Weight-Loss Encapsulated: Capitalizing on America’s Obesity Epidemic 
(An Evaluation of Diet Pill Advertising Strategies) 

By: Christina Kalinowski
Qualitative Research Methods
Prepared for Dr. Vigilant
5/02/06

	With current estimates proclaiming that over half of the U.S. adult population is overweight with approximately half of those qualifying for the obese category, it is no surprise that everyone is starting to take notice that we are turning into a fat country.   Between the years of 1991 and 2001 alone there was a 60% increase in the prevalence of obesity among adults (DeEugenio and Henn 2005).  Especially alarming is the striking increase in weight gain in children. Currently, approximately 30% of children and adolescents, ages nine through nineteen, are classified as overweight, with 15% of those falling into the obese category (DeEugenio and Henn 2005).  Doctors and physicians have been warning us about the dangers of being too overweight for decades as health problems such as heart disease, stroke, type 2 diabetes, cancer, gallbladder disease, sleep apnea, and osteoarthritis, just to list a few, have clearly been linked to the carrying of excess body fat.  These health concerns have remained largely unchanged, but our society’s perceptions of overweight and obesity haven’t.  Over the last century, obesity has undergone a considerable shift in ontological status as it has been “transformed from being the product of something that individuals do to something that they experience” (Chang and Christakis 2002).  A moral conception of fat as a personal wrong or failure on the part of the individual was once the reigning ideology regarding the phenomenon of obesity (Chang and Christakis 2002).  Weight functioned as an index of moral character (Chang and Christakis 2002).  The presence of excessive weight on a person’s body was perceived as something that one did to oneself.  An individual was held personally responsible for excessive weight gain.  Although our society still holds these moral judgments regarding an overweight or obese person’s character to some extent, these perceptions have largely been reduced.  Instead of holding an individual personally responsible for his or her excessive weight, the blame has increasingly been shifted onto the entity of obesity itself.  Presently, obesity is no longer merely seen as a health concern that increases a person’s susceptibility to diseases, it is has principally become conceptualized as a disease in itself.  We have progressed from a society that once largely perceived an individual’s excess fat to be morally problematic to one in which fat has been medicalized into a sickness that requires medical intervention.  What factors are responsible for this change?
	Before I can explore the answer to this question in more complete detail, I must first address and define some central concepts relevant to our discussion of our societal shift in perception regarding the phenomenon of obesity.  For starters, some definitions are in order.  What exactly does the term medicalization mean?  Medicalization refers to the process of redefining or relabeling a personal or social problem as a medical problem that requires medical intervention (Chang and Christakis 2002, Montagne 1992).  More specifically, according to Conrad and Schneider (1992), obesity has undergone the medicalization of deviance, which is referred to as the defining and labeling of a deviant behavior as a medical problem, usually an illness, and mandating the medical profession intervene and provide some type of treatment for it (29).  This medical intervention then becomes the focus of remedy and social control (Chang and Christakis 2002).  Medical intervention as social control seeks to limit, modify, regulate, isolate, or eliminate deviance or deviant behaviors with the use of medical means and for the sake of health (Conrad and Schneider 1992).  As we are well aware in our society, obesity signifies deviance from our cultural norm that equates thinness with beauty.  Thus, we tend to identify people who do not conform to this cultural norm as deviant.  The term deviant (or deviance) conjures up many negative connotations.  To put it most simply, deviance is considered bad.  But with the increasing usage of medicalization to transform a plethora of social phenomena into illnesses, many forms of deviance, including obesity, are experiencing a shift in these negative connotations from the individual to their subsequent sickness.  Conrad and Schneider (1992) note that our society is currently experiencing a paradigm shift due to the medicalization of deviance from one in which we largely regarded deviance as badness to one that increasingly perceives deviance as sickness (34).  With badness deviants are considered responsible for their behavior, but with sickness they are not, or at least responsibility on their part is diminished (Conrad and Schneider 1992).
