Selling Crap to Kids, Part 12

In his New York Times piece, “Why Your New Year’s Diet Is Doomed,” Mark Bittman wrote,

The interactions among calorie intake, exercise, fat accumulation, insulin resistance and genetic background, along with other environmental factors that cause diet-related diseases (such as stress and generational poverty), are variable and complicated.

In other words, and not surprisingly, this problem is and always will be multi-factorial, and thus not amenable to any facile solution. Still, it is always possible that some factors weigh more heavily than others, and in this case, the factor known as ultra-processing was recognized as quite significant because, “Now, more than half of our total calories come from ultra-processed foods.”

What does that mean exactly? One apt definition was provided by the Brazilian scientist, Carlos Monteiro, who characterized such foods as containing ingredients that are “never or rarely used in kitchens.” But they are used in factories where, for example, the perceived necessity of a freakishly unnatural, extremely prolonged shelf life is also to blame.

We have seen that researchers easily obtain from children confessions about how they harass their parents, both at home and in public places, to obtain their substances of choice. Of course, these exertions are aided by the cunning strategy employed by grocery stores, of placing the products garnished with pictures of cartoon characters on the lower shelves where children can’t miss them.

We say it, you believe it

Such predatory practices set kids up to fail and obviously contribute to the obesity epidemic, and nobody seems able to do anything about them. Or rather, the people who are able are not willing; while those who are willing are not able.

Many individuals and groups lobbied for stricter rules that would require supermarkets to rearrange their shelves and keep sweets out of children’s sightlines. Even some politicians risked incurring the anger of their corporate overlords by demanding that foods with low nutritional value and high obesity potential be placed on higher shelves.

Unfortunately, studies from the Netherlands indicated that such cosmetic measures are pretty much doomed to futility:

[P]ositioning healthier snacks at the checkout counter, without removing less healthy snacks, did not result in the replacement of less healthy snack purchases with healthier alternatives. To discourage the purchase of less healthy snacks at supermarket checkouts, a total substitution of less healthy with healthier snacks is clearly the most effective.

Clearly, no business is going to hide its highly processed and fattening foods in the back room. Those products will remain out where the people who want them can easily find them. And just offering a healthful alternative next to the crappy stuff does not inspire people to choose the healthful alternative.

The only way to stop customers from buying worthless substances posing as food is to not even offer it for sale. In which case, most people will just go to a different store whose products are more to their liking.

How low can you go?

Over in the United Kingdom, there are some standards in place regarding what may be publicly said about food and drink, in places where young folks might hear. One year ago, researchers from the University of Chicago looked at a bunch of Instagram posts made by the “beautiful people” and applied those standards to what they saw:

They found 87 percent of celebrity accounts analyzed received an unhealthy overall food nutrition score, with 89.5 per cent receiving the same result for beverages.

These messages, in the main, were not obviously paid-for advertisements, but allegedly spontaneous and sincere remarks the famous folk just happened to make in the course of living their everyday lives. Many of those remarks did and do concern alcohol, which is nobody’s idea of a healthful influence (and which contributes to obesity both by containing calories and by corrupting people’s judgment about what they ought to be eating).

And in the food category, it comes as no surprise to learn that those observations tend overwhelmingly to concern snacks and sweets. Also, this type of message, which is perceived by fans as authentic and credible, draws more reactions or “engagement,” which in turn rewards the celebrities who regard attention as a form of payment.

Of course, some of them also make millions of dollars for a single post, but shhhh! We are supposed to pretend we don’t know that.

Your responses and feedback are welcome!

Source: “Why Your New Year’s Diet Is Doomed,” NYTimes.com, 01/09/21
Source: “Can Healthy Checkout Counters Improve Food Purchases? Two Real-Life Experiments in Dutch Supermarkets,” NIH.gov, 11/19/20
Source: “Are influencers making our children FAT?,” DailyMail.co.uk, 01/12/22
Source: “20 of Instagram’s Highest Paid Stars in 2024,” InfluencerMarketingHub.com, 01/30/24
Image by balu/CC BY 2.0 DEED

Pet Obesity Survey Reveals U.S. Cats and Dogs Getting Fatter

We haven’t discussed pet obesity in a while, with such hot topics as advertising to kids and the GLP-1 weight-loss drugs taking over for a while. So now is a good time as any to revisit this topic.

Although there isn’t currently much in the news about pet obesity, except for some pet food companies tooting their own horn by promoting their weight-management pet food products, maybe the lack of news is still news — or non-news — or at least a stark reminder that not much is being done about our fat pets.

