Mindfulness Background

In the fabled Sixties, one of the hottest books was Be Here Now, by Ram Dass, the spiritual leader who is still visited by seekers today. His teachings have spread to such places as the National Institute for the Clinical Application of Behavioral Medicine, whose page describes the reactions of several professionals to a well-attended webinar.

Jack Kornfield, a student of Ram Dass, has said that mindfulness is…

[…] an innate human capacity to deliberately pay full attention to where we are, to our actual experience, and to learn from it.

Mindfulness Based Stress Reduction (MBSR) has been taught for years in the realms of business, education, and healthcare. The program’s creator, Jon Kabat-Zinn, is quoted in a book titled Teaching Mindfulness: A Practical Guide for Clinicians and Educators. These are his words:

Mindfulness meditation is a consciousness discipline revolving around a particular way of paying attention in one’s life. It can be most simply described as the intentional cultivation of nonjudgmental moment-to-moment awareness.

Another definition is quoted, from Nyanaponika Thera:

Attention or mindfulness is kept to a bare registering of the facts observed, without reacting to them by deed, speech or by mental comment which may be one of self-reference (like, dislike, etc.), judgment or reflection.

According to the American Psychological Association (APA), mindfulness is not a trait, but a state. Some practices or activities, like meditation, of course promote mindfulness, but the state of mindfulness is not confined to any one of them. The description of a continuing education class says:

[…] most of the literature has focused on mindfulness that is developed through mindfulness meditation — those self-regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calmness, clarity and concentration.

How does this all translate to a clinical setting? For one thing, therapists and trainees are said to benefit as much as patients, in quality-of-life terms, making MBSR a definite win-win situation.

Among the benefits, the APA lists reduced rumination, stress reduction, boosts to working memory, focus, less emotional reactivity, more cognitive flexibility, relationship satisfaction, and more. The mention of “less emotional reactivity” is promising, because so much food-oriented and eating-related grief stems from the inability to cope with emotions.

An upset person has a negative emotional reaction and soothes the discomfort by eating. The world is jam-packed with things that can upset people. Events that cause emotional distress hide around every corner and wait to pounce.

We call them triggers, and patients who are obese because of emotional problems have a million triggers. Nobody has time to lie on a Freudian couch for years, tracking down and extirpating them one by one. We need tools to handle any trigger, the moment it rears its ugly head.

Your responses and feedback are welcome!

Source: “The Benefits of Mindfulness Meditation: Ram Dass on Cultivating Loving Awareness,” NICABM.com, undated
Source: “Teaching Mindfulness,” Google Books, undated
Source: “What are the benefits of mindfulness,” APA.org, July/August 2012
Photo credit: Wendy Longo photography via Visual Hunt/CC BY-ND

Another Teen Surgery Compendium

Last week, we were just getting started on a reminder post about all the aspects of bariatric surgery for young people that have been discussed here. Supposedly, without it, only 2% of severely obese teens can achieve long-term weight loss.

As Dr. Pretlow says, bariatric surgery is the only obesity treatment that has resulted in significant long-term weight loss. But that alone is not much of an endorsement, because its record is not unblemished. There seems to be an overall 20%-30% failure rate attached to teen weight-loss surgery.

One of the problems in assessing this is the lack of long-term studies, because allowing young people to be operated on in this way is a relatively recent phenomenon. There are pros and cons galore.

Even the safest procedure, the Lap-Band method, has its risks. Even in the very best-case scenario, the person who has most of her or his stomach blocked will need to rigorously adhere to a whole new set of lifestyle rules. A common drawback with any of the various procedures is that often, the underlying emotional deficiencies are not addressed. The patient is just as insecure, troubled, and bereft of coping skills as before — with the added burden of a post-op routine that never ends.

It is an accepted fact that severely obese teens resist lifestyle changes and medication, and the bad news is that every type of weight-loss surgery brings inevitable lifestyle changes and probably some involvement with medication, even if it is only nutritional supplementation. Teenagers can be willful and heedless, and if a young person ruins a Lap-Band placement by eating so much that the small remaining pouch enlarges, the question “Where do we go from here?” is serious and possibly life-threatening.

This excerpt from a post about risks and complications paints a dismal picture:

The conditions that might indicate the need for a revisional procedure include the inability to tolerate solid food; nausea and vomiting,; strictures; nonhealing ulcers; and severe dumping syndrome. The revisional procedures come under the headings of conversion, correction, or reversal. With them, the mortality goes up to 1.65%. The need for a reversal is counted as a treatment failure. In addition, some of these surgical interventions are designed from the start to occur in stages, which guarantees the need for additional surgery.

