How Diet-Pill Ads Fuel Obesity

Just viewing a promotion for a quick-fix weight-loss drug was enough to make people eat worse, a new study found.

In October 2010, under pressure from the Food and Drug Administration, pharmaceutical company Abbott pulled its weight-loss drug Meridia from the market.

“Meridia’s continued availability is not justified when you compare the very modest weight loss that people achieve on this drug to their risk of heart attack or stroke,” Dr. John Jenkins, director of the FDA’s Office of New Drugs, said in a statement at the time, referencing a clinical trial that linked Meridia to an increase in cardiovascular problems. “Patients should stop taking this medication.”

But during its 14 years of availability, Meridia—and other drugs of its kind—may have also caused a more subtle and more widespread kind of harm, one that affected even those who never took a weight-loss pill in their lives: New research has found that that just being exposed to advertisements for weight-loss medication was enough to drive people toward unhealthier choices.

In a study in the forthcoming issue of The Journal of Public Policy and Marketing, researchers from Pennsylvania State University, Darthmouth College, and the University of Pennsylvania had 134 volunteers read a warning about the health dangers of high-fat diets. For some, the message concluded there. For others, it continued: “Until now! Introducing Chitosan Rx Ultra,” a weight-loss aid “capable of absorbing up to 60 percent of the fat in your food.”

Afterwards, the participants were told they would be taking part in a taste test for a new snack product; half read marketing materials that described it as “delicious yet guilt-free,” while the other half believed they were getting a “rich, sinful” (and high-fat) treat. When they were given a plate of 30 cookies, those who had seen the message about Chitosan took significantly more than those who saw only the general nutrition advice. A few took all 30.

Study author Lisa Bolton, a marketing professor at Penn State, characterized the findings as a “boomerang effect,” a psychological phenomenon in which efforts to persuade people one way actually push them in the opposite direction—in this case, a message about losing weight actually nudged them towards actions that made them more likely to gain it.

“People see the drug as a sort of get-out-of-jail-free card,” she said. The reminder that quick-fix remedies exist “undermines your motivation,” she said, “and also your feeling that you have the ability to [lose weight] by yourself.”

Or, as the study so aptly put it, “Why make healthier food choices to manage weight if a weight-management drug can manage your weight for you?”

Bolton and her colleagues have previously studied the effects of so-called “remedy marketing” across several different areas and found that across the board, exposure to advertisements touting easy solutions tends to nudge people into poorer decision-making. In finance, for example, “just being exposed to marketing for a debt-consolidation loan makes you think, ‘Hey, the risks of my credit-card spending aren’t too bad, because if I do get into trouble, I can get one of these debt-consolidation loans,’” she said. “And so that kind of leads to reducing your perceptions of the risk and engaging in more risky financial behaviors, in this case.”

Oddly, though, the researchers also found that with weight-loss aids, the remedy-marketing effect was almost all in the framing. When volunteers were exposed to the same Chitosan ad with one small change—the treatment was described as a “supplement” rather than a drug—the boomerang effect went away, even after Bolton and her colleagues controlled for perceived effectiveness. (Whether or not a drug would be considered more effective than a supplement, in other words, wasn’t the driving force behind the difference.)

It bears noting that with a few exceptions—like Meridia and the infamous Fen-Phen—prescription and over-the-counter weight-loss drugs are, on the whole, less dangerous than the dietary supplements that promise the same result. Unlike drugs, supplements don’t need to be formally approved by the Food and Drug Administration. A manufacturer or distributor simply needs to notify the FDA that they intend to market a supplement and explain why it’s “reasonably expected to be safe,” leaving plenty of space for diluted or harmful substances to slip through the cracks unregulated. Since 2004, according to The New York Times, half of all products recalled by the FDA were supplements that contained banned pharmaceuticals—including Zi Xiu Tang Bee Pollen Capsule, a weight-loss supplement whose active ingredient, sibutramine, is the same as that of Meridia. (Earlier this year, the Federal Trade Commission created “Gut Check,” a website devoted to helping people spot red flags in weight-loss advertisement claims.)

But still, from a marketing standpoint, supplements appeared to be a more effective driver of healthy consumption than did drugs. “With the supplement, the very name reminds you that this is supplemental to other health protective behavior,” Bolton said. “They think [losing weight] is something they have to do as well … but people believe that the drug alone will take care of the problem.”

“If you played Monopoly, right, who wouldn’t want to have that get-out-of-jail-free card and play it when needed,” she said, “rather than the more costly paying your way out of jail?”