	Now that I have outlined the changes our society has undergone regarding perceptions of deviance, in particular that of obesity, I can begin to explore the factors that contributed to this striking paradigm shift.  Naturally, due to the scope of this project I will be unable to discuss all of the factors responsible for this societal shift concerning views of obesity.  Nonetheless, I will discuss several factors that I feel are of tremendous importance to aiding in the explanation of this significant change.  One major factor that led to the medicalization of obesity can be attributed to the rising dominance of the medical profession.  The medical field was not always the powerful, prestigious, successful, and lucrative profession of our present day (Conrad and Schneider 1992).  According to Conrad and Schneider (1992), the current status of the medical profession is largely a product of “medical politicking and therapeutic enterprise” (9).  The medical profession has historically held strong political ties and influence due in large part to the organization and lobbying by the American Medical Association, and has leveraged this connection to its advantage.  Also, as overall health and life expectancy of the population began to increase around the middle of the 19th century, the medical profession was the beneficiary of much credit for improved health, although in actuality medical innovations had little to do with this change.  Improved health and increased life expectancy were largely a result of improved social conditions such as a rising standard of living and public health innovations such as sanitation.  However, in recent decades the medical profession has accrued considerable credibility with the development and emergence of scientific medicine, and through subsequent breakthroughs in medical knowledge and treatment (Conrad and Schneider 1992).  Subsequently, the domain of medicine has dramatically expanded.  The expertise of the medical profession is now increasingly looked upon to solve a plethora of problems, particularly those that fall within the realm of social problems and human behavior, which extend beyond the limits of contemporary medical jurisdiction.  Obesity, once considered to be largely a product of faulty human behavior, has been adopted by the medical profession and transformed into an affliction that requires medical intervention to correct.  
	In conjunction with this, the medical profession’s increasing adoption of deviant behaviors can also be attributed to a failure on the part of social institutions that once governed these forms of deviance to bring it under control.  In a sense, the medical profession has decided to step up and take responsibility for attempting to control or limit the occurrence of undesirable deviant behaviors.  Because of the substantial amount of prestige attributed to the medical profession, it reserves the right to define abnormal human behaviors as illnesses and prescribe treatment for those maladies.  A chief concern of the medical profession has always been in keeping the population in good health so that society may function properly, and this has commonly been regulated by the prescription of medicine(s).  Being overweight increases health risks, and as more and more people become “diagnosed” with obesity, this increases the likelihood that the population as a whole will contract more serious illnesses and be rendered unable to serve their normal functions in society.  As mentioned previously, medical intervention functions as an agent of social control, especially in its efforts to “normalize” illness and return people to their conventional, functioning, and desired state in society.
	The final contributing factor that I will discuss regarding our society’s shifted perceptions pertaining to obesity can simply be seen as a result of the increasing prevalence of obesity in our society.  As I mentioned earlier, over half of the adult population can currently be classified as being overweight, an additional half of which fall into the obese category.  Perhaps this increase in sheer numbers afflicted can in itself render a particular phenomenon less deviant, less a matter of individual responsibility (Chang and Christakis 2002).  Indeed, this can clearly be seen in the public framing of obesity as an epidemic. 
	Although our cultural perceptions regarding obesity have shifted to encapsulate an entirely new paradigm from one that predominated a century ago, I do not wish to suggest that individuals are no longer held accountable for their weight status.   Even though the blame has largely been shifted from the individual and onto obesity itself as an affliction, personal responsibility has not been erased.  Medicalization of obesity merely delays  responsibility.  According to Talcott Parsons’ sick role, once an individual recognizes that he or she is sick, he or she should realize that illness is undesirable and strive to get better.  This applies to obesity as well.  Once an individual recognizes or is diagnosed as being overweight or obese, one should try to reduce his or her weight to a healthy level.  This can be done through a variety of medical interventions ranging from surgery, to prescribed diet and exercise plans, to diet pills.  Also, we must not forget that we live in a society in which the ideal body shape is slim and slender.  Excessive body fat is deemed undesirable and unattractive.  Obese persons are still at risk for social ridicule and rejection, and there continues to be constant social and medical pressure for overweight or obese individuals to lose weight.  As Chang and Christakis (2002) note, “The diet, fitness, and beauty industries are dependent on a discourse of individual agency, and obesity continues to be a highly stigmatized state with prejudice and reprobation against obese persons widespread within medicine and society at large” (171).  In order for these industries to continue to thrive, a person must, at least to some extent, remain responsible for his or her weight and seek a solution to their problem.  
