WEIGHT-LOSS ADVERTISING

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WEIGHT-LOSS ADVERTISING:An Analysis of Current TrendsRichard L. ClelandWalter C. GrossLaura D. KossMatthew DaynardKaren M. MuoioPrincipal AuthorsA REPORT OF THE STAFF OF THE FEDERAL TRADE COMMISSIONSeptember 2002

FEDERAL TRADE COMMISSIONTIMOTHY J. MURIS, ChairmanSHEILA F. ANTHONY, CommissionerMOZELLE W. THOMPSON, CommissionerORSON SWINDLE, CommissionerTHOMAS B. LEARY, CommissionerThis report is a project of the staff of the Federal Trade Commission with the assistance of thePartnership for Healthy Weight Management, a coalition of representatives from science, academia, thehealth care profession, government, commercial enterprises, and organizations whose mission is topromote sound guidance on strategies for achieving and maintaining a healthy weight. The principalauthors of this report are attorneys with the Bureau of Consumer Protection, Federal Trade Commission.The views expressed in this report are those of the authors and do not necessarily represent the views ofthe Federal Trade Commission or any individual Commissioner. Special thanks are given to members ofthe Partnership, for their contributions to this report and to Michelle Rusk, an attorney with the FederalTrade Commission, for her assistance in editing this report, and Devenette Cox, who managed the database for the report. The authors wish to acknowledge the contributions of Elizabeth Nichols, Eva Tayrose,Steve Sawchuk, Trisa Wilkens and Michelle Reeve for their assistance in the collection and coding of theadvertisements reviewed in this report.i

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IntroductionGeorge L. Blackburn, M.D., Ph.D.As health care professionals, we are concerned about the epidemic of obesity: the relationsbetween excess body weight and such medical conditions as cardiovascular disease, hypertension,type 2 diabetes, osteoarthritis, sleep apnea, and certain cancers (such as breast, ovarian, prostateand colon) are well established. We are equally concerned about false and misleading claims in theadvertising of weight loss products and services. Many promise immediate success without the needto reduce caloric intake or increase physical activity. The use of deceptive, false, or misleadingclaims in weight loss advertising is rampant and potentially dangerous. Many supplements, inparticular, are of unproven value or have been linked to serious health risks.A majority of adults in the United States are overweight or obese. All told, they invest over 30 billion a year in weight loss products and services. These consumers are entitled to accurate,reliable, and clearly-stated information on methods for weight management. They have a right toknow if the weight loss products they're buying are helpful, useless, or even dangerous.For this reason, the staff of the Bureau of Consumer Protection, Federal Trade Commission(FTC), joined with the Partnership for Healthy Weight Management–a coalition of representativesfrom science, academia, the health care professions, government agencies, commercial enterprises,and public interest organizations--to collect and analyze weight loss advertising. The Partnership'spurpose is to promote sound guidance to the general public on strategies for achieving andmaintaining a healthy weight. This report by the FTC staff is a major advance in that direction.Evidence-based guidelines issued by the National Institutes of Health call for weight loss bysimultaneously restricting caloric intake and increasing physical activity. Many studies demonstratethat obese adults can lose about 1 lb. per week and achieve a 5% to 15% weight loss by consuming500 to 1,000 calories a day less than the caloric intake required for the maintenance of their currentweight. Very low calorie diets result in faster weight loss, but lower rates of long-term success.While exercise added to caloric restriction can help overweight and obese people achieveminimally faster weight loss early on, physical activity appears to be a very important treatmentcomponent for long-term maintenance of a reduced body weight. To lose weight and not regain it,ongoing changes in thinking, eating, and exercise are essential. Behavioral treatments that motivatetherapeutic lifestyle changes can promote long-term success by helping obese individuals makenecessary cognitive and lifestyle changes.The public often perceives weight losses of 5% to 15% as small and insufficient even thoughthey suffice to prevent and improve many of the medical problems associated with weight gain,iv