Dogs and cats are getting fatter

A pet obesity survey conducted by the Association for Pet Obesity Prevention in 2022 (the most recent statistics available) showed an increase in overweight and obese dogs and cats, with 59% of dogs and 61% of cats classified as overweight or obese. For dogs, this percentage increased from 56% in 2018 and 2017, and for cats a slight increase from 60%.

Let’s put this in perspective. To put a visual on how even a “little” weight gain for a pet compares to an average human, for a cat, 2 lbs over ideal weight is equivalent to 30 lbs in humans. For a small dog, compared to a human, it’s 12 lbs, and for a large dog, it’s 5 lbs.

Other key survey findings include these revelations:

Consistent with previous surveys, many dog and cat owners failed to recognize excess weight or overweight body conditions in their pets. Nearly one-third (32%) of owners of overweight or obese pets (BCS 6-9) classified their pet as “normal,” “ideal,” or “thin” body condition when asked by their veterinary professional.

36% of dog owners considered their pet’s body condition “normal” when their veterinary professional classified it as BCS 6-9 (overweight to obesity).

28% of cat owners considered their pet’s body condition “normal” when their veterinary professional classified it as BCS 6-9 (overweight to obesity).

That’s a pretty skewed perception, especially considering the fact that pets count on us to keep them healthy.

Do veterinarians discuss healthy weight?

Yes, and it’s gotten better. The survey found that 49% of respondents reported that their veterinary professionals discussed their pet’s ideal or healthy weight yearly, compared to 46% in 2021. Adding to this somewhat hope-inspiring finding, two-thirds (67%) of pet owners surveyed said they “have not felt embarrassment or uncomfortable after being told their pet needed to lose weight.”

Pet weight loss strategies and success rates

The numbers show that the majority of pet owners try to help their pets lose weight (73% of dog owners and 58% of cat owners). The survey attempts to explain the difference between cat and dog weight loss efforts may be attributable to factors such as:

[…] being able to exercise a dog through walks or outdoor physical activities, the ability to perceive weight gain more easily on a canine, or familiarity with breed standards and morphology.

As for the self-reported success rates, dog owners reported higher “success” or “some success” rates than cat owners (34% vs. 19%, and 26% vs. 34%, respectively). “No success” or “My pet did not lose weight despite my best effort” was reported by 23% of dog and 29% of cat owners.

Causes of pet obesity and who is to blame

Finally, the survey used a Likert Scale format to help determine pet owners’ opinions on the causes of pet obesity. There were five response choices: strongly disagree, disagree, neutral, agree, and strongly agree. To the question of whether or not pet owners thought obesity was a result of overfeeding 73% of pet owners somewhat or strongly agreed. Seventy percent of respondents somewhat agreed that pet obesity is caused by poor feeding choices, and 68% agreed or somewhat agreed that obesity is caused by not enough exercise.

The last finding we cite here might give us pause, since a majority of pet owners reported being aware their pets are overweight and trying to help them lose weight. Still, only 32% of pet owners surveyed strongly agreed that pet owners are to blame for an overweight or obese pet, 30% somewhat agreed, 23% were neutral, 8% somewhat disagreed, and 7% downright disagreed.

Your responses and feedback are welcome!

Source: “2022 U.S. Pet Obesity Prevalence Survey,” Association for Pet Obesity Prevention, 2022
Source: “What does weight gain actually look like for your pet?,” HillsPet.com, undated
Image by Nika Benedictova on Unsplash

Selling Crap to Kids, Part 11

As the 20-teens decade progressed, conditions grew worse in the realm of celebrity endorsements. A study from New York University’s School of Medicine zeroed in on the sick relationship between the sports industry and the junk food industry.

Journalist Megan Sheets summarized it thusly:

More than three quarters of food products and half of beverages sponsored by the leagues most popular among American children are unhealthy… The findings revealed that 76 percent of food products are unhealthy and 52.4 percent of beverages are sugar sweetened across all of the sports-organization sponsored advertisements. Little League had the third-most unhealthy sponsorships.

Increasingly, individual athletes were blamed and shamed for making money from this unholy alliance. A study published in Pediatrics demonstrated that:

Social-media “influencers” can drive kids to consume unhealthy foods… But that clout disappears when it comes to their promoting healthy foods… [S]eeing influencers promote healthy snacks didn’t significantly move the needle on food intake.

The United Kingdom’s University of Cambridge published a study which indicated that setting a limit on the hours when TV ads directed at children could be shown, would make a “meaningful contribution” toward reducing childhood obesity. Dr. Oliver Mytton told the press,

Our analysis shows that introducing a 9 PM watershed on unhealthy TV food advertising can make a valuable contribution to protecting the future health of all children in the UK… However, children now consume media from a range of sources, and increasingly from online and on-demand services… [I]t is important l to ensure that this advertising doesn’t just move to the 9-10pm slot and to online services.