A 2010 survey of doctors found that nearly half of them said they would never refer a teen patient for any type of bariatric surgery. Deeply-felt ideological battles have been fought in this arena. One centers around the concept of early intervention, which is always felt to be superior — unless that intervention is surgical.

Babies need intervention before they are even conceived, and that’s undeniably early. Mothers are given a ton of advice on how not to produce an obese child. But when it comes to operating, the teen years strike many professionals as being too early to intervene in that particular way. “More about Bariatric Surgery for Adolescents” looks back at some of the early efforts to make use of the technology without doing harm.

We discussed Teen-LABS, or the Teen-Longitudinal Assessment of Bariatric Surgery, whose goal is “to facilitate coordinated clinical, epidemiological and behavioral research.” It has become accepted that increasing numbers of these procedures will be done, so the task now is to figure out the best ways to keep everybody healthy.

Fortunately, Teen-LABS is interested in understanding the causes and the behavioral ramifications of adolescent obesity — those underlying emotional issues that so often get in the way of true and lasting recovery. The same post also outlined a case history.

As always, Childhood Obesity News recommends the W8Loss2Go smartphone application as an adjunct to, or even a substitute for, surgery.

Your responses and feedback are welcome!

Image by Ian Bertram.

Globesity and Its Numbers

Statisticians know that everything comes with a plus-or-minus allowance. The smart ones realize that their profession is like that of an old-time shade-tree mechanic tinkering with an engine, who says, “The fewer moving parts, the less can go wrong.”

Obesity is nothing but moving parts. Sure, people can be corralled into pigeonholes, intermittently. They’re either diabetic or pre-diabetic, and so on. But the dismaying thing about obesity is, there are few one-size-fits-all preventatives or remedies. The rules with universal application really stand out, like, “Stop drinking sugar-sweetened beverages.” On the other hand, it’s likely that a specimen or two could be found of superbly healthy people who guzzle fizzy soft drinks all day long.

One size does not fit all

The bottom line is, people’s bodies are different and their minds are different. This is why so many obstacles stand in the path of researchers who try to locate bedrock insight so that policy may be constructed. A whole separate but related set of problems involves any attempt to make sense of a phenomenon with only about, approximately, several hundred variables or thereabouts.

Longitudinal studies have their uses, but, inevitably, technology and communications improve, and soon the present-day studies become less possible to align with past studies in a meaningful way. It is clear that even the most erudite scientists are floundering. We see how hard it is to keep track of what goes on here in the United States, one of the world’s most advanced countries.

The problems that researchers have to cope with in less-developed countries are easily imagined. The net result is that all these numbers are guesstimates based on local conditions and procedures, and possibly even some political considerations.

The latest WHO report

In January, the World Health Organization announced that worldwide, 41 million children under age five are overweight or obese. Just in case that number didn’t register the first time, it applies only to overweight and obese kids younger than five years old. WHO is concentrating on the youngest age group because of the huge importance of both prevention and early intervention.

Jason Best reminds us that many people tend to think of obesity as a first-world problem resulting from “poor lifestyle choices and a contemptible lack of self-control,” and corrects this misapprehension:

But in its report, the WHO’s Commission on Ending Childhood Obesity deftly dispels those myths. Noting that nearly half the world’s overweight or obese children under the age of five live in Africa, while a quarter live in Asia, the report states that “in absolute numbers there are more children who are overweight and obese in low- and middle-income countries than in high-income countries.”

Peter Gluckman, cochair of the Commission, told the press that, in the developing world, childhood obesity is “an exploding nightmare.” The entire world has become an obesogenic environment fraught with risk factors — the hundreds of variables mentioned above. Sugar-sweetened beverages come in for heavy blame, and policy recommendations reflect that.

The International Food Policy Research Institute (funded by an eclectic crew of philanthropists and governments) produces the annual Global Nutrition Report. The current year’s report reminded news consumers that that obesity is not the only problem:

According to the report, malnutrition is responsible for nearly half of all deaths of children under five worldwide and, together with poor diets, is the number one driver of disease.

At least 57 countries have a double burden of serious levels of under nutrition — including stunting and anemia — as well as rising numbers of adults who are overweight or obese, putting a massive strain on sometimes already fragile health systems.

One of the most heartbreaking facts to emerge from these studies, as in previous years, is that many children and adults are both overweight/obese and undernourished.

Your responses and feedback are welcome!

