how are people influenced to eat too much without

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How Are People Influenced to Eat Too Much Without Awareness? Deborah A. Cohen, MD, MPH May, 2010 3/4/2008 Outline Human “wiring” How marketers exploit human wiring “Atmospherics” and Proximal Cues The relevance of alcohol control policies in addressing marketing tactics; Using marketing strategies to control obesity StanMark

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Page 1: How Are People Influenced to Eat Too Much Without

How Are People Influenced to Eat Too Much

Without Awareness?

Deborah A. Cohen, MD, MPHMay, 2010

3/4/2008

Outline

• Human “wiring”•How marketers exploit human wiring•“Atmospherics” and Proximal Cues•The relevance of alcohol control policies in addressing marketing tactics; •Using marketing strategies to control obesity

StanMark

Page 2: How Are People Influenced to Eat Too Much Without

3/4/2008

Popular Understanding of Human Eating Behavior is Incorrect

•Obesity is the result of an individual’s conscious choices

•Adults should be able to ignore or resist the temptation to overeat

3/4/2008

Most Behaviors, Including Eating,are Automatic

•Lack of awareness •Lack of intent•Lack of effort•Lack of control, meaning the inability to stop if we choose

(Bargh, 1994)

Automatic behaviors do not require conscious direction(To be considered automatic, it doesn’t have to be automatic all the time)StanMark

Page 3: How Are People Influenced to Eat Too Much Without

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People Cannot Easily Ignore External Stimuli

•People reflexively respond to external sensory stimuli:• orient gaze to visual stimuli• turn toward auditory and olfactory stimuli

•People pay more attention to novel stimuli

•We also pay more attention to negative stimuli/warnings

Dijksterhuis, 2002

3/4/2008

Behavior Is Typically Caused by the Environment & Initiated Before

Conscious AwarenessStimulus

Perception

Action InitiatedMotor neurons

AwarenessAction Completed

Source: Libet B et al., 1991

Speed of light

Neural transmission, 250 mi./sec.

0.5 seconds

0.1 seconds

StanMark

Page 4: How Are People Influenced to Eat Too Much Without

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People Have a Limited Cognitive Capacity

• We can think about only one thing at a time

• Everything else functions automatically

− Humans can process 40-60 bits per second

− But entire processing capacity (including visual system and unconscious) can process ~11 million bits per second

− Most actions and decisions are NOT consciously directed

Impulsive,automatic> 95%

Cognitive< 5%

Brain Processes

Source: Dijksterhuis A, et al The Unconscious Consumer: Effects of Environment on Consumer Behavior. Journal of Consumer Psychology 2005;15(3):193-202.

3/4/2008

The Brain Relies on Shortcuts Called “Heuristics”

• Simple, efficient rules, hard-coded by evolutionary processes which have been proposed to explain how people make decisions, come to judgments, and solve problems-- “shortcuts”

− Sugar and fat−Brands− Prices− Salience−What other people do−Appearance/ color/ size/ shape

StanMark

Page 5: How Are People Influenced to Eat Too Much Without

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NeutralFood

• Dopamine automatically secreted in response to food cues (and novelty)

• Brain dopamine is a powerful motivator, creating thedesire to obtain the food and eat

• The pathways activated by food are the same ones responsible for addiction

Food Makes Us Hungry

Volkow ND. This is your brain on food. Interview by Kristin Leutwyler-Ozelli. SciAm. Sep 2007;297(3):84-85.

3/4/2008

Seeing + Convenience Creates Desire

•Secretaries ate 46% more Hershey’s kisses when the candy was placed on desks in clear jars than when in opaque jars

• They ate 2.2 more chocolates per day when candy was placed on desk than when it was placed across the room

Wansink B, Painter JE, Lee YK.. Int J Obes. May 2006;30(5):871-875.

Painter JE, Wansink B, Hieggelke JB. Appetite. Jun 2002;38(3):237-238.

StanMark

Page 6: How Are People Influenced to Eat Too Much Without

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Fruit Salad or Chocolate Cake?