	Many obese individuals seek out help directly from the medical community to aid in their weight loss.  However, people have increasingly been drawn to over-the-counter treatments because they are easy to obtain and are affordable.  As obesity is something that is clearly easily diagnosable, people are inclined to self-medicate.  Since obesity has increasingly become medicalized, the market has literally been flooded with remedies all claiming to be able to safely, easily, and effectively help an individual lose weight.  According to the American Dietetic Association, Americans spend an estimated 33 billion each year on various methods of weight loss including pills, foods, and supplements (DeEugenio and Henn 2005, Mitchell and Dodson 2002).  The increasing usage of diet pills, in particular, is the subject of primary concern regarding this research project.  It is still largely unknown how prevalent diet pill use is among the U.S. population, but several estimates suggest that it is relatively high and on the increase.  
	As mentioned previously, people are increasingly being attracted by the prospect of over-the-counter diet pills instead of visiting a physician to obtain a prescription weight-loss drug.  What is it about over-the-counter diet pills that make them so attractive?  For starters, many consumers generally view non-prescription drugs and herbal remedies as safer, easier to use and obtain, and less expensive than their prescription counterparts (Montagne 1992).  Montagne (1992) notes that “many consumers hold fallacious or irrational health beliefs, and their health care practices reflect those misperceptions (391).  For instance, one consumer health survey reported that 75% of those surveyed believed that supplements that contain extra vitamins provide more energy and vitality, among a whole host of other beneficial and miraculous outcomes (Montagne 1992).  In actuality, the beneficial effects vitamins can have on a person’s body are limited.  Another common misperception is the widely held belief that products that are herbal or all-natural are 100% safe.  But this is untrue as well.  There are several natural or herbal supplements that are quite toxic.  Perhaps you’ve heard of ephedra?  Ephedra, which is derived from the natural herb ephedrine, is a stimulant commonly found in diet pills that mimics adrenaline to boost energy levels and induce weight loss (DeEugenio and Henn 2005).  It also functions as an appetite suppressant and increases metabolism.  However, ephedra increases heart and blood pressure and increases the risk of heart attack, seizure, stroke, and sudden death (DeEugenio and Henn 2005, Berg 1999).  Since its introduction to the world of weight loss supplements, ephedra has been linked to over 60 deaths and over 800 medical complaints (Mitchell and Dodson 2002).  Despite increasing evidence proving the dangers of diet pills, many continue to believe in the safety and efficacy of diet pills as a means to lose weight.  Not only do people continue to believe that herbal and all-natural supplements are always safe, they also fallaciously believe that manufacturers of diet pills are required to adhere to the same strict guidelines that prescription medications must follow (Mitchell and Dodson 2002).  Many might be surprised to learn that, in actuality, diet pills are largely unregulated by the Food and Drug Administration.  Diet pills are classified as dietary supplements, not drugs, and are not subject to FDA review prior to being sold.  This means that diet pill manufacturers do not have to prove the safety or effectiveness of their product before being sold on the market (DeEugenio and Henn 2005).  Also, diet pill manufacturers do not have to disclose potential side effects of their products to consumers or any possible interferences or interactions with other medicines one might be taking (DeEugenio and Henn 2005).   But wait, it gets even worse.  Diet pills are not held to federal standardization requirements which dictate that manufacturers must ensure consistency of quality between batches of product (DeEugenio and Henn 2005, Berg 1999).  This means that two different bottles of the same product could contain completely different amounts of active ingredients, so the consumer can’t be sure whether a product actually contains the ingredients listed on the label.  Hold on, there’s more.  Diet pill manufacturers do not have to tell consumers the amount of each ingredient in their product.  There is a loophole.  Diet pill manufacturers can claim that the recipe used to make their product is a special proprietary blend that they wish to keep secret (Mitchell and Dodson 2002).  Scary, huh?  Clearly we are a nation of misinformed consumers.  