A noble ambition, but one doomed from its inception because obviously, the trend would only continue in one direction, toward 24 hours per day of entertainment financed by ads for everything awful.

The year 2021 began with a New York Times piece by Mark Bittman pessimistically titled “Why Your New Year’s Diet Is Doomed.” He placed the blame on “the Big Food marketers that sell you that junk” to the tune of $14 billion (with a B) spent on advertising per year, and then generously extended the shame to “politicians who enable them.” Why? Because government serves “the interests of agribusiness, food processors, marketers and retailers.”

In relation to this, Bittman helpfully pointed out that the Centers for Disease Control and Prevention work with a budget of less than $1 billion per year to prevent disease and promote health. For the mathematically challenged, that means the promoters of disease and preventers of health were spending 14 times as much. It’s all about money, in more ways than one.

The primary determinant of the quality of diet is income, not ignorance, intelligence or will. With 12 percent of Americans going hungry, and millions of households with children uncertain that they’ll be able to feed their kids, the “choice” is often between eating processed food and not eating at all.

Sabrina Sanchez wrote those words in the middle of 2021, by which time COVID-19 had become a factor to be reckoned with. A 72-page report was published showing that “brands and platforms including McDonald’s, Unilever, Facebook and Twitch use technology-driven marketing tactics to sell high-sugar and high-sodium products to kids, leading to obesity.”

Jeffrey Chester, executive director of the Center for Digital Democracy, warned that manufacturers had built “arsenals of data profiling services” using artificial intelligence and machine learning. The purpose of these constructs was to predict the most effective way to advertise, and then to make sure that the predictions came true. Chester says,

In 2020, children between the ages of 6 to 8 years-old cited McDonald’s as their number-one favorite brand, followed by YouTube, Oreo and M&Ms, according to youth market researchers Smarty Pants. Minors ages 9 to17 years-old cited YouTube first, followed by Oreo, Hershey’s, Cheetos and Doritos among the top 10.

The issue was raised that such marketing machinations could be violating the 1998 Children’s Online Privacy Protection Act of 1998. Advocacy groups tried their best, but realistically, obtaining protection via child privacy legislation never stood a chance.

Your responses and feedback are welcome!

Source: “Sports leagues blamed for fueling childhood obesity as 76% of teams promote junk food and soda,” DailyMail.co.uk, 03/26/18
Source: “How social-media influencers are making your kids fat,” NYPost.com, 03/05/19
Source: “Television advertising limits can reduce childhood obesity, study concludes,” ScienceDaily.com, 10/13/20
Source: “Why Your New Year’s Diet Is Doomed,” NYTimes.com, 01/09/21
Source: “Fast food and soft drink advertising contributes to childhood obesity,” CampaignLive.com, 05/12/21
Image by Tony Alter/CC BY 2.0 DEED

Selling Crap to Kids, Part 10

Suppose that a prominent medical journal published a review paid for by Coca-Cola, General Mills, Hershey’s, Kellogg’s, Kraft Foods, and Monsanto, and partly authored by “a member of the scientific advisory board of Tate & Lyle, one of the world’s largest suppliers of high-fructose corn syrup” — which actually happened in 2016. What would a person expect that article to say? Well, if they guessed that it would say sugar is just fine and dandy, and all the unrealistically alarmist warnings against sugar are based on flimsy evidence — they would be correct.

As soon as Annals of Internal Medicine hit the streets, the backlash flared up, and plenty of health experts pointed out that the patron who put up the money for this “news,” the International Life Sciences Institute, was a very biased, partial, and subjective tool of the industry. For its part, the poor, misunderstood industry, especially the junk food contingent, claimed to only want the development of “trustworthy guidelines on sugar intake.”

This was all part of a larger strategy by which the industry endeavored to recruit as many bent academics as possible to volubly cheer for Team Sugar. Even way back in the 60s, the same deceptive voices had been hired to put a halo around sugar and cast all blame on saturated fat.

So in 2016, the effort was still going strong, when “the Associated Press reported in June that food companies paid for studies that claimed candy-eating children weigh less.” In its turn, the new shocking paper was characterized as “reminiscent of tactics once used by the tobacco industry, which for decades enlisted scientists to become ‘merchants of doubt’ about the health hazards of smoking.”