• Study participants asked to choose snack

• Before choosing snack− First group memorized 2-digit number− Second group memorized 7-digit number

Source: Shiv B, Fedorikhin A 1999

3/4/2008

0

20

40

60

80

100

Limited Processing Resources Leadto More Cake

45 %

62 %

Memorized 7 digits Memorized 2 digits

Percentage Choosing Cake

Source: Shiv B, Fedorikhin A 1999

StanMark

Page 7: How Are People Influenced to Eat Too Much Without

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Implications

“……any factor that reduces the availability ofprocessing resources in the shopping environment is likelyto increase impulse buying by consumers. Marketers of… could therefore benefit from actionsdesigned to constrain processing resources such as havingdistracting music or displays ...

Another tactic … is to reduce the checkout time so that consumers deliberate less about what is in their shopping carts and end up leaving the store with products they chose on impulse.”

3/4/2008

Ability To Use Analytic Processing Increases with Age

a) Children use heuristic reasoning, like adultsb) Competencies to inhibit heuristic reasoning

improve from childhood to adolescence, c) Despite these improvements, most adolescents

still use heuristic processing (as do adults).d) Youth don’t have better judgment than adults.e) They acquire more biased judgment strategies as

they develop (increase knowledge of stereotypes) and use them inappropriately, like adults.

Jacobs and Klacynski, 2002

StanMark

Page 8: How Are People Influenced to Eat Too Much Without

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Context Influences Choices

•Decision errors are widespread and predictable. Choices influenced by framing and context

• Order

• Comparisons

• Whether outcomes are losses or gains

Source: Kahneman D. A perspective on judgment and choice: mapping bounded rationality. Am Psychol. Sep 2003;58(9):697-720.

3/4/2008

Chocolate Chip Cookie or Yogurt?Time Horizons Affect Choice

N=160 Choose Cookie

Select one 47.5%Same choice next week 70.0%Yogurt next week 90.0%

People are optimistic about exerting self-control in the future

Source: Khan U, Dhar R. Where there is a way, is there a will? Jl of Experimental Psychology: General. May 2007;136(2):277-288.

StanMark

Page 9: How Are People Influenced to Eat Too Much Without

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M & M’s or Gluestick

Choose M & MSelect one 50%Give up one 85%

When having to give a reason for choiceSelect one 55%Give up one 62%

Hedonic characteristics more salient when you have to diet.

Dhar R, Wertenbroch K. Consumer choice between hedonic and utilitarian goods. Journal of Marketing Research. Feb 2000;37(1):60-71.

3/4/2008

How Do Food Outlets Make Us Eat Too Much Without

Awareness?

•Atmospherics- (1970’s– Phil Kotler)

− Engineering of displays, lighting, crowding, layout, scent, music, etc. to influence consumer purchases

− Promote impulsive, automatic responses

StanMark

Page 10: How Are People Influenced to Eat Too Much Without

3/4/2008

Abundance Increases Consumption

44%49%

59%

28%

0%10%20%30%40%50%60%70%

Type of fruit/vegetable

Perc

ent i

ncre

ase

in s

ales

Hard fruit

Soft fruit

CookingvegetablesSalad vegetables

Source: Curhan R. J Marketing Research 1974;11:286-94

Increase in Sales of Fruits and Vegetables Caused by Doubling of Display Space

3/4/2008

Chips Are in Season!Doubling shelf space increases sales by 40%

Source: Curhan RC, 1972

StanMark

Page 11: How Are People Influenced to Eat Too Much Without

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Placing products at eye-level triples sales compared to placement on second orbottom shelf

3/4/2008

End aisle display increases sales 2-5 fold

StanMark

Page 12: How Are People Influenced to Eat Too Much Without

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Music Affects How Much We Consume Without Awareness

•Compared slow, fast and no music in supermarket.•Customers walked through the store faster and bought less with fast music•Sales receipts increased 38% with slow music •No difference in customers recall of whether there was music or it was fast or slow.

Source: Milliman RE. Using background music to affect the behavior of supermarket shoppers. Journal of Marketing. 1982;46(3):86-91.