Source: “No, it’s not just U.S.: Childhood obesity an ‘exploding nightmare’ in developing countries,” AOL.com, 01/27/16
Source: “Too fat, too thin: Report finds malnutrition fuels disease worldwide,” Reuters.com, 06/13/16
Photo credit: gruniek via VisualHunt/CC BY.

The Unending Quest for More Research

An interesting thing that Dr. Pretlow has noticed is how the same information is susceptible to being parsed in different and sometimes contrary ways by different authorities. Various institutions perform studies, and then experts make pronouncements based on their subjective interpretations.

In the recent past, for instance, unfortunate misunderstandings were fostered by bureaucrats, news reporters and editors when the President spoke about the obesity epidemic. Currently, two contemporary studies have added to the confusion.

In April, a report from the Duke Clinical Research Institute was published by the journal Obesity with the title “Prevalence of obesity and severe obesity in US children, 1999-2014.” The lead author was Dr. Asheley Skinner, joined by colleagues from the University of North Carolina and the Wake Forest School of Medicine.

The data they analyzed came from NHANES, the National Health and Nutritional Examination Survey, which contains decades of information on Americans. In this case, the subjects were young people age 2-19. Wiley has made available online many tables of numbers from which these researchers derived their findings.

The “Conclusions” section reads:

There is no evidence of a decline in obesity prevalence in any age group, despite substantial clinical and policy efforts targeting the issue.

Consumer Affairs reported on it with the headline, “Childhood obesity rates continue to climb, study finds,” and said:

Skinner and her team admit that there are limitations to their study, but assert that using data from the NHANES is a more accurate gauge of obesity rates than the metrics that other studies have used to show that obesity rates have declined.

Then, along came a more recent study, carried out by the Centers for Disease Control (CDC) and published in the Journal of the American Medical Association, with the mouthful of a title, “Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014.” As we mentioned yesterday, at least one of the multiple authors, Katherine M. Flegal, Ph.D., had already gone on record as being uncomfortable with previous assessments of the childhood obesity situation.

The “Conclusions” and “Relevance” section of the report says:

In this nationally representative study of US children and adolescents aged 2 to 19 years, the prevalence of obesity in 2011-2014 was 17.0% and extreme obesity was 5.8%. Between 1988-1994 and 2013-2014, the prevalence of obesity increased until 2003-2004 and then decreased in children aged 2 to 5 years, increased until 2007-2008 and then leveled off in children aged 6 to 11 years, and increased among adolescents aged 12 to 19 years.

Howell Wechsler, of Alliance for a Healthier Generation, frames it like this:

In simplest terms, here is what we learned from the latest report from the Centers for Disease Control and Prevention (CDC) on children and adolescent obesity: there has been modest progress with the youngest age group, flattening levels of obesity with kids and a slight increase in obesity rates among adolescents.

And what was the take-home for the researchers themselves? According to News-Medical.net:

The authors write that although there has been considerable speculation about the causes of the increases in obesity prevalence, data are lacking to show the causes of these trends, and there are few data to indicate reasons that these trends might accelerate, stop, or slow. “Other studies are needed to determine the reasons for these trends.”

Has anyone compared the two studies both released in the first half of 2016? Yes. For Wiley.com, William H. Dietz wrote the very reasonably titled, “Are we making progress in the prevention and control of childhood obesity? It all depends on how you look at it,” saying:

The difference in the interpretation of these findings depends on what year is chosen to anchor the analysis. Skinner et al. anchored their analysis with 1999–2000 data whereas Ogden et al. based theirs on 2003–2004 data. Although the two studies appear contradictory, neither analysis is incorrect — it all depends on whether you start with the 1999–2000 or 2003–2004 data. This observation suggests that reliance on NHANES data alone does not provide conclusive information on the state of the epidemic and indicates that we need to broaden our inquiry.

In other words, Dietz agrees with the authors of just about every obesity study, ever, in advising that more research is needed.

Your responses and feedback are welcome!

Source: “Prevalence of obesity and severe obesity in US children, 1999-2014,” Wiley.com, 04/25/16
Source: “Childhood obesity rates continue to climb, study finds,” ConsumerAffairs.com, 04/26/16
Source: “Trends in Obesity Prevalence Among Children and Adolescents in the United States,” JAMANetwork.com, 06/07/16
Source: “Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014 Published in JAMA, June 7, 2016,” HealthierGeneration.org, 06/08/16
Source: “Study examines trends in obesity prevalence among U.S. Adults,” news-medical.net, 06/08/16
Source: “Are we making progress in the prevention and control of childhood obesity? It all depends on how you look at it,” Wiley.com, 04/25/16
Photo credit: Kingsway School via Visual hunt/CC BY

Hoax or Honest Mistake, Reportage Gave False Hope

In the 2010 State of the Union address, President Obama acknowledged the work done by the First Lady to get her anti-obesity program off the ground. In his 2014 State of the Union speech, the President said, “Michelle’s Let’s Move partnership with schools, businesses, and local leaders has helped bring down childhood obesity rates for the first time in thirty years.”