overeating, and a sedentary lifestyle. Many in the weight loss industry promise effortless, fast weightloss, then support this misperception by bombarding Americans with spurious advertising messagestouting physiologically impossible weight loss outcomes from the use of unproven products andservices. All advertisers, whatever their choice of media--cable television, infomercials, radio,magazines, newspapers, supermarket tabloids, direct mail, or commercial e-mail and Internetwebsites--know that only those products and services that help people adopt lifestyles that balancecaloric intake with caloric output will prevent and treat the disease of obesity.For certain businesses (weight loss franchises, pharmaceutical firms, food companies, the dietbook industry, makers of exercise equipment, suppliers of dietary supplements, to name a few)these deceptive and misleading advertisements prevent the public from hearing their messages,words that promote therapeutic lifestyle changes as advocated by professional societies and theU.S. Department of Health and Human Services. Data indicate that at any given time, almost 70million Americans are trying to lose weight or prevent weight gain. In 2000 they spentapproximately 35 billion on products they were told would help them achieve those objectives-videos, tapes, books, medications, foods for special dietary purpose, dietary supplements, medicaltreatments, and other related goods and services.As with cigarette smoking and alcohol abuse, false or deceptive advertising of weight lossproducts and services puts people at risk. Many of the products and programs most heavilyadvertised are at best unproven and at worst unsafe. By promoting unrealistic expectations andfalse hopes, they doom current weight loss efforts to failure, and make future attempts less likely tosucceed. In the absence of laws and regulations to protect the public against dangerous ormisleading products, a priority exists for the media to willingly ascribe to the highest advertisingstandards, i.e., those that reject the creation and acceptance of advertisements that contain false ormisleading weight loss claims.The public would be well served by becoming more knowledgeable about the evidencebased guidelines, the scientifically-proven and medically-safe standards that underlie national publichealth policy. When more people know what's important and realistic in achieving and maintaining ahealthy body weight, fewer will be inclined to waste their money, time, and effort on dangerous fadsor miracle cures. The staff of the FTC’s Bureau of Consumer Protection has provided an analysisof current trends in weight loss advertising. It is now up to the consumer and media to act in thebest interest of the public health.George L. Blackburn, M.D., Ph.D.S. Daniel Abraham Chair in Nutrition MedicineHarvard Medical School, Boston, MAPast President of The American Society for Clinical Nutrition,North American Association for the Study of Obesity, and theAmerican Society for Parenteral and Enteral Nutritionv

TABLE OF CONTENTSIntroduction. ivExecutive Summary. viiI. An Overview.A. A Never-Ending Quest for Easy Solutions.B. The Role of Advertising for Weight-loss Products and Services.C. Weight Loss: A Multi-Billion Dollar Industry.II. Collection Methodology and Coding.III. Analysis of Weight-loss Advertisements.A. General Observations.B. Media and Product Types.C. Claims by Category.1. Consumer Testimonials.2. Before/After Photos.3. Rapid Weight-loss Claims.4. Lose Weight Without Diet or Exercise.5. Lose Weight Permanently.6. No Matter How Many Times You Have Failed Before.7. Scientifically Proven/Doctor Endorsed.8. Money-back Guarantees.9. Safe/All Natural Claims.IV. Historical Comparison: 1992/2001.V. Regulatory Framework.A. Legal Standards Applicable to Weight-loss Advertising.B. FTC Enforcement History.C. FDA Regulation of Weight-loss Products.VI. Media Responsibility.VII. Conclusion.Appendix A: Product ListAppendix B: Examples of Questionable Ad Claims From 2001 Samplevi1122355679111314151617181921252525272830