3/4/2008

Other Environmental Influences (Priming)

• Music influences purchases:− People at restaurant playing

classical music (compared tothose listening to pop or no music)

• spent more money• ordered more appetizers and coffee• ordered more desserts *

* Source: North AC, Shilcock A, Hargreaves DJ, 2003

StanMark

Page 13: How Are People Influenced to Eat Too Much Without

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Restaurant Menus

Often designed using “choice architecture”

• The Upper Right-Hand Corner (people look there first)

• Use an Anchor (A high price item makes everything else look like a bargain)

• Boxes and larger, bolder fonts draw attention to items

• Pictures of food are powerful motivators

• Bury items they don’t want to sell as much at the bottom or in smaller fonts

Poundstone, 2009

3/4/2008

Most Restaurant Meals Increase the Risk of Getting or Exacerbating Chronic Diseases

•Meals contain excess calories, fat, salt, too much red meat

•Meals have insufficient fruits, vegetables, fiber, vitamins, calcium

•Requires people to figure out how to compensate

•Too difficult for most people to track and replace missing nutrients over 24 hours, much less a few days or week.

StanMark

Page 14: How Are People Influenced to Eat Too Much Without

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People Naturally Attracted to Large Sizes

Source: Raghubir P, Krishna A, 1999

However, we are not able to judge volume

3/4/2008

Marketers Elongate Packages

StanMark

Page 15: How Are People Influenced to Eat Too Much Without

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Portion Sizes Play a Role in How Much People Eat

• When offered the largest portion rather than the smallest portion, subjects consumed 30% more calories

• Larger portions led to greater calorie intake regardless of serving method and subject characteristics

Source: Rolls BJ, Morris EL, Roe LS, 2002

oror

3/4/2008

Multi-packs Increase Consumption

•Groups asked to watch TV, help themselves to potato chips while they watch•Half of each group offered 200 gm bags, half offered 45 gm bags

•Measured how much they ate

•People offered the small bags ate more because they were more likely to open the bag.

Source: Coelho do Vale R, Pieters R, M. Z. Flying under the Radar: Perverse Package Size Effects on Consumption Self-Regulation. Jl of Consumer Research 2008;36:380-390.

StanMark

Page 16: How Are People Influenced to Eat Too Much Without

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Variety Increases Consumption

Subjects offered 3 different shapes of pasta ate 14% more than those offered only 1 shape

Source: Rolls BJ, Rowe EA, Rolls ET, 1982

3/4/2008

More than 10,000 New Products Introduced Annually

StanMark

Page 17: How Are People Influenced to Eat Too Much Without

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How Does Advertising Influence Choices to Make Us Eat Too

Much Without Awareness?

•Conditioning•Mere Exposure Conditioning•Priming•Automatic Stereotype Activation•Mimicry•Incentives

3/4/2008

Conditioning: Pavlov’s Dog

• Pavlov conditioned dogs by ringing a bell when food was available

• Dogs salivated when they heard the bell

• Humans are also conditioned to “feel hungry”− stimulated by symbols, smells, memories

associated with food, and especially food itself

StanMark

Page 18: How Are People Influenced to Eat Too Much Without

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Marketing : Creating Associations Between a Product and Human Desires

Branding- people buy brand, rather than product

Celebrity endorsementsAppeals to needs (fun, power, status, sex)

Easy to condition;Hard to extinguishconditioned responses

3/4/2008

Mere Exposure(e.g. Product Placement)

•Seeing or perceiving something without it being paired with any other stimulus. •Seeing something repeatedly increases our preferences for that object. •Effect is stronger when we don’t remember that we saw it. •The object becomes part of the familiar background that we evaluate as safe

Source: Zajonc RB. Mere exposure: A gateway to the subliminal. Current Directions in Psychological Science. Dec 2001;10(6):224-228

StanMark

Page 19: How Are People Influenced to Eat Too Much Without

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Pepsi vs. Coke (Coke more popular in England 3:1)

Group 1: Children saw a “Home Alone” clip of family eating pizza, milk, and Pepsi, Pepsi spills Group 2: Watched star eating macaroni and cheese and drinking only milk. After the showing, children were invited to help themselves to either Coke or Pepsi.Among children who had seen the picture before:

• Group 1: 67% chose Pepsi

• Group 2: 42% chose Pepsi.Source: Auty S, Lewis C. Exploring children's choice: The reminder effect of product placement. Psychology & Marketing. Sep 2004;21(9):697-713.