Dr. Dean Schillinger, internal medicine specialist at San Francisco General Hospital, accused the industry of “hijacking the scientific process in a disingenuous way to sow doubt and jeopardize public health.” Many other experts joined in the condemnation. Journalist Anahad O’Connor reported,

“This comes right out of the tobacco industry’s playbook: cast doubt on the science,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University who studies conflicts of interest in nutrition research. “This is a classic example of how industry funding biases opinion. It’s shameful.”

In the following year, California toughened up rules that had been in effect for a decade, against soft drinks and foods high in fat and sugar being available in school. Now, the education system also banned advertising for such products in any form, and tossed out some of the sneaky workarounds that the industry had devised to avoid the rules. Journalist Cameron St. Germain wrote,

[T]he bill includes restrictions on corporate incentive programs such as the Box Tops for Education program, which rewards schools for collecting box tops clipped from specially marked products. The products, however, tend to be processed foods like cereals, snack bars, cookies, frozen pizzas, and other foods full of added sugar, salt, and fat… As this type of program constitutes a type of in-school advertising, it has been banned as part of the new bill.

Your responses and feedback are welcome!

Source: “Study Tied to Food Industry Tries to Discredit Sugar Guidelines,” NYTimes.com, 12/19/16
Source: “California Targets Childhood Obesity with New Advertisement Regulations,” NYCFoodPolicy.org, 11/21/17
Images by Ricardo Liberato, Sage Ross, Aidan Jones/CC BY-SA 2.0

Two Recent Childhood Obesity Studies in the Spotlight

We’ve been focusing recently on advertising to kids and the GLP-1 weight-loss drugs in the news, but what’s going on in the world of childhood obesity research? Most notably, two recent studies reveal the worsening of severe childhood obesity and cast doubt on one of the AAP-recommended guidelines. Let’s take a look.

A WIC study shows an obesity rate rebound to 2020

Last December, Fortune reported that a recent study published in Pediatrics indicates that severe obesity is becoming more common among young children in the United States. While previous research had shown a slight decrease in obesity rates among children enrolled in the Women, Infants and Children (WIC) program, the latest update reveals a rebound in obesity rates by 2020.

The study examined children aged 2 to 4 enrolled in the WIC program, finding that the rate of severe obesity had initially decreased from 2.1% in 2010 to 1.8% in 2016, but then rose to 2% by 2020. This increase was observed across various states and racial/ethnic groups, with notable rises among Hispanic children. While the exact reasons for the increase are unclear, some speculate that changes in policy, such as the elimination of the expanded child tax credit, and economic hardships faced by low-income families may have contributed.

The study’s findings are significant despite some challenges faced by the researchers, such as declining enrollment in WIC over the past decade and incomplete data due to the COVID-19 pandemic. As was the case with similar studies, further research is needed to understand the ongoing trends in childhood obesity, especially in light of the potential impacts of the pandemic.

This AAP guideline doesn’t seem to work, study finds

Another study reveals there’s no proven benefit to the AAP-recommended motivational interviewing method. A recent study, also published in Pediatrics, found that Motivational Interviewing (MI), a weight loss intervention recommended by the American Academy of Pediatrics (AAP), did not effectively reduce childhood obesity. MI is a patient-centered communication style recommended by the AAP to address various health behaviors, including nutrition and physical activity.

The study randomly assigned 18 pediatric primary care practices to either use the MI intervention or provide usual care for childhood obesity. The intervention included counseling sessions by pediatric clinicians and registered dietitians, text message reminders, and a study portal for parents and healthcare providers. However, results showed that children in the intervention group actually gained more weight compared to those receiving usual care.

The researchers suggested that methodological and cultural factors, along with the COVID-19 pandemic, might have contributed to the lack of improvement. Laura Rolke, Ph.D., and Michelle J. White, M.D., MPH, both of the Duke University School of Medicine, commented that the study reflected the “urgent need for child obesity interventions that target the structural factors which contribute to child obesity including socioeconomic, built environment and food policies.”

They also said:

Although pandemics are (we hope) rare, the social, environmental, and economic factors that lead to child obesity are ubiquitous… Interventions focused on individual or family behavior change alone are unlikely to overcome them. Moreover, such interventions may place too much onus on the caregiver to initiate and maintain behavior change against a powerful current of adverse factors.

The study authors recommended reconfiguring the intervention model, possibly by involving healthcare professionals trained in behavioral change counseling and motivation more extensively. They wrote:

The required dose to achieve weight effects may be unattainable in our current health care delivery system… Further, the use of dietitians and pediatricians may need to be reconsidered. It may be beneficial to include other health care professionals who are primarily trained in behavioral change counseling and motivation, perhaps providing them with nutrition counseling skills or perhaps engaging dieticians only once or twice during the intervention.