Executive SummaryThis report attempts to take a comprehensive look at weight loss advertising. The need todo so is compelling. In the last decade, the number of FTC law enforcement cases involving weightloss products or services equaled those filed in the previous seven decades. Consumers spendbillions of dollars a year on weight loss products and services, money wasted if spent on worthlessremedies. This report highlights the scope of the problem facing consumers as they consider thethousands of purported remedies on the market, as well as the serious challenge facing lawenforcement agencies attempting to prevent deceptive advertising.According to the U.S. Surgeon General, overweight and obesity have reached epidemicproportions, afflicting 6 out of every 10 Americans. Overweight and obesity constitute the secondleading cause of preventable death, after smoking, resulting in an estimated 300,000 deaths peryear. The costs, direct and indirect, associated with overweight and obesity are estimated to exceed 100 billion a year.At the same time, survey data suggest that millions of Americans are trying to lose weight.The marketplace has responded with a proliferating array of products and services, many promisingmiraculous, quick-fix remedies. Tens of millions of consumers have turned to over-the-counterremedies, spending billions of dollars on products and services that purport to promote weight loss.In the end, these quick-fixes do nothing to address the nation’s or the individual’s weight problem,and, if anything, may contribute to an already serious health crisis.Once the province of supermarket tabloids and the back sections of certain magazines,over-the-top weight loss advertisements promising quick, easy weight loss are now pervasive inalmost all media forms. At least that is the impression. But are the obviously deceptiveadvertisements really as widespread as they might appear watching late night television or leafingthrough magazines at the local newsstand? To answer this and other questions, we collected andanalyzed a nonrandom sample of 300 advertisements, mostly disseminated during the first half of2001, from broadcast and cable television, infomercials, radio, magazines, newspapers,supermarket tabloids, direct mail, commercial e-mail (spam), and Internet websites. In addition, toevaluate how weight-loss advertising has changed over the past decade, we collected adsdisseminated in 1992 in eight national magazines to compare with ads appearing in 2001 in the samepublications.We conclude that false or misleading claims are common in weight-loss advertising, and,based on our comparison of 1992 magazine ads with magazines ads for 2001, the number ofproducts and the amount of advertising, much of it deceptive, appears to have increaseddramatically over the last decade.Of particular concern in ads in 2001 are grossly exaggerated or clearly unsubstantiatedvii

performance claims. Although we did not evaluate the substantiation for specific products andadvertising claims as part of this report, many of the claims we reviewed are so contrary to existingscientific evidence, or so clearly unsupported by the available evidence, that there is little doubt thatthey are false or deceptive. In addition to the obviously false claims, many other advertisementscontain claims that appear likely to be misleading or unsubstantiated.Falling into the too-good-to-be-true category are claims that: the user can lose a pound aday or more over extended periods of time; that substantial weight loss (without surgery) can beachieved without diet or exercise; and that users can lose weight regardless of how much they eat.Also falling into this category are claims that a diet pill can cause weight loss in selective parts of thebody or block absorption of all fat in the diet. These types of claims are simply inconsistent withexisting scientific knowledge.This report catalogues the most common marketing techniques used in 300 weight lossadvertisements. Nearly all of the ads reviewed used at least one and sometimes several of thefollowing techniques, many of which should raise red flags about the veracity of the claims.Consumer Testimonials; Before/After Photos. The headline proclaimed: “I lost 46 lbsin 30 days.” Another blared, “How I lost 54 pounds without dieting or medication in less than 6weeks!” The use of consumer testimonials is pervasive in weight-loss advertising. One hundred andninety-five (65%) of the advertisements in the sample used consumer testimonials and 42%contained before-and-after pictures. These testimonials and photos rarely portrayed realistic weightloss. The average for the largest amount of weight loss reported in each of the 195 advertisementswas 71 pounds. Fifty-seven ads reported weight loss exceeding 70 pounds, and 38 ads reportedweight loss exceeding 100 pounds. The advertised weight loss ranges are, in all likelihood, simplynot achievable for the products being promoted. Thirty-six ads used 71 different testimonialsclaiming weight loss of nearly a pound a day for time periods of 13 days or more.Rapid Weight-loss Claims. Rapid weight-loss claims were made in 57% of theadvertisements in the sample. In some cases, the falsity of such claims is obvious, as in the ad thatclaimed that users could lose up to 8 to 10 pounds per week while using the advertised product.No Diet or Exercise Required. Despite the well-accepted prescription of diet andexercise for successful weight management, 42% of all of the ads reviewed promote an array ofquick-fix pills, patches, potions, and programs for effortless weight loss and 64% of those ads alsopromised fast results. The ads claim that results can be achieved without reducing caloric intake orincreasing physical activity. Some even go so far as to tell consumers “you can eat as much as youwant and still lose weight.”Long-term/Permanent Weight-loss Claims. “Take it off and keep it off” (longterm/permanent weight loss) claims were used in 41% of the ads in the sample. In fact, the publiclyviii