While many professionals familiar with the field shook their heads in honest bewilderment, some critics went on full red alert. On the PoliticalOutcast.com website, Mark Horne called this “bizarre and unbelievable,” a “crazy pretense,” and even an “insane claim” in a piece titled “If The President Can Credit Michelle Obama With Lowering Childhood Obesity, Then He can Get Away With Anything.” Horne quoted a source stating merely that the increase in obesity rates had slowed down since 2005, and noted that decelerated growth is hardly the same as a decrease.

The following month, Associated Press journalist Mike Stobbe wrote about a report published by the Journal of the American Medical Association (JAMA) about a Centers for Disease Control study. The editor of an Oregon newspaper titled the syndicated story, “Sharp decline in child obesity, but only for preschoolers.” The exact same story was titled by a local editor in Illinois, “Childhood obesity down more than 40 percent, new study says.” Despite their wildly disparate titles, the content of both stories was the same, and both included the sentence:

The main finding was that, overall, both adult and childhood obesity rates have held flat in the past decade. And there were no significant changes in most age groups.

In March, Sharon Begley of Reuters put it like this:

If the news last month that the prevalence of obesity among American preschoolers had plunged 43 percent in a decade sounded too good to be true, that’s because it probably was, researchers say…

As obesity specialists take a closer look at the data, some are questioning the 43 percent claim, suggesting that it may be a statistical fluke and pointing out that similar studies find no such decrease in obesity among preschoolers.

In fact, based on the researchers’ own data, the obesity rate may have even risen rather than declined.

Begley went on to explain in exquisite and protracted detail exactly what the CDC study reported in JAMA actually said and meant, and why so many interpreters grabbed the wrong end of the stick. Her unpacking of all the nuances influenced others, and led to a few headlines in the vein of “That Big Childhood Obesity Decline May Have Been a Statistical Error.”

Alert observers began to understand that positive change had only taken place in the toddler demographic, ages two to five, and even that wasn’t a sure thing. However, as we said at the time, from the way some media outlets carried on, a person could easily think the entire childhood obesity epidemic had been irrevocably and eternally vanquished.

Other news overtook the obesity decline controversy, until the following August 15, when in a Proclamation, President Obama harkened back to the introduction of National Childhood Obesity Awareness Month, then in its fifth year, and gave an amended version of his previous, misleadingly positive claims:

Since then, childhood obesity rates have stopped rising, and we have seen an encouraging drop in obesity rates among children ages 2 to 5 years old.

Not long afterward, in October of 2015, the thorny topic surfaced again, now looking like not quite such an innocent mistake. Back when the 2014 State of the Union speech was delivered, the Daily Caller had glommed onto the discrepancy of viewpoints and immediately filed FOIA requests for email records, which they did not receive until 17 months later. Chuck Ross reported on how…

[…] the White House seized on one slight glimmer of hope — the finding that obesity rates for children between two and five years old fell from 13.9 percent in 2003-2004 to 8.4 percent in 2011-2012.

[…] the White House wanted the CDC and the Department of Health and Human Services (HHS) to highlight that news while ignoring the rest in order to lend credence to Michelle’s pet childhood obesity project — “Let’s Move.”

Among other items, the investigative journalists found an email from a senior CDC press officer to three co-workers saying, “Well our press release is skewed to highlight the good news per HHS request.” The reporters went back in time to compare the original press releases that had started the whole dispute.

These were the headlines:

  • JAMA — “Obesity Prevalence Remains High in U.S.; No Significant Change in Recent Years”
  • CDC — “New CDC data show encouraging development in obesity rates among 2 to 5 year olds”

Ross wrote:

The full extent of the White House’s pressure on HHS and CDC to spin the study in favor of “Let’s Move” is not clear. Many of the 713 pages of emails are withheld, citing executive privilege invoked by the White House. But the government’s footprint is evident in the differences between JAMA’s press release and the CDC’s.

The effect of the fudging was evident. Even the usually conscientious New York Times went with a sensational “Obesity Rate for Young Children Plummets 43% in a Decade.” Of course even then, before the incriminating emails were uncovered, there was pushback.

