate-filled croissant, a message like: “For your health, avoid foods that are too fatty, too sweet, or too salty.” That’s a message for which I doubt Le McDonald’s would be as enthusiastic. 

Learning about this rebound effect has made me reflect on my work on NutritionFacts.org, distilled into How Not to Die. It doesn’t get much more remedy messaging than that! If we can get such dramatic benefits with diet and lifestyle changes so late in life, in such a short amount of time, why can’t we just live lives of gluttony and sloth, and then around 50 or so, just clean up our acts? The reason is because it may be too late. Our first symptom may be our last.

Most people know the number one killer of both men and women in the United States is heart disease. What people may not know, though, is that, according to the American Heart Association, for the majority of Americans that die of heart disease, their first symptom occurs not years before they die, but literally minutes before they die. Sudden cardiac death is the first manifestation of heart disease for the majority of individuals––particularly among women, meaning you had no idea you even had heart disease until you’re literally dying from it. Heart disease reversal is great, but that’s why prevention is the key. When it comes to sudden death, an ounce of prevention truly is worth more than a pound of cure, because there is no cure… for dead.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

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.

Denmark ended up canceling its saturated fat tax on meat and dairy, and shelving their sugar tax because the farming and food company interests claimed too many jobs would be lost if people ate healthier. Apparently, a healthy economy was more important than a healthy citizenry. Ironically, the fat tax was abolished just when evidence of the effects started to appear. The intake of saturated fat among Danish consumers from some meat and dairy products was declining, but not from sour cream. The public ended up eating so much more low-fat sour cream that it ended up outweighing the smaller reduction in high-fat sour cream. So, you always have to think about the unintended consequences.

If incentives have people swapping out sugary cookies for salty chips, for example, it might not be doing the public’s health many favors. One field study of a tax on soda found that you can drop soft drink purchases, but households may just end up buying more beer. Another study found that calorie labeling of sugary drinks ironically led to an increase in consumption, presumed to be because the consumers may have previously overestimated their caloric content.

Stark warnings about the risks of unintended negative consequences of obesity-targeted health policies are trumpeted by those with ties to the likes of Coca-Cola, Kraft, PepsiCo, Wrigley, Red Bull, the World Sugar Research Organization, the National Cattlemen’s Association, Mars, and corn syrup giant Archer Daniels Midland (and that’s just a single scientist). The concern about unintended consequences shouldn’t paralyze our efforts, but should serve up a healthy dose of humility when considering policy proposals.

How about releasing a video game for kids that promotes fruit? Sounds good, right? Well, what do you think happened when kids were sat down in front of bowls of fruit and candy, and randomized to play one of three different computer “advergames” (advertising-game hybrids incorporating product placements) promoting either candy, fruit, or toys? The pro-candy game group ate more candy, but disappointingly the pro-fruit group didn’t eat more fruit. But then it gets interesting. They ate more candy in the fruit game, too. Compared to the toy promotion control group, having a kid play a video game promoting fruit led them to eat more candy. Presumably, both the candy and fruit games just made them think about food, and they naturally gravitated to their preferred snack.

One of the most fascinating phenomena I came across was the boomerang effect of “remedy messaging.” One might presume that the advertising of smoking cessation aids like nicotine gum would help make quitting easier. After all, the vast majority of smokers want to quit, and so availing them of helpful options couldn’t help but help, right?

Instead, such remedy marketing can create a vicarious “get out of jail free card” that ends up reinforcing risky behavior. Exposure to nicotine replacement product advertising was found to undermine quitting intentions––especially among the heaviest smokers, the very ones who needed it the most. The thought is that smokers may subconsciously interpret the remedy as evidence that the hazards of smoking are more manageable, hence less risky, and thereby help to justify their habit.

You can see how easily this would translate to the weight loss arena. Previously, I explored how self-licensing could cause those taking slimming supplements to inadvertently eat more, but just exposure to a “fat-fighting pill” advertisement appeared to have a similar type of effect. So, even when companies are ostensibly selling health rather than disease, they still may be inadvertently making the problem worse. In the marketplace, there’s just no incentive for risk-avoidance messaging. Nobody makes money selling “just say no,” unless it can be somehow linked to saleable products and services.

A policy in France—where burgers now outsell baguettes—may represent an interesting real-world example of this counterintuitive remedy messaging effect. Industry lobbyists morphed a valiant effort to ban the advertising of junk into a mandate for preventive health messaging on junk food advertisements. So now, on products like “Lay’s Chips Saveur Poulet Rôti” (chicken-flavored potato chips), you’ll see messages like “Pour votre santé, pratiquez une activité physique régulière”––“For your health, practice regular physical activity.” Sounds good, right? But any time an industry agrees to a regulation, one should get skeptical as to its effectiveness.

To see if such messaging might lead to a boomerang effect, research subjects were randomized to view a Big Mac advertisement with or without the preventive health message “Eat five fruits and vegetables per day.” I mean, wouldn’t it be great if McDonald’s was forced to advertise healthy food? The participants then filled out some BS questionnaire, and before they left were allowed to choose one of two McDonald’s coupons as a reward for their participation: a free sundae or a free bag of fruit. Guess who was more likely to pick the fruit?

Only one in three of those who just saw the straight burger advertisement chose the fruit over the sundae. But that number fell to only one in six among those who’d been prompted to eat healthier. Let that sink in for a second. Isn’t that crazy? The absence of the healthy message doubled the choice of the healthy snack. The health message made things worse. This may be the remedy messaging boomerang effect in action. By simultaneously offering a temptation with a reminder about how they can dig themselves out later justifies the excuse to indulge. Subconsciously, it may give the chicken-y chip eater the rationalization that they can just work it off the next day––even if the next day at the gym never comes.

The advised antidote to avoid justification effects is to instead use negative framing. Instead of offering a way out to compensate for indulging “just this one time,” cautionary messages may be more effective. For example, on your next ham and cheese, or chocolate-filled croissant, a message like: “For your health, avoid foods that are too fatty, too sweet, or too salty.” That’s a message for which I doubt Le McDonald’s would be as enthusiastic. 

Learning about this rebound effect has made me reflect on my work on NutritionFacts.org, distilled into How Not to Die. It doesn’t get much more remedy messaging than that! If we can get such dramatic benefits with diet and lifestyle changes so late in life, in such a short amount of time, why can’t we just live lives of gluttony and sloth, and then around 50 or so, just clean up our acts? The reason is because it may be too late. Our first symptom may be our last.

Most people know the number one killer of both men and women in the United States is heart disease. What people may not know, though, is that, according to the American Heart Association, for the majority of Americans that die of heart disease, their first symptom occurs not years before they die, but literally minutes before they die. Sudden cardiac death is the first manifestation of heart disease for the majority of individuals––particularly among women, meaning you had no idea you even had heart disease until you’re literally dying from it. Heart disease reversal is great, but that’s why prevention is the key. When it comes to sudden death, an ounce of prevention truly is worth more than a pound of cure, because there is no cure… for dead.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

Do Healthy Fast Food Options Lead to Healthier Choices? is the video I mentioned about self-licensing.

For some good old-fashioned negative framing, see Cut the Calorie-Rich-And-Processed Foods.

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