	And now for the answer to the question that everyone is dying to know, do diet pills really work?  Yes, it has been shown that some diet pills are, in fact, able to aid in a person’s weight loss.  However, there is a however.  In a majority of cases, the best one can expect from over-the-counter diet pills is a slight increase in the amount of overall weight lost when used in conjunction with a proper diet and exercise.  Hardly seems worth it bearing in mind the considerable costs of diet pills.  Diet pills can work in three ways: by increasing energy expenditure (calories burned), by decreasing the number of calories that are absorbed during digestion, and by suppressing appetite to decrease food intake (DeEugenio and Henn 2005).  However, there are resulting side effects that are commonly found and they include, increased blood pressure and heart rate, nervousness, insomnia, dry mouth, diarrhea, flatulence, constipation, and they also can interfere or prevent the absorption of other medications one may be taking (DeEugenio and Henn 2005).  Also, the effects of diet pills plateau at around six months and most people typically regain weight lost once they discontinue using diet pills (DeEugenio and Henn 2005).  
	As mentioned previously, people are inclined to self-medicate, especially in regards to weight problems.  These inclinations are often irrational, and, according to Montagne (1992), are largely dependent upon two factors: “Their self-perceptions of symptom-states and their social knowledge about health and illness” (391).  Perceptions of obesity lead consumers to act, to seek medication that will eliminate their affliction.  What regimen consumers decide to use to treat their affliction is largely dependent upon the social knowledge he or she possesses in regards to things such as symptom states, illness, treatment options, and medications.  A lack of social knowledge in these areas leaves a consumer more vulnerable to external influences, such as the media.  Diet pill manufacturers recognize that the media is a powerful tool and use it to advertise their products.  Diet pill manufacturers must be doing something right because it is estimated that, as a whole, they bank over 2 billion in sales annually (Berg,1999).  What can this success be attributed to?  How are diet pill manufacturers able to convince consumers that they need their product to lose weight?

Methodology
	I chose to conduct a content analysis of both diet pill commercials and official diet pill websites.  Prescription diet pills are not included in this study.  I chose to analyze only over-the-counter diet pills because OTC and prescription diet pills are regulated by two completely different sets of government guidelines.  Official websites are defined as those whose primary concern is the promotion, marketing, and sale of a particular brand of diet pill.  Those websites that merely functioned as a place of purchase were not used as they did not provide any additional information regarding a particular diet pill.  I analyzed a total of 11 websites, those belonging to Phentermine, Relacore, Hoodithin, MetaboSpeed XXX, Bioslim, Cortislim, Suvaril, Carb Bloc, Zantrex-3, Lipovarin, and Dietrine.   I chose to analyze diet pills that I felt were relatively well-known and/or popular.  Diet pill television commercials were recorded as they appeared during my regular television watching.  The commercials used in this sample come predominantly from the channels of MTV, TLC, and the CW (formerly the WB), and were typically recorded in the later evening hours.  Since the advertisements were recorded using a VCR and on a limited number of channels and viewing times, my sample wound up being relatively small.  I feel that having had access to more advanced technology such as Tivo would have proved beneficial and provided me with a larger and more diverse sample size, not to mention the ease of obtaining commercials in their entirety.  I was able to successfully record six different diet pill commercials, those of Hydroxycut, Smart Burn, Trimspa, Leptoprin, Propolene, and Lipozene.  This gives me a total sample size of 17 diet pill advertisements.  As I closely examined each television commercial and website, I paid special attention to what advertising strategies and terminology were being used.  With assistance from Chananie (2005), I was able to establish three principal advertising strategies that were nearly universal among my entire sample.  I also created a table that depicts key words and phrases commonly utilized among my sample of advertisements to establish the desired connotations and elicit specific responses from consumers.

The Strategies     
	  According to Chananie (2005) there are three main interrelated advertising strategies that are predominantly used to persuade consumers to purchase their product(s).  These strategies consist of: (1) establishing medical legitimacy, (2) blaming and shaming, and (3) offering validation and empowerment (Chananie 2005).  I found that these three main advertising strategies, coupled with a few lesser strategies of my own formulation, were predominant among my sample.  It is important to note that by all means is this not an exhaustive list.  Due to the limited amount of research time and overall scope of this project, I found I had to restrict the number of strategies I could focus on.  I chose to discuss those strategies that were most predominantly used, appeared to be most effective, or were just of interest.  It is important to understand that these advertising strategies reinforce the medicalization of obesity.  Not only do these advertising strategies solidify the obesity-as-illness paradigm in consumers’ minds, they also place the “burden” of individual responsibility for getting help directly on the consumer (Chananie 2005).  Advertisements present consumers with solutions to their afflictions and they are subsequently empowered to act.  Advertisements simultaneously emphasize consumers’ individual responsibility for their recovery from illness and present them with a solution to their problem, which is just a phone call away.  These advertisements offer a fast and easy solution to obesity through the ease of taking a pill and send the message that consumers will be able to regain control over their body through use of their product.  