Lawrence Appel of Johns Hopkins wrote to the Times editor, “It is really unfortunate that the CDC highlighted such a tenuous finding,” and senior CDC scientist Katherine Flegal went off the reservation and wrote, “The finding is exaggerated and questionable in a variety of ways, and the HHS press release made far too much of it.”

Your responses and feedback are welcome!

Source: “If The President Can Credit Michelle Obama With Lowering Childhood Obesity, Then He can Get Away With Anything,” PoliticalOutcast.com, 01/29/14
Source: “Childhood obesity down more than 40 percent, new study says,” Daily-Journal.com, 02/25/14
Source: “A plunge in U.S. preschool obesity? Not so fast, experts say,” Reuters.com, 03/16/14
Source: “That Big Childhood Obesity Decline May Have Been a Statistical Error,” NationalReview.com, 03/18/14
Source: “Presidential Proclamation — National Childhood Obesity Awareness Month, 2015,” WhiteHouse.gov, 08//31/15
Source: “Emails Show White House Pressured Health Agencies To Highlight ‘Tenuous’ Childhood Obesity Research,” DailyCaller.com, 10/19/15
Photo credit: FlickAbuse via Visualhunt.com/CC BY

Willpower, Ego Depletion, and Mindfulness

As Dr. Pretlow points out, “The quandary is, when emotional eaters realize what they are doing, they still are not able to stop… In the moment the ramifications don’t seem to have an effect…”

Many people believe that they really can’t control their actions, even the self-harming ones. In this area of the human psyche, the ruling principle seems to be cognitive dissonance — the ability to hold onto two opposing beliefs at the same time.

For instance, a juror might be absolutely certain that a rapist or murderer could have stopped himself (or herself), and that juror might righteously vote for a life sentence or the death penalty, based on a certainty that the criminal only needed to “just say no” to the violent impulse. “It’s that simple,” the juror might say. “No matter how much you feel like doing it, no matter how much you want to do it, you don’t rape and you don’t kill.”

So far, so good. But what if that juror stops at a store on the way home, and later scarfs down a quart of ice cream? Where is the certainty now? No voice is saying, “No matter how much you feel like doing it, no matter how much you want to do it, you don’t buy ice cream.”

No voice says, “You don’t have to do this. You can choose not to eat the ice cream.” That voice is silent. Only a short time ago, a person believed that it is possible to resist the impulse to kill. Now, the same person is overwhelmed by the desire to devour a quart of ice cream. How is this contradiction possible?

The wants and the shoulds

The short answer is, nobody knows. Questions about volition and choice may never be definitively answered. Researchers have come at the issue of human motivation from a lot of different angles. Katherine L. Milkman, Ph.D., associate professor at the University of Pennsylvania, has written extensively about want options versus should options and why people choose one or the other. In one paper, she attempted to reconcile the decision-making process with what has been discovered about “ego depletion.”

According to one theory, self-control is like a muscle — but not in the way we might intuitively take that to mean. Probably most people would think self-control is compared to a muscle because it can be strengthened and made larger with repeated exercise. Many of us have been taught that willpower improves with practice.

For instance, when tempted by junk food, we should just remember, “Nothing tastes as good as being thin feels.” (The picture on this page, by the way, is an anonymous Internet meme based on a photo of entertainment figure Kirstie Alley, subject of previous posts.)

Surprise: The concept of ego depletion is the exact opposite. Prof. Milkman writes:

“According to this theory, after an individual makes one attempt to engage in self-control, subsequent attempts are less likely to be successful. More specifically, ‘self-control strength is used and consumed any time the self actively initiates, alters, or stifles a response’ (Muraven and Baumeister, 2000, p. 249), and such use is ‘ego-depleting’, reducing one’s capacity for subsequent exertions of self-control.

The empirical support for this model of self-control as a limited resource is extensive.

In other words, willpower is not a muscle that grows with exercise, but a muscle that becomes feeble, flabby, and worn out with use; and a lot of research backs up that assertion. How does this discouraging news stack up against the concept of “mindfulness” as a pathway to healthful eating? Childhood Obesity News will examine that more deeply.

Your responses and feedback are welcome!

Source: “Unsure What the Future Will Bring? You May Overindulge: Uncertainty Increases the Appeal of Wants over Shoulds,” UPenn.edu, 7/19/2012
Image: Anonymous Internet meme

Many Aspects of Bariatric Surgery for Teens

Not long ago, laparoscopic gastric band surgery for adolescents was considered “experimental.” The procedure had been done on minors, but only as a last-ditch alternative, and the Food and Drug Administration had not yet made up its mind.