Your responses and feedback are welcome!

Source: “Study findings cast doubt on childhood obesity intervention,” Healio.com, 1/29/24
Source: “Severe obesity increasing among young American children, new study confirms,” Fortune.com, 12/18/23
Image by Kenny Eliason on Unsplash

Selling Crap to Kids, Part 9

A 2016 study revealed that children “as young as 2 years old could recognize food and beverage characters…” and for several years they are deeply impressionable. Children under the age of eight were found to be extremely susceptible to outside influence, like advertising, for instance, because “the brain is most open to priming.”

Attributed to various sources is a centuries-old maxim. One authority says,

Educationalists should take the hint from the dictum of Ignatius Loyola… “Give me a child until he is 7, and I will give you the man.”

Throughout the decade, the battle for children’s minds and hearts raged on. While some manufacturers made the effort to appear nobly concerned, others just went with the flow, and got away with whatever chicanery they could. But while a cartoon character might captivate a child, more is required to snag the attention of teenagers.

Celebrities had already been taking some flak for endorsing junk food. A study revealed what anyone with half a wit realized anyway: “Most of the foods and beverages endorsed by celebrities are unhealthy.”

The industry was so enamored of capturing young minds that it spent $2 billion per year on the art and science of doing that. Not surprisingly, the most fervent employers of media stars were PepsiCo, Coca-Cola, and Red Bull. Also generating minimal shock, this news was announced:

Very few celebrities were endorsing healthy products, and not one popular TV, film, or music star was featured in ads for fruits, vegetables, or whole grain products.

But never fear… there is always a place for the beautifully famous, in the world of junk food marketing. Just like there is always a place for little kids in the media marketing landscape. The junk food advertising industry discovered the pester-power factor, utilizing both electronic screens and in-store displays to inform children exactly what they ought to desire, and motivating behavior that parents don’t love, and neither does the general public.

Back in the day

Most media did not used to be on-demand. There were three TV networks, and you watched what they broadcast, on their schedule. Certain types of programming clustered around certain time slots, and Saturday morning was cartoon heaven.

In 2016, Gwendolyn Wu wrote on Medium.com:

[T]wo separate studies published last week suggest that the constant barrage of junk food advertisements on television is a driving factor behind rising childhood obesity levels…

For one study […] researchers from McMaster University in Canada conducted randomized trials and found that children who saw commercials for junk foods consumed more unhealthy foods than healthy ones…

Those findings are supported by a study [that] analyzed kids’ responses to junk food commercials on TV and found that children commonly ask their parents to purchase items that they see on screen.

The public talked about setting boundaries, and if necessary, laying down some laws. Marketing should be a grown-up conversation, with the kids left out of it. Some very worried adults pointed out that advertising to children is a sort of gradual brainwashing to get what the adult wants, a process that in another context is called grooming.

Meanwhile, young cartoon aficionados were absorbing an average of five junk-food commercials per hour. The children under scrutiny reported that, among other things, the ads made them think of nutritionally null snacks, when they would not ordinarily have done so.

Your responses and feedback are welcome!

Source: “Silly rabbit! Junk food ads contribute to childhood obesity, study says,” PBS.org, 07/05/16
Source: “Give me a child…,” NewScientist.com, 12/19/06
Source: “Study: 80% of Celebrity Endorsements Are for Junk Foods,” EurWeb.com, 07/05/16
Source: “Kids Admit Commercials Make Them Pester Parents for Junk Food,” Medium.com, 07/11/16
Image by Leonid Mamchenkov/CC BY 2.0 DEED

Selling Crap to Kids, Part 8

We are up to Part 8 of this series already, and it’s only 2015. In February of that year, YouTube made bold moves that were characterized by complaints to the Federal Trade Commission as “deceiving kids by mixing ads and content without clear delineations,” a situation described for WIRED by Julia Greenberg.

It wasn’t supposed to be like that. What was supposed to happen was that the special app would provide safer and easier access to “family-friendly videos, channels, and educational clips.” Yet somehow, this innocent gateway to safe, uncontroversial children’s programming ended up being perceived by a coalition of 10 consumer groups as a font of unfair and deceptive marketing that targeted children, rather than serving them. Rules, the critics charged, were being violated, and parents were being misled.

The thing is, although the rules for broadcast television were pretty strict, the internet was a different matter altogether. By its very nature, advertising over the World Wide Web is much more mutable and inconsistent, so it is not so easy to make rules that stick. A discrete, established channel like Nickelodeon was not allowed to have its programs write the commercials, or let show hosts peddle the merch, and the amount of advertising per hour was limited. But YouTube was the Wild West.