“I’m not really a doctor, I just play one on TV!”  
Establishing medical legitimacy
	The first strategy, that of establishing medical legitimacy, can be executed in numerous ways.  Perhaps the most popular way this is done is through the “voice of authority” (Chananie 2005).  Chananie (2005) notes that “narrated medical descriptions legitimate the authority of the speaker, setting up the voice of the ‘expert,’” which in the case of diet pill advertisements we assume to be a medical professional (496).  To be effective, however, the message conveyed must be understood by the consumer.  Complex medical terminology is replaced with words and phrases that most consumers can comprehend.  Even though advertisements use phraseology that is easily understood, in most cases the language used is still largely scientific, which further conveys medical legitimacy.  Take this example from Hoodithin: “Hoodia basically tricks the brain into thinking that you’re full.  The chemical constituents in Hoodia work within the satiety center by releasing a chemical compound similar to glucose but much stronger.  The hypothalamus in the brain receives this signal as an indication that enough food has been consumed and this in turn stunts the appetite.”  Relatively easy for the consumer to understand, yet it still sounds like a medically legit statement.  Oftentimes while the narrator is speaking, visual depictions assist in aiding consumers’ comprehension of how a product works while simultaneously contributing to the establishment of medical legitimacy (Chananie 2005).  I am here reminded of a commercial for Smart Burn.  A young female “physician” in a white lab coat makes the claim that Smart Burn will help consumers achieve total body weight loss.  To illustrate, a computer-generated image of a human body carrying excess body fat is shown.  As the narrator explains how Smart Burn works, the fat shrinks away from various parts of the body, namely butt, stomach, and thighs, all areas that people typically have issues with.  This demonstration is effective in establishing medical legitimacy because it shows consumers how their product works and what results they can expect from it.
	Another popular means through which medical legitimacy is established is through the depiction of medical professionals and use of serious tones of voice (Chananie 2005).  It is not uncommon to see a “physician” in a lab coat depicted in diet pill commercials testifying to the product’s effectiveness at helping consumers lose weight or decrease body fat.  Doctors represent the epitome of health.  Most place great trust in doctors and their knowledge.  The use of medical professionals in advertising is equivalent to a stamp of approval for many.  By using depictions of medical professionals, diet pill manufacturers are conveying messages of authenticity, safety, and efficacy of their product.  Generally in television commercials, these physicians use serious tones throughout the advertisement, which serve as a reflection upon the legitimacy of the product.  I find that even if the voice is not coming directly from a medical professional, it is still similarly effective.  Take the commercial for Leptoprin for instance.  In this commercial, the primary narrator is a smartly dressed woman.  As she speaks, her gravely serious tone of voice and piercing stare command the attention of her audience.  She clearly establishes and asserts herself as a voice of authority, one to be taken seriously.  The seriousness of her tone and demeanor prove effective in conveying the message that Leptoprin is a powerful and proven effective weight loss aid.  	Sometimes, however, upbeat and optimistic vocal inflections may be used as testimonials about a product’s effectiveness.  Take Hydroxycut for example.  In this particular commercial, not only is the male physician recommending the product, but he claims to have used the product himself and achieved “fantastic results.”  The vocal inflections he utilizes while testifying to the effectiveness of Hydroxycut are positive and upbeat.  This is done to establish a connection with the consumer and inspire hope in one’s mind that a particular product will work for them.  The purpose of establishing medical legitimacy, however manufacturers decide to convey it, is to send the message to the viewer that the information presented be taken seriously, as coming from a credible source (Chananie 2005).

“I wanna be like Mike!” 