It is easy to see why there was hesitation. The country had been through years of upset over anorexia and bulimia, and was well aware that teenagers are capable of irrational and self-destructive behavior, especially when body dysmorphia is involved. Nobody wanted to see a wave of elective surgery done on vulnerable kids.

In 2011, the tide turned. The rules changed, and suddenly well over 10% of Americans were theoretically eligible candidates for Lap-Band surgery. Perhaps out of gratitude, the Allergan company stopped asking the FDA to lower the legal age to 14. There was some newsworthy drama around doctors who did not appear to know the meaning of the term “best practices.”

Should preventative surgery be a thing?

One of the most vital parts of any argument for or against teen surgery is the notion of prophylaxis, or taking an action to prevent disease. Is it defensible to remove perfectly good body parts to fend off future trouble? Taking this reasoning to an extreme, why not pull all of a child’s teeth, yes, even the designedly permanent ones? It makes sense, because there is a good chance that at a future time, dental caries will appear.

This insane idea, on some level, makes sense. The only thing it doesn’t take into consideration is the entire rest of the body, which relies on properly chewed food to get its work done. Also, it doesn’t take into account pain from misaligned joints in the head, and the loss of ability to speak clearly, and the resulting grotesque appearance. But full-mouth extraction does prevent cavities, and there may be people who do the cost/benefit analysis and decide that this is the way to go.

The law wants to make sure that some equally radical solution is not practiced on a human, too young to drive, drink, marry or vote, who may regret the consequences later. Of course, not all bariatric surgeries entail permanent removal of anything, thank goodness. This is why the Lap-Band procedure has gained such favor.

Surgery used to be considered a very serious step saved for last resorts. Now it seems to be treated as lightly as an eyebrow-shaping or a pedicure. Over the past few years, the idea of performing irreversible, life-altering surgery on young people has become normalized.

Even with theoretically reversible techniques, life will never be the same and it certainly won’t be easy, for reasons described in “After Teen Surgery,” and that page doesn’t even cover all the possibilities.

In one study of teenagers, more than one out of 10 had to go back for additional surgery. The threat to adequate nutrition is ever-present and needs constant attention. This part is worth repeating:

Overeating and lack of exercise are not the only causes of childhood obesity.

Ideally, children and teens who contemplate surgery would sign up with W8Loss2Go and put the big decision on hold for a while. The long-range outcome for bariatric surgery is not overwhelmingly impressive. Sure, a lot of patients get better for a year or even a few years. Unfortunately, a lot of patients eventually return to their former sizes. W8Loss2Go, on the other hand, advocates and teaches a re-learning that lasts a lifetime.

Your responses and feedback are welcome!

Photo credit: Internet Archive Book Images via Visualhunt/No known copyright restrictions

Advertisers and the Super Bowl

In 1983, the year after the release of the mega-famous Thriller album, the Jackson brothers made the biggest celebrity endorsement deal so far ($5 million) with Pepsi. The idea for such a marriage had first been proposed to Coca-Cola, which passed, probably to the corporation’s everlasting regret. Jackson rewrote the hit song “Billie Jean” to include the line, “Guzzle down and taste the thrill of the day.”

Guzzle down, indeed. The CEO who signed the megastar estimated that 97% of the American public saw the Jackson Pepsi ads at least a dozen times apiece. The following year, Jackson suffered serious burns when his hair caught fire during the making of a Pepsi commercial. One theory of his ultimate downfall holds that the terrible maiming incident triggered his addictions to both plastic surgery and painkilling drugs. In 1987-88, Pepsi paid $10 million to support the global “Bad” tour.

In 1993, the Michael Jackson Super Bowl halftime show was one of the most-watched performances in television history. By then, Jackson had been selling his talents to Pepsi for a decade, but the ride was over. In that year, the unseemly accusations surfaced. Jackson stopped touring, and Pepsi dropped him.

But a new generation of Pepsi consumers came along, who had forgotten or never heard of the scandal. In 2012, to celebrate the 25th anniversary of “Bad,” Pepsi made a deal with Jackson’s estate to put his image on a billion soft drink cans — including limited edition 16-ounce cans. Even of the larger cans, too many were manufactured to make them decently collectible. However, an unopened 1993 “Dangerous Tour” can is currently being offered on eBay for $125,000.

The saga of Pepsi’s relationship with Jackson is so enthralling that a movie is being made from it. When approached by soft-drink exec Roger Enrico, screenwriter Jesse Kornbluth conceived the project as “a film about business that could be, in form and theme, both meaningful and fun.”

America’s most important football show

The Super Bowl halftime shows used to be much more tame and middle-of-the-road-ish, with entertainment supplied by college marching bands and drill teams, and Up with People. In the mid-’80s a Hollywood spirit began to creep in, along with some diversity of form. Halftime talent included figure skaters, and more adult-oriented singers.

In 2007, the sponsor was Pepsi and the world-class artist was Prince. In 2013, Beyoncé and Destiny’s Child were the Pepsi-sponsored stars. In 2014, Pepsi paid for Bruno Mars and the Red Hot Chili Peppers. In 2015, Pepsi bought Katy Perry and Lenny Kravitz; and in 2016 paid a bundle to Beyoncé, Coldplay, and others.

The Sellouts is a 2:25 video montage, assembled by the Center for Science in the Public Interest, of dozens of celebrity endorsements of sugar-sweetened beverages. This piece of work could be shown to business majors, for the purpose of training advertising experts to make even more effective advertisements.

There is probably not much utility in showing it to, for instance, grade-school kids. CSPI’s final words are:

Children love celebrities. Their devotion brings celebrities success. That success comes with enormous responsibility. Celebrities shouldn’t use their influence to market a product that sickens their fans. Tell them to stop.

After the visual barrage of glamour, camaraderie, and happy feels, the message — worthy as it is — lands with a rather feeble impact.

Your responses and feedback are welcome!

Source: “Michael Jackson, Pepsi Made Marketing History,” Billboard.com, 07/03/09
Source: “Roger Enrico: How The Pepsi CEO And Michael Jackson Invented ‘New Coke’,” HuffingtonPost.com, 06/10/2016
Source: “Michael Jackson to Appear on Pepsi Cans,” RollingStone.com, 05/04/12
Source: “The Sellouts,” Youtube.com
Image by celebrityabc

Celebrities Are Loved and Shamed

Yesterday, Childhood Obesity News reviewed the advertising careers of two gigantic music stars, Beyoncé and Katy Perry, who have been criticized for lending their names and images to the promotion of sugar-sweetened beverages. But why should anyone begrudge these hard-working entertainers their juicy corporate contracts?

One answer comes from Susan Linn, speaking on behalf of the Campaign for a Commercial-Free Childhood:

There’s no moral, ethical, or social justification for marketing any product to children. Advertising healthier foods to children is problematic. We want children to develop a healthy relationship to nutrition and to the foods that they consume. Advertising trains kids to choose foods based on celebrity, not based on what’s on the package.

Many other famous performers have been raked over the coals for taking what is widely regarded as unclean money. Singers are most commonly seen in advertisements, but sports figures are prominent too.

Marie Bragg, Ph.D, of New York University’s College of Global Public Health, is a clinical psychologist who specializes in food policy and obesity. She is interested in such matters as how and why the choices of people are manipulated in grocery stores and restaurants and in the online environment, and how people handle the information presented by food packaging.

Several years ago she carried out a study of paid endorsements made by celebrity athletes for energy-dense, nutrient-poor products, and determined that teens are more likely than adults or children to see these ads. Pointing out a fact often mentioned by Dr. Pretlow, that health education alone cannot end the obesity epidemic, Prof. Bragg wrote:

What do we expect to happen when the best tasting and cheapest foods are the worst for you? The biggest take home point is that health education is not powerful enough in isolation, but if we combine a variety of environmental policies, we can create an environment that’s healthy by default.

More recently, Prof. Bragg’s team published another study blaming sports stars and entertainers for contributing to obesity by advertising unhealthy products. We can’t mention them all here, but among singers, Nicki Minaj sold Pepsi, Taylor Swift sold Coke, and Justin Timberlake sold McDonald’s (and received $6 million for one three-minute jingle). Lionel Richie has advertised Taco Bell and beer; Madonna got in early with Pepsi as far back as the late 1980s; Britney Spears and Pink followed her example. Glamorous model Cindy Crawford has sold Pepsi and Pizza Hut.

In 2012, basketball star Michael Jordan was widely censured for peddling Gatorade, and in the following year additional athletes (Peyton Manning, LeBron James and Serena Williams) received scoldings for promoting fast food and junk food. Even President Obama was chastised for eating junk food in public, at a time when the First Lady was growing a White House garden and trying to halt the childhood obesity epidemic.

Your responses and feedback are welcome!