In July of that year, several “marketing icons” including Ronald McDonald, the Trix Rabbit and Sour Patch Kids were named as contributors to the childhood obesity epidemic. For PBS, Laura Strum explained the implications of a new study:

The investigation pooled data from 29 randomized trials involving 6,000 children to examine how exposure to marketing for high-calorie and sugary foods […] increased a child’s short-term desire for these items. The study found that kids consumed 30 more calories when exposed to just four minutes of junk food advertising relative to control groups.

McMaster University’s Dr. Bradley Johnston opined, “If we were to ban TV ads for bad fats, sugars and salts we could potentially reduce [the rates of] overweight and obese [children] by 15 and 2.5 percent respectively.”

Incapable of distinctions

But YouTube was able to get away with a bunch of techniques that watchdog groups considered underhanded, like letting popular hosts or beloved characters double as salespersons and being insufficiently obvious about what was advertising versus what was programming. YouTube was pulling off an unacceptable amount of boundary obfuscation. Greenberg wrote,

We adults see sponsored stories right next to news… On YouTube, Instagram, and Pinterest we follow people who tout clothes or play with gadgets they’ve been given by sponsors. For adults, the failure to clean up the mix between ads and content doesn’t seem so pressing.

In the opinion of the FCC, because children do not yet have the necessary cognitive skills in place, they are unable to tell the difference between entertainment and advertising, so expecting them to make such fine distinctions is unacceptable.

But although the FCC has jurisdiction over TV, its powers were not considered broad enough to get the job done on the internet, so the FTC with its more comprehensive muscle was asked to step in like the new sheriff in town and clean the place up. YouTube, of course, denied all guilt. Its staunch self-defense included an ostensibly righteous repudiation of classist snobbery. It communicated,

We worked with numerous partners and child advocacy groups when developing YouTube Kids… While we are always open to feedback on ways to improve the app, we were not contacted directly by the signers of this letter and strongly disagree with their contentions, including the suggestion that no free, ad-supported experience for kids will ever be acceptable. We disagree and think that great content shouldn’t be reserved for only those families who can afford it.

Your responses and feedback are welcome!

Source: “Exposing the Murky World of Online Ads Aimed at Kids,” WIRED.com, 04/07/15
Source: “Silly rabbit! Junk food ads contribute to childhood obesity, study says,” PBS.org, 07/05/16
Image by erenkumcuoglu/CC BY-ND 2.0 DEED

GLP-1 Weight Loss Drugs in the News, Again

The latest news about the GLP-1 weight-loss drugs looks at how the latest developments can potentially both positively and negatively affect consumers and businesses. Let’s take a look at several recent headlines to glimpse at what’s happening in the world of weight loss meds.

North Carolina won’t cover GLP-1 weight-loss drugs for its state employees

The North Carolina state employee health plan is discontinuing coverage for expensive GLP-1 weight-loss drugs like Wegovy and Zepbound due to their high cost. The decision, made by the plan’s board of trustees, comes as the drugs have become increasingly popular among members, costing the plan $102 million in 2023 alone.

This decision is expected to be the first major state health plan to cease coverage for these drugs. Despite concerns about the affordability of the drugs for members, especially considering the state’s economic ties to the manufacturer, Novo Nordisk, the board has decided to end coverage entirely, except for current users who will be grandfathered in.

This move is projected to save costs for the plan, but it also means losing a substantial rebate from the drug’s manufacturer. Other states, like Texas and Connecticut, have also grappled with the high costs of these weight-loss medications, with some implementing restrictions or prior authorization procedures to manage their use.

Unsurprisingly, the manufacturers are not amused. As Ars Technica reported a couple of days ago,

A spokesperson for Novo Nordisk called the vote to end coverage entirely “irresponsible,” according to a statement given to media. “We do not support insurers or bureaucrats inserting their judgment in these medically driven decisions,” the statement continued.”

Ars Technica’s Senior Health Reporter Dr. Beth Mole also quotes Sam Watts, director of the North Carolina State Health Plan, who told Bloomberg:

Every state has been wrestling with it, every professional association that my staff is a part of has had some discussion about it… But to our knowledge, we’re the first major state health plan to act on it.

Why is this important?

We’d say for three reasons. First, because people still want them, despite potentially serious side effects and sticker-shock prices. Second, this could be seen as a trend, for lack of a better description, that other states might follow.

The third reason is a downright dangerous one. As Reuters reported just two days ago, The World Health Organization (WHO) has issued a warning about global shortages of popular diabetes medications used for weight loss, such as Ozempic, leading to a rise in suspected counterfeit versions.