Celebrity Endorsements as an Extension of Medical Legitimacy
	There were two different diet pill manufacturers in my sample that used celebrity endorsements instead of or in addition to attempting to establish medical legitimacy, those of Trimspa and MetaboSpeed XXX, although I question the credibility of the latter.  Upon visiting the MetaboSpeed XXX website, the first item one sees are a set of before and after pictures of what appears to be Jennifer Lopez below the caption “Mega-Star Sizzlin’ New Body Secrets.”  Upon closer examination of the pictures, I personally cannot verify whether or not they are, in fact, photos of J. Lo.  To me, it looks like the webmasters got creative with Photo Shop and digitally enhanced both sets of cheeks.  And nowhere in the article does it ever explicitly mention J. Lo’s name; the manufacturers only drop creative hints as to her identity.  Nevertheless, Jennifer Lopez is a very popular celebrity and whether or not it is actually her depicted or a look-a-like, the suggestion that J. Lo uses diet pills, in particular MetaboSpeed XXX, can’t be bad for business.  
	In a more legitimate celebrity endorsement, that of the advertisement for Trimspa, a scantily clad Anna Nicole Smith poses seductively as the commercial plays and a narrator explains how she lost weight using Trimspa.  This ad only makes a slight effort at establishing medical legitimacy by briefly explaining how Trimspa works.  Celebrity endorsements of a product mean large profits for manufacturers because consumers look up to, idolize, and respect celebrities, and want to be just like them.  We are often willing to try products that celebrities endorse in the hopes that it will make us more like them.  The influence celebrities have upon consumer decisions to buy products can be enormous, and manufacturers use this knowledge to their advantage.  Because of this, I speculate that diet pill manufacturers who are able to land celebrity endorsements often don’t find it necessary to further establish the medical legitimacy of their product.  The celebrity endorsement is enough of a legitimizing force.           

“There’s no such thing as bad publicity.”
The Mass Media as a Legitimizing Force
	Not only is the mass media a forum through which to advertise a manufacturer’s product, it can also be used to convey legitimacy.  For example, the Lipovarin website boasts that its product has been featured in magazines such as Shape, Star, and Journal.  These are very popular and esteemed magazines, and the fact that Lipovarin has appeared in them adds to the credibility and legitimacy of the product.  The popularity and prestige associated with a particular type of media, whether it be through television, magazines, newsprint, or the internet, is an important determinant of how much credibility a product will gain by its subsequent connection to such media.  Hoodithin wins the prize for having cultivated the most mass media depictions out of all the diet pills in my sample.  Hoodithin has a whopping seven mass media portrayals listed on its website.  Hoodithin boasts of having been featured on 60 Minutes, The NBC Today Show, as well as having been seen on such networks as ABC, WBAL, and BBC News, in addition to having been written about in Oprah Winfrey’s “O” magazine and numerous other newspaper articles.  This is quite a prestigious list of references to be attached to a product, much less a diet pill.  The extensive amount of exposure Hoodithin has been privileged with lends a significant amount of credibility to the product. 

“When a 5-year-old says you’re fat, it’s cause you are.” 
 Blaming and Shaming
	The second strategy used, that of blaming and shaming, is used primarily to persuade and convince afflicted viewers that they need to take action and do something about their problem (Chananie 2005).  As Chananie (2005) notes, “messages of blame and shame are implicit, overlapping, subtle, and sometimes difficult to discern from one another” (499).  I certainly found this to be true through my own analysis.  In some advertisements messages of shame and blame were loud and clear, and in others barely audible.  Two vivid instances of implicit shame are provided by commercials for Propolene and Trimspa.  The advertisement for Propolene begins with a slender, smartly-dressed woman standing next to a container filled with an unsightly yellowish substance.  She explains that “This is what only five pounds of body fat looks like.  Five pounds!”  She then proceeds to query, “How much extra body fat are you carrying around every day?”  These blatant messages of shame are similarly found in the commercial for Trimspa.  The commercial begins with two short video clips depicting obese women, one clip from a family Christmas celebration, and one of a bride on her wedding day.  As each clip is shown, a short narrative plays.  The first is a woman who states that, “My rear end was so wide I couldn’t even sit on a swing set.”  This is followed by another woman who declares, “When a five-year-old says you’re fat, it’s cause you are.”  Millions of Americans can relate to these women’s blatant declarations of shame and self-blame.  Strategies of shame are particularly effective on afflictions that have highly visible symptoms, such as obesity.  Not only do obese persons have to live with the shame of being overweight, they also have to deal with the shame associated with publicly suffering the symptoms.  