available scientific research contains very little that would substantiate long-term or permanentweight-loss claims for most of today’s popular diet products. Accordingly, long-term or permanentweight-loss claims are inherently suspect.Clinically Proven/Doctor Approved Claims. Clinically proven and doctor approvedclaims are also fairly common in weight-loss advertisements, the former occurring in 40% and thelatter in 25% of the ads in the sample. Some of the specific claims are virtually meaningless. Forexample, a representation such as, “Clinical studies show people lost 300% more weight evenwithout dieting,” may cause consumers to conclude mistakenly that the clinically proven benefits aresubstantial, whereas, in fact, the difference between use of the product and dieting alone could bequite small (1.5 lbs. vs. .5 lbs.). These claims do little to inform consumers and most ads fail toprovide consumers with sufficient information to allow them to verify the advertisers’representations. Moreover, the Federal Trade Commission, in past law enforcement actions, hasevaluated the available scientific evidence for many of the ingredients expressly advertised asclinically proven, and challenged the weight-loss efficacy claims for these ingredients.Natural/Safe Weight-loss Claims. Safety claims are also prevalent in weight-lossadvertising. Nearly half of all the ads in the sample (42%) contained specific claims that theadvertised products or services are safe and 71% of those ads also claimed that the products were“all natural.”Safety claims can be difficult to evaluate, especially when so many ads fail to disclose theactive ingredients in the product. On the other hand, some advertisements disclose ingredients, e.g.,ephedra alkaloids, that make unqualified safety claims misleading. Nevertheless, marketers in almosthalf (48%) of the ads that identified ephedra as a product ingredient made safety claims. Only 30%of the ads that identified ephedra as an ingredient included a specific health warning about itspotential adverse effects.Historical Comparison. To develop a perspective on how weight-loss advertising haschanged over time, this report also compares advertisements appearing in a sample of magazinespublished in 2001 with ads in the same magazines in 1992. Compared to 1992, readers in 2001saw more diet ads, more often, and for more products. Specifically,CThe frequency of weight-loss advertisements in these magazines more than doubled,andCThe number of separate and distinct advertisements tripled.Moreover, the type of weight-loss products and services advertised dramatically shifted from “mealreplacements” (57%), in 1992 to dietary supplements (66%), in 2001. Meal replacement productstypically facilitate the reduction of caloric intake by replacing high-calorie foods with lower-calorieix

substitutes, whereas dietary supplements are commonly marketed (55%) with claims that reducingcaloric intake or increasing physical activity is unnecessary.The considerable changes in the methods used to promote weight-loss products are themost revealing indication of the downward spiral to deception in weight-loss advertising. The 2001advertisements were much more likely than the 1992 ads to use dramatic consumer testimonials andbefore-and-after photos, promise permanent weight loss, guarantee weight-loss success, claim thatweight loss can be achieved without diet or exercise, claim that results can be achieved quickly,claim that the product is all natural, and make express or implied claims that the product is safe.Finally, although both the 1992 and 2001 examples include unobjectionable representations, as wella

that obese adults can lose about 1 lb. per week and achieve a 5% to 15% weight loss by consuming 500 to 1,000 calories a day less than the caloric intake required for the maintenance of their current weight. Very low calorie diets result in faster weight loss, but lower rates of long-term success.