These fake drugs, primarily distributed through unregulated outlets including social media platforms, pose serious health risks due to potential lack of efficacy and contamination. Instances of dangerously low blood sugar and hypoglycemia have been reported in those who took suspected fake versions of these medications.

The high demand for these drugs, coupled with manufacturing constraints, has led to shortages in the U.S. market, exacerbating the issue of counterfeit drugs. The WHO emphasizes the importance of obtaining medicines from authorized and regulated suppliers to ensure patient safety. Not only all patients are at risk should they choose to (or unknowingly) buy counterfeit, “but the increased circulation of fake versions was likely to have a disproportionate effect on patients with type 2 diabetes.”

The rise in GLP-1 prescriptions can also influence commercial real estate

Say what? Bear with us. Last week, CoStar, a commercial real estate information outlet, reported that the increasing popularity of weight-loss drugs like Ozempic could have significant implications for commercial property demand, according to Anton Pil, an executive at J.P. Morgan Asset Management.

With potentially millions of users in the United States, the rise in GLP-1 prescriptions could influence consumer behavior and impact real estate decisions. Pil said:

While there’s no guarantee the popularity of the drug will grow or that any behavioral changes will be long-lasting or widespread, spending patterns already are changing for people who are taking GLP-1s, according to anonymous data from 95 million J.P. Morgan Chase Bank customers…

TheRealDeal.com broke down the four ways the drugs’ increased use and popularity could influence commercial real estate, and it makes sense. Here goes:

Decline in fast-food sales: Weight-loss-drug users may reduce spending on fast food by about 85 percent, prompting questions about how fast-food restaurants can adapt their offerings, which could impact real-estate footprints.

Drop in alcohol sales: Individuals on these drugs might make a 60-70 percent reduction in their alcohol consumption, impacting liquor retailers.

Shift in snack and soda preferences: Spending on snacks may decrease by 80 percent, and soda consumption may drop by 70 percent, potentially leading to increased spending at alternative venues like juice bars.

Increased demand for fitness and apparel space: A shift towards a healthier lifestyle post GLP-1 usage could result in higher demand for spaces such as gyms, spa and beauty retailers, and apparel stores as consumers seek to support their new lifestyle.

Your responses and feedback are welcome!

Source: “Blockbuster weight-loss drugs slashed from NC state plan over ballooning costs,” Ars Technica.com, 1/29/24
Source: “Rise in reports of fake weight-loss drugs linked to shortage of real thing, WHO says,” Reuters.com, 1/29/24
Source: “Four Ways the Rise of Ozempic Could Shift Real Estate Investments,” CoStar, 1/22/24
Source: “Weight-loss drugs could reshape commercial real estate,” TheRealDeal.com, 1/27/24
Image by Anna Pelzer on Unsplash

Selling Crap to Kids, Part 7

In 2015 celebrities, especially if they worked for Disney, were catching flack for moonlighting in Coca-Cola ads. Journalist Jon Yaneff wrote,

Take for example a recent study published in the June edition of the journal Pediatrics. The study looked at 590 endorsements from 163 different celebrities. Researchers found that 65 celebrities were associated with 57 different food and beverage brands, including low-nutrient and sugar-sweetened drinks.

The American Academy of Pediatrics (AAP) wanted to ban both straightforward and covert advertising during children’s television shows. They established that pretty close to 100% of the food ads shown amongst highly-rated children’s programming featured junk food, and it wasn’t uncommon for any given child to see 20 such ads in a single day. That’s a lot of propaganda, particularly when poured into an immature mind.

The AAP wanted Congress, the FTC (Federal Trade Commission) and FCC (Federal Communications Commission) to forbid ads aimed at kids from being shown on TV, cell phones, and the like. In the same way that cigarettes and smoking had been excluded from entertainment movies, they also wanted to ditch the depiction of junk food. Julia Greenberg wrote of the FCC,

By the agency’s rationale, children haven’t developed the cognitive skills to distinguish between ads and content (or even read!). As a result, the FCC has set time limits on the number of ads allowed per hour during children’s programming. It’s also banned TV characters from selling products and prohibits product placement on kid channels and shows.

In another article written at the time, Drucilla Dyess said, “It is estimated that the ban could reduce the rates of overweight children and childhood obesity by as much as 15 to 20 percent.” But then, the Council of Better Businesses looked at the studies used by the AAP to reach its conclusions about the harmfulness of such advertising, and of course found them inadequate to the purpose.