	Interestingly, I found mixed messages regarding blame among my sample.  For starters, I found that oftentimes messages of blame were deflected from individual responsibility.  In fact, most of the advertisements in my sample avoided placing blame upon the individual or made it a point to emphasize that the individual was not to blame for his or her weight problems.  This is consistent with the phenomenon of the medicalization of obesity.  Take Relacore for example.  On the official Relacore website, one of the very first lines reads “Excess tummy flab is not your fault.”  The website then proceeds to explain the true cause of excess belly fat, which can simply be reduced to the experience of stress which causes excess levels of cortisol (a stress hormone).  Individuals are not even held accountable for overeating in response to stress.  “So if everyday life makes you stressed out and anxious… if you’re overeating in response to daily stress, it’s time to try Relacore.”  The blame here has been largely shifted from the individual and onto biological factors that are largely out of one’s control.  
	Relacore wasn’t the only diet pill that deflected blame away from an individual’s diet and eating habits.  A person’s diet and eating habits are behaviors that are ingrained in a person very early on in their development, and are thus very hard to change.  For many, changing one’s diet is a struggle, and for some, impossible.  This is a well-known fact and I found that many diet pill manufacturers used this knowledge to their advantage.  They made sure to inform the consumer that their product could be used without diet change.  For instance, Carb Bloc and Dietrine, both diet pills that claim to be able to block the absorption of carbohydrates into the body, don’t blame the individual for wanting to eat unhealthy foods. Rather, they present it as a natural, normal human desire.  One needn’t change their diet to lose weight, the product will do it for them.  Upon visiting the Dietrine website, it queries, “Do you find it difficult to cut down on delicious foods filled with carbohydrates such as cakes, breads, potato chips, and ice cream?  Dietrine allows you to indulge on occasion without having to feel guilty…”  And, similarly, Carb Bloc states that it “is designed to help carb lovers like you occasionally enjoy their favorite foods without obsessing about the extra weight gain carbohydrates can cause.”  The less a person has to change his or her lifestyle in regards to weight loss, the more likely he or she will be able to successfully adhere to a weight-loss regimen.  Products that promise that no diet change is necessary to lose weight often proves to be a very effective selling point.  As I mentioned previously, diet modification can be extremely difficult, even impossible for some.  A person who has or who knows that diet modification is or will be a struggle will be more motivated to lose weight if the process is made as pain-free and effortless as possible.
	While I found that blame was largely deflected from individual responsibility in most cases, there were some instances where manufacturers pointed the finger of blame in the consumers direction.  These messages, so far as I could tell, were never implicit, but rather were subtlety implied.  This was most commonly done through the suggestion that consumers diet and exercise in addition to use of their product.  For example, in the commercial for Trimspa, it states that “They lost weight using diet, exercise, and Trimspa.  Be envied.”  When consumers are recommended that they diet and exercise in conjunction to use of their product, blame on the part of the individual for his or her weight status is implied.  If a consumer had only been eating a sensible diet and exercising regularly, then they wouldn’t be overweight or obese in the first place.  Since the consumer realizes that his or her weight status is excessive and undesirable, he or she must now do something to reduce the weight to a normal, manageable level.  Consumers are expected to take a more active role in their weight-loss regimen when they are advised to take a larger part in and put forth more effort to lose weight.  This insinuates blame because consumers are expected to do their part in regards to their weight-loss.  Failure to do so results in even greater blame.  Diet pills can help the consumer lose weight, but it is ultimately up to the consumer as to how much results they will see and how quickly they will receive them.   
	Moreover, blame is applied when those sick individuals fail to take appropriate steps toward recovery, namely by weight reduction.  These advertisements provide consumers with a means through which to solve their weight problems.  The blame is insinuated on behalf of the consumer if they fail to do something about their affliction and order their product.  Advertisers draw on our societal understanding that people do feel shame, and that those persons who are afflicted with a particular illness, such as obesity, are particularly vulnerable recipients of messages of shame and blame (Chananie 2005).  This conveys the idea that an individual is responsible for seeking treatment and can and should get help for their affliction through readily available medicines.