3/4/2008

People Perceive Ads on the Side Columns, But Don’t Know It

From Shapiro et al, 1999

StanMark

Page 20: How Are People Influenced to Eat Too Much Without

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Priming

•Sensitizing someone to activate specific memories or associations so that it influences a subsequent behavior.

•Works when people are unaware of the intention or existence of the prime

3/4/2008

Automatic Stereotype Activation•People respond to others based upon stereotypes and that the responses are unintended, efficient, and outside the awareness of the perceiver.

e.g. People automatically have favorable attitudes towards people who look like they do, and negative reactions to those who appear different

StanMark

Page 21: How Are People Influenced to Eat Too Much Without

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Mimicry Leads to Unconscious Eating• Participants invited to judge ice cream quality.

Confederate took a sample of ice cream first.

• Participants ate more if the confederate took a large amount, and less if the confederate took a small amount

• Participants did not know how much the other person ate and did not believe they were influenced.

….and more favorable ratings• Subjects mimicked drank 60% more of an energy drink and enjoyed it more than those not mimicked.Source: Tanner et al 2008;34(6):754-766.

Source: Johnston LU.. 2002 Feb;20(1):18-35.

3/4/2008

Incentives Change Our Behaviors•People who preferred vanilla ice cream, worked harder for and chose pistachio because it was valued more highly

•People who though they would enjoy a chocolate heart candy chosea chocolate cockroach when valued higher

•People who get a frequent customer purchase card, buy at a higher rate when getting close to completing the card

60 pts. 100 pts.

$.50 $2.00Hsee 1999, Psych Bull & Review 6(4):535-561.

Kivetz et al, 2006;43(1):39-58. Goal-gradient hypothesis

Hsee & Hastie, 2006;10(1):31-37.StanMark

Page 22: How Are People Influenced to Eat Too Much Without

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Self-Control is a Reflection of Cognitive Capacity

• Self-control is limited and behaves like a muscle– it fatigues over time

• Dieters relapse under stress and at the end of the day

• Studies indicate that dieters have impaired “executive functioning” (decision-making, thinking tasks due to preoccupation)

3/4/2008

Refusing Chocolate Chip Cookies Takes a Toll

X

Subjects in lab setting divided into three groups, then asked tosolve puzzle

Source: Baumeister RF, et al., 1998

• Food available: − Cookies− Candy− Radishes

• Subjects told to help themselves

• Food available: − Cookies− Candy− Radishes

• Subjects told to eat only radishes

• Food available:

− NoneStanMark

Page 23: How Are People Influenced to Eat Too Much Without

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Refusing Chocolate Chip Cookies Takes a Toll

• Food available: − Cookies− Candy− Radishes

• Subjects told to help themselves

• Food available: − Cookies− Candy− Radishes

• Subjects told to eat only radishes

• Food available:

− None

Gave up after 8 minutes

Worked21 minutes

Worked19 minutes

X

Subjects in lab setting divided into three groups, then asked tosolve puzzle

3/4/2008

Too Much Food

People are designed to over-consume when food is available:

Too many calories (esp. energy dense, low in nutrients)Too convenientToo many cues to eatPortion sizes too large

We can’t train people to ignore the environment.

StanMark

Page 24: How Are People Influenced to Eat Too Much Without

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Policies That Work for Alcohol Control: Reduce Accessibility, Cues, &

Impulsive Behavior•Licensing Alcohol outlets•Limiting Alcohol outlet density•Limiting hours of operation•Prohibiting alcohol specials (e.g. 2 for 1)•Prohibiting “all you can drink”

•Quality control and portion control (0.6 oz/drink)•Alcohol taxes•Banning drive-up window sales•Social reference pricing•Controls on displays•Limiting sales of alcohol by age

3/4/2008

Front of Package Labeling Could Be Promising

Use easy to understand icons and symbols to convey risks and benefits, like energy savings symbols

Balanced meal

Increases risk of cancer

Increases risk of heart disease

Increased risk of obesity

StanMark