The business groups claimed that the data used to condemn junk food advertising was either outdated, seriously inaccurate to begin with, or both. They claimed that research used flawed methodologies, and that there had been recent product improvements which the industry had not been given credit for. Some TV advertising was curbed, but obesity rates did not decrease, so the industry’s advocates claimed that forbidding ads obviously didn’t do any good. Of course, the other side argued that the children being observed had already been subjected to a ton of junk food ads, and were still responding to years of earlier brainwashing, so a dramatic change could not be expected to show up right away.

Back and forth

But industry representatives maintained that the situation had improved, because the products being advertised to kids were innocuous foods like “yogurt, soup, canned pasta, cereals, and meals with vegetables or fruit, milk or juice.” The child protectors responded by finding authorities who decried every one of those items. But the industry had another argument up its sleeve: leaving ads aside, there were also studies showing that just watching TV alone, without any food ads, also contributed to weight gain.

Furthermore, with or without advertising, just watching screens too close to bedtime had been shown to interfere with children’s sleep patterns, and it had been shown that bad effects on the quality and duration of sleep affected children’s tendency to put on pounds.

Some critics even proposed an extreme position: How about just not advertising to minors, period? After all, it’s not as if every child in America has a paycheck burning a hole in her or his pocket. Of course, that proposition was destined to go nowhere.

Your responses and feedback are welcome!

Source: “Selena Gomez, Madison Pettis Share Birthdays and Endorse Coca-Cola,” FoodsForBetterHealth.com, 08/27/15
Source: “Exposing the Murky World of Online Ads Aimed at Kids,” WIRED.com, 04/07/15
Source: “UPDATED: Will a Ban on Junk Food Ads Curb Childhood Obesity?,” HealthNews.com, 01/27/15
Images by Daniel M Vierdo, Pearl, Quinn Dombrowski/CC BY-SA 2.0

Selling Crap to Kids, Part 6

Early in 2014, Hank Cardello in a Forbes.com article noted how a drugstore chain had sacrificed $2 billion in annual profits by removing cigarettes from its shelves. Apple expunged 6,000 “sexually suggestive apps” from iTunes, and Costco banned firearms from its premises. Some companies discovered that what they lost in immediate income they could make back by the circuitous route of adopting “more socially acceptable products and practices.”

Before anyone could start feeling too warm and fuzzy about all this, the writer added,

[C]ompanies like CVS don’t give up a profitable line of business unless it is in their best long-term financial interest to do so. What CVS did is what I call having a moment of profitable morality.

Over a period of years, Disney theme parks shifted their children’s menus toward the healthier end of the spectrum. French fries were out; carrots were in. Even more surprising…

In 2012 Disney announced that it would no longer run junk food ads on its TV and radio stations, sacrificing a share of this $2 billion market in advertising to children… Disney’s stock price has doubled in the past two years.

Once the “halo effect” had been discovered, some corporations wasted no time “devoting their sharpest minds to figuring which of their products can thrive as the market changes, and de-emphasizing or eliminating the ones that no longer make sense.” But sadly, not enough corporations threw their sharpest minds into the job, and over the ensuing years, the world has seen plenty of examples that have no connection with morality, profitable or otherwise.

At the same time, though, other organizations became more conscious and more conscientious. In Australia, where almost two-thirds of school-age children participate in organized sports, a study published by a sports medicine journal shined a spotlight on the practice of advertising junk food at sports fields and even on the uniforms of young athletes.

By 2014, it was estimated that corporations spent a combined 1.6 billion every year on advertising specifically tailored to children, which achieved spectacular results, especially when imaginary characters were telling the kids what to eat. An interesting detail: The technique worked equally well in persuading them toward either junk food or healthy fare like vegetables.

Around the same time, Cornell University researchers studied the success of various in-store advertising ploys, such as positioning children’s cereal lower on the shelves, where actual children who happened to be shopping with a parent (and were too big to ride in the grocery cart) could more readily see them. It was also discovered that the friendly characters depicted on children’s cereal boxes were designed to make eye contact with their prospective customers, whereas on adult cereal boxes, characters like sports figures did not make eye contact with the viewer, but looked straight ahead.

Apparently, that is the sort of project into which most of the cereal industry’s sharpest minds invested their creative energies.

Your responses and feedback are welcome!

Source: “CVS and the Rise of Corporate Profitable Morality,” Forbes.com 02/27/14
Source: “Junk food ads taking over kids sport – study,” WordPress.com/,10/06/14
Source: “Me eat vegetable: Cookie Monster wants kids to snack healthier,” TheGuardian.com, 10/04/14
Source: “Warning: Cereal Box Characters Are Stalking The Children,” CBSNews.com, 04/07/14
Images by dancingbarefoot3, Karen, Matthew Sheales/CC BY 2.0

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources