Are Marketers Responsible for Obesity?

Years of diet culture and unfounded marketing messaging have often left consumers confused and rarely slimmer

The trial and error of weight loss can feel like a bad relationship. People get their hopes up, then a setback dashes them. A moment of reconciliation rekindles the optimism. But just when it starts to feel like it’s going to work, it collapses, leaving them to start all over again.

Cyclical ebbs and flows have a name in weight-loss parlance: yo-yo dieting. There are 93.3 million obese adults in the U.S., home of a $66 billion weight-loss market. With that many potential customers and so much money at stake, a lot of diets are bound to fail. Like searching for a soulmate online, finding a weight-loss solution can mean wading through many offers that seem too good to be true—because they are. Others—legitimate products—can be overlooked in a crowded market. Effective weight-loss products must juggle standing out, being transparent and remaining engaged throughout the user life cycle. It’s a lot to ask, but a committed brand-user relationship can be a beautiful thing.

Too Many (Bad) Fish in the Sea

Vintage weight-loss ads are an easy laugh. Today, it’s hard to imagine being convinced to swallow a waist-trimming tapeworm or chew an appetite-suppressing gum. It’s great comedy—until you see ads in 2018 hawking waist-reducing belts and appetite-suppressing lollipops. With a low barrier to entry, the weight-loss industry plays like the Wild West.

“This is a difficult area to enforce,” says Richard Cleland, assistant director for advertising practices at the FTC’s Bureau of Consumer Protection. “Unlike drug-type products, weight-loss products don’t have to be registered. They don’t have to have any prior showing of efficacy. It’s a post-market enforcement mechanism.”

Delayed oversight and an overweight nation make the field fertile for scams. The FTC’s 2011 survey on fraud, published in 2013, found more consumers were victims of fraudulent weight-loss products than of any other fraud covered in the report. The agency estimated that 2.1% of consumers, or 5.1 million U.S. adults, purchased and used fraudulent weight-loss products in 2011. That’s a lot of lollipops.

In its research, the FTC considered weight-loss products fraudulent if they were marketed to help consumers easily lose a substantial amount of weight or to lose weight without diet or exercise. “When consumers purchased and used the product, they lost less than half of the weight they had expected to lose, if they lost any weight at all,” the FTC reported. Weight-loss products as defined by the report included nonprescription drugs, dietary supplements, skin patches, creams, wraps or—wait for it—earrings.

The commission can’t review every weight-loss product. As Cleland explains, it can be difficult to track the products after they’ve been set free on the market. Prior to 1994, weight-loss products were considered to be drugs and required approval by the FDA to be sold. But when Congress passed the Dietary Supplement Health and Education Act, it reclassified weight-loss products as foods that do not require any type of registration and approval, which unleashed what Cleland calls “a torrent of fraudulent and deceptive weight-loss claims.”

In the early 2000s, the FTC assembled a workshop on weight-loss advertising, which included a science panel, industry panel and media panel. “The panelists recognized that deceptive weight-loss advertising was a growing problem, despite increased FTC law enforcement and consumer education efforts,” a report on the workshop reads. “To address the problem, the weight-loss industry expressed a willingness to strengthen self-regulation, including the development of more effective weight-loss advertising guidelines and the exploration of a larger role for the NAD (National Advertising Division of the Council of Better Business Bureaus).”

Aside from this summary document, there’s little else to show for the workshop. There were suggestions of writing ad guidance, but industry groups showed resistance. The National Nutritional Foods Association was concerned that a list of what it called “presumptively false claims” would be too narrow, “and that marketers would interpret any claim not specifically listed as being allowed.”

There may be another reason the results from the workshop were limited: The problem would soon grow too big. The summary document only mentioned the internet twice, suggesting the impact of this platform wasn’t yet realized.

“If the fraud in this area is going to be effectively addressed, there needs to be some kind of regulation that would require companies to get prior approval of their weight-loss products,” Cleland says. “There are some self-regulatory organizations—particularly the Council for Responsible Nutrition on the industry side and the National Advertising Division on the advertiser side—that have tried to make an effort to engage in self-policing. I think this problem is too big for them as well.”

CRN did not return a request for more information on the topic. A spokesperson for the American Herbal Products Association, one of the groups involved in the FTC’s 2003 workshop, pointed to voluntary guidance published by the Partnership for Healthy Weight Management, but that guidance was published by the FTC in 1999. A spokesperson for the National Advertising Division of the Council of Better Business Bureaus says the group focuses on investigating individual cases brought to its attention, rather than overarching recommendations.

For its part, the FTC is working to combat fraudulent weight-loss products. The agency launched an initiative in 2014 called “Operation Failed Resolution,” a strategy aimed at cracking down on fraudulent products and marketing campaigns and educating the media on how to identify false claims. The weight-loss industry mostly supported this operation, which included fines of approximately $34 million paid by Sensa, L’Occitane and LeanSpa for consumer redress. The FTC also levied the largest-ever penalty against an ad agency—$2 million—to settle a false-advertising complaint related to weight-loss claims.

“[Consumers] have a mentality of, ‘I just want something that will do it for me because I’ve tried it myself and it didn’t work’,” Cleland says. “It’s partly in desperation that consumers want to believe that somebody will come up with the magic pill. Marketers understand the desperation of their clientele, as well as how to play to that market. Consumers that have heard the health messaging understand the risks of being overweight and obese. And they really are vulnerable to those types of claims.”

Cleland says even legitimate companies sometimes join the race to the bottom, becoming susceptible to exaggerations of product effectiveness because of the competitiveness of the market. “The consumers are the first line of defense,” he says. “This is not a criticism but a statement of fact: We can only devote so many resources to a particular area.”

So many dishonest players can give the entire industry a bad reputation, making it imperative for the legitimate products to stand out. “Many industries face the challenge of bad actors who taint the industry through unethical marketing practices,” says Lindsay Carnett, president and CEO of Marketing Maven. She emphasizes the need for proven results, ideally through clinical studies on the formulation of the product. “Responsible marketing is imperative. In the world of social media, this means appropriate influencer disclosures and still utilizing approved structure/function claims from an FDA/FTC attorney.”

Another way to look out for the consumer is to report false claims by other brands. Marketers who intentionally break the rules, Carnett says, are harmful not only to consumers, but to the space in general.

Maybe It Was a Misunderstanding

Even for products with proven efficacy, not every customer’s story ends with triumphantly holding out the waistband of too-big jeans. Legitimate weight-loss products do not produce results without lifestyle changes by their users.

“You can lose weight yourself by just managing your caloric intake and energy output, but you can also do it with the assistance of an aid or remedy,” says Lisa Bolton, marketing professor at Pennsylvania State University. “From the consumer’s point of view, the hope is that the remedy will resolve the problem, and the consumer won’t have to do much else. I can take this fat-fighting pill and I don’t have to worry now about healthy eating or exercise.”

Bolton’s research, published in Journal of Public Policy & Marketing, set out to test the theory that marketing weight-management remedies may have unintended consequences. Remedies are defined in the paper as products or services designed to reduce risk and offer solutions to consumer challenges. “In the health domain, weight-management remedies reduce the health risks associated with obesity and purport to help consumers reduce or maintain their weight,” the authors wrote.

The knowledge of available remedies may actually encourage people to engage in riskier behavior or make them less mindful about their diet or exercise. Though marketers may not intentionally mislead users, consumer perception thwarts the results.

The authors had 134 people read a warning about the health dangers of high-fat diets. Some of the people were shown additional text: “Until now! Introducing Chitosan Rx Ultra,” a weight-loss aid that claimed to absorb as much as 60% of the fat in food. The entire group was then told it would participate in a taste test of a new snack. Half the people were given marketing materials that said the product was “delicious yet guilt-free,” and the other half read that the product was “rich, sinful.” Those who had seen the message about Chitosan took significantly more of the snack than participants who only saw the general nutrition advice.

“Put simply, why make healthier food choices to manage weight if a weight-management drug can manage your weight for you?” the authors wrote. Bolton says that the knowledge of available remedies may actually encourage people to engage in riskier behavior or make them less mindful about their diet or exercise. Though marketers may not intentionally mislead users, consumer perception thwarts the results.

Portion-control products pose similar issues. Hundred-calorie snack packs, all the rage in the early 2000s, became many a dieter’s midnight snack-mare. Maura Scott, a professor of marketing at Florida State University, studied the relationship between packaging and restrained eaters in a 2008 Journal of Consumer Research paper. “Restrained eating is basically a definition of consumers who tend to have a relatively more complex relationship with food,” Scott says. These consumers are hyper-aware of the weight they gain and how they approach eating in a social context. The report authors found that restrained eaters tended to consume more calories overall when eating smaller foods in small packages, compared to unrestrained eaters. “The irony there, from a marketing standpoint, was the smaller food in the smaller packages tends to be designed to facilitate weight loss among restrained eaters, or people who are on a diet,” Scott says. “It was very surprising to us that those were the people who didn’t exercise as much restraint.”

The 100-calorie packs appear as diet food, an innocent option for consumers trying to eat in moderation. Instead, their target consumer feels license to consume more. Bolton also noted consumer license—the permission to consume— in her research as it relates to remedies: “Erroneous remedy beliefs seem to reflect motivated reasoning: The more consumers want to believe that a remedy obviates the need for healthy eating, the more they feel licensed to indulge in unhealthy eating.”

A Real Commitment, Flaws and All

Even the top players in the weight-loss field, the scientifically proven pharmaceuticals, have struggled to gain market share. The five drugs currently approved for weight loss by the FDA all face skepticism from many doctors and patients because of their safety concerns and limited efficacy. Additionally, few health insurers cover the products. One weight-loss company, Orexigen Therapeutics, maker of FDA-approved Contrave, filed for bankruptcy in spring 2018. It was a move that The Wall Street Journal emphasized the difficulty of marketing weight-loss drugs, as patients and doctors struggled with the product’s safety risks and costs. It flies in the face of experts who claim the best advertising is backed by clinical trials: Those results aren’t always impressive.

The weight-loss industry could consider looking at obesity as an ongoing challenge, staying involved throughout the consumer’s health journey, beyond the onboarding stage. “We’ve categorized [weight loss] under this category of health inertia,” says Lindsay Resnick, EVP of Wunderman Health. “How do we get people to face a personal health challenge, stick with a plan of action and then continue to stay motivated to be involved?”

Even legitimate companies sometimes join the race to the bottom, becoming susceptible to exaggerations of product effectiveness because of the competitiveness of the market.

Resnick says that healthcare marketers are grappling with a two-fold problem: They’re offering a single message to everyone, despite the wide range of consumer personalities, and the messaging is product-focused, describing benefits but not the work required to get them. “What’s often missing and what you really need to change behavior is more motivational, more personal, more gut-level inspiration,” he says. What’s needed is a better understanding of how to get more audience participation, how to be engaged and how to do so on the appropriate channel.

The messaging needs to be as varied as the audience. Whereas improved energy levels from weight loss may appeal to some consumers, messaging about self-esteem may work better for others. “Smoking is a great parallel,” Resnick says. “I’ve seen these ads on TV recently that show people with horrible disfigurements from smoking. Absolutely no teeth, or they’re talking through a little tube in their neck. That scare tactic works for some; but for others, show a happy message of people who quit smoking, like spending more time with grandkids.” Healthcare companies have learned to dig into claims data, but they need to explore more customer data to find which ad angles resonate.

Even with the right messaging, the side effects and the cost of weight-loss remedies can be rather unsexy. “It’s an advertising nightmare, really,” Resnick acknowledges. There’s really no magic answer here, it’s mostly a matter of emphasizing that the benefits are far greater than the risks.

For benefits to emerge, though, marketers need to stay with the user beyond the initial buy-in. This is where technology could play an interesting role. For example, a company could gamify the weight-loss process or develop a mobile app that pushes out notifications to the user. Healthcare marketers have focused on medication compliance in recent years, and their lessons could drive some weight-loss product solutions.

The healthcare industry tends to take a B2B approach to marketing, having long focused on securing uptake among providers and insurers. A B2C, or user-centric, mindset considers how to engage the customer and better ensure compliance. Consider WW, formerly known as Weight Watchers. The brand is more than 50 years old and is famous for its user engagement, including the point system, food options (recipes for the cooking-inclined and premade items for others) and in-person meetings.

The trickier aspect of a B2C approach is being clear about the science, much of which is highly technical and indecipherable to the average consumer. Bolton’s research also underscored this problem: Consumer health literacy was not being considered in weight-loss marketing. “A lot of companies tend to talk above the market and the people don’t understand,” Resnick says. “How do you break that down into a more common denominator that Joe and Jill Consumer can understand?” The simplest way is to temper the reading-comprehension level of the messaging.

Although consumers are in the habit of searching through product reviews, ingestible products amplify the need for comprehensive marketing literature, Carnett says. Using layman’s terms and communicating via YouTube, social media channels and owned media are above and beyond what many do today, she says.

Such improved marketing can be the difference between another bad weight-loss remedy and a real relationship that changes a consumer’s life. The stakes are high for everyone involved with weight-loss products, and it can feel like a minefield. The brands likely to stand out can’t simply tell consumers what they want to hear, they need to be honest about what’s necessary—and remain with them every step of the way. Even the best relationships require work.