Source: “The tricky business of advertising to children,” TheGuardian.com, 02/24/14
Source: “Marie Bragg, PhD,” NYU.edu, undated
Source: “Katy Perry under fire for promoting childhood obesity by shilling Pepsi,” Examiner.com, 10/21/13
Photo via VisualHunt.com

Obesity Villains? Katy Perry and Beyoncé

The study everyone is talking about comes from the Langone Medical Center at New York University, where a team led by Prof. Marie Bragg performed what has been called the “first quantifiable examination of the nutritional quality of food and drink endorsements by music celebrities popular among teens.” Arthur Dominic Villasanta described how rigorous nutritional analysis was employed to evaluate the health value of foods and drinks endorsed by entertainers idolized by teens.

Several dozen stars of popular music were chosen according to certain criteria, which included receiving a Teen Choice Award nomination and appearing in Billboard magazine’s “Hot 100” list. They are people with a high recognition factor among the youth; people who serve as role models. They are listened to and imitated.

The investigators used an advertising database called AdScope to examine all the ads made in a four-year period utilizing the talents of these people. Out of the 163 identified thought influencers, 65 were found to have done what might be characterized as selling out. They peddled, between them, 57 brands of drinks and foods.

And yes, selling is the correct word. As Pepsi executive Adam Harter freely admits, the Super Bowl halftime performers are not just artistic collaborators but marketing partners, and although they are the biggest examples of the trend, selling is also unequivocally the job of even the most obscure backup singer in the least-watched commercial.

As Yasmin Tayag reported, of these 65 celebrities:

[…] nearly all of them were associated with food and nonalcoholic drinks, a massive 81 percent of which were deemed “nutrient poor” according to the Nutrient Profile Model, a standard food industry metric.

By “associated,” we mean enjoying some form of reward for representing a brand in the marketplace. By “nutrient poor” we mean junk food, or junk food’s close relatives. Of the celebrities whose advertising careers were scrutinized, only one, Snoop Dogg, endorsed a natural product considered healthful, namely pistachio nuts.

Two bad girls

A while back, we mentioned the disapproval that greeted singing star Beyoncé’s promotion of Pepsi as far back as 2002 and 2003. Lately, the singer has been featured in such headlines as “Study Finds Beyoncé and Taylor Swift Shill for Sugary, Nutrient-Poor Garbage Food.”

The Center for Science in the Public Interest (CSPI) criticized her multi-year, $50 million contract agreeing to endorse Pepsi products. One project was a global advertising campaign that introduced the song “Grown Woman,” whose lyrics include the line, “I’m a grown woman, I can do whatever I want,” including, presumably, drink Pepsi and eat snacks all day. Another line of the song declaims “She got that bum,” an appurtenance which anyone who indulges in enough Pepsi products will certainly attain.

Katy Perry has been on the CSPI radar for a while, since they and several other advocacy groups published an ad in Variety urging her to change her mind about selling out to the same fizzy drink corporation. Activist Michael Jacobson told the press, “We’re focusing on Katy because she’s so popular with young people.” The ad copy read, in part:

Being popular among children brings with it an enormous responsibility. Don’t exploit that popularity by marketing a product that causes disease in your fans.

Although industry publication Adweek covered the incident editorially, its fellow entertainment publications The Hollywood Reporter and Billboard protected Perry by refusing to allow the open letter to her in their pages. Journalist Andrew Hampp noted that Pepsi’s support ranged “from co-hosting the 2012 premiere of her Part of Me concert film, to supporting her 2013 VMA performance under the Brooklyn Bridge and the premiere of PRISM single ‘Dark Horse’.”

With Pepsi’s help, Perry engages the young with her interactive ways, like asking fans to vote on what song she would sing for an awards ceremony. Hampp’s interview with soft-drink exec Adam Harter established that Perry is totally “on-brand” for his corporation, because of her energy and optimism and of course the fact that she has more Twitter followers than anybody. The Pepsi rep told the reporter, “The ability to tap into that fanbase and social network was really appealing.”

Of the Top 10 Twitter personalities, five others besides Perry are singers. Interestingly, the entity with the 9th largest number of followers is Twitter itself.

Your responses and feedback are welcome!

Source: “Study Says Recording Artists Help Boost Childhood Obesity in the US,” ChinaTopix.com, 06/06/16
Source: “Super Bowl Exclusive: Pepsi’s Adam Harter on Hiring Katy Perry,” Billboard.com, 01/30/15
Source: “Study Finds Beyonce and Taylor Swift Shill for Sugary, Nutrient-Poor Garbage Food,” Inverse.com, 06/06/16
Source: “Katy Perry under fire for promoting childhood obesity by shilling Pepsi,” Examiner.com, 10/21/13
Source: “Health Groups Target Katy Perry for Marketing Pepsi,” Adweek.com, 10/21/13
Photo credit: Noodles and Beef via VisualHunt.com/CC BY

Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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