Sympathetic Inquiry
	Do you feel out of shape?  Are you lacking the energy to exercise?  Have you lost the will to diet?  Are you embarrassed to wear a bathing suit?  Do you want to see the reflection of a slimmer, trimmer you when you look in the mirror?  Do these questions sound familiar?  These and similar questions often accompany diet pill advertisements.  They are initially used to establish a connection to the frustrated consumer who has tried numerous weight-loss methods and has been unable to see results.  The consumer is first made to feel that all too familiar shame of being overweight or obese, and are subsequently reminded about past failed attempts at weight loss.  Once feelings of shame and guilt over having been unable to successfully control one’s weight have been brought to the surface, the advertisement then proceeds to inform consumers that now there is a solution to their problem, one that is guaranteed to give them the results they have been searching for.  Consumers are then injected with messages of hope and empowerment when they are at their most vulnerable as they are promised that this is the last product they will have to try because they will see results and finally be able to successfully lose all that unwanted weight.

“You can do it!”  
Offering Validation and Empowerment
	The third and final strategy consists of offering validation and empowerment.  Chananie (2005) states that “Validation and empowerment promise increased feelings of self-efficacy to the sufferer, resulting in increased feelings of control over the problem and over their lives in general” (505).  If an advertiser is successful in appealing to consumers’ desires for self-efficacy, self-control, knowledge, and validation, their sales increase.  If a consumer believes that he or she can effect change regarding their illness, they are more likely to be motivated to seek a cure for their affliction.  Messages of empowerment can be effectively conveyed through the testimonials of fellow sufferers.          Whether they were spoken, written, or depicted through the use of before and after photos, use of consumer testimonials proved to be a popular one as the majority of my sample utilized this particular strategy.  This was done not only to demonstrate the effectiveness of their product, but also to empower and motivate afflicted consumers to buy their product.  Testimonials also serve a legitimizing function as well.  Take the testimonial depicted on the MetaboSpeed XXX website for example.  One of the first things seen upon visiting the website is a before and after picture of a woman below the caption “I lost 61 lbs!”  Next to this woman’s photos is the message “Learn how Tina lost 61 lbs.  You can do it too with MetaboSpeed XXX…”  A link is then provided so that consumer’s may see more pictures of Tina and read all about how she was able to lose so much weight using their product.  Consumers can relate to these individuals who once shared their affliction.  If testimonials are able to successfully demonstrate that others have been able to cure their affliction through use of a particular product, consumers are lead to believe that it will work for them as well.  Testimonials empower individuals by demonstrating that there is an effective solution to their particular problem, all a consumer needs to do is take action and order their product.  

Versatility of Medication 
	Most of the diet pills in my sample promised consumers that their product would either help them lose weight or decrease body fat through a variety of ways, all with one pill.  For instance, Suvaril promises weight loss by boosting one’s metabolism and converting food into fuel more efficiently.  Through the use of “bifurcated weight loss compounds,” Zantrex-3 promises rapid weight loss and incredible energy.  MetaboSpeed XXX not only boosts one’s metabolism and burns fat, it is also a powerful appetite suppressant.  Diet pills that claim to be able to reduce weight and body fat through a variety of means are more attractive to consumers because the underlying assumption is that not only will it work more quickly and efficiently, it will also prove to be more effective.  And this is what consumers want; fast, easy, painless solutions to their problems.  Consumers want to see results and they want them now.
	While many diet pill manufacturers advertise their pills as being capable of inducing weight loss through a combination of means, thus making their product more attractive to consumers, some even take it a step further than this.  For example, both Relacore and Smart Burn advertise their products as stress reducers in addition to their primary function as weight-loss aids.  Not only does this make the product more marketable, it is also more attractive to consumers.  In the commercial for Smart Burn, the female physician rattles off a whole host of product claims relative to weight loss, then mentions that Smart Burn promotes relaxation while reducing stress.  Similarly, but to a greater extent, the website for Relacore touts that it is the premiere “feel good pill.”  Relacore is sold as an anti-anxiety, stress-reducing, mood-elevating pill.  Relacore reasons that by minimizing and controlling stress, one will be able to rid themselves of excess body fat that was caused as a result of stress in the first place.  Advertising diet pills that also function as stress-reducers is brilliant.  Everyone experiences stress on a daily basis and would love to be better equipped to manage it.  For many consumers, the thought of obtaining both weight loss and stress reduction in one pill is a dream come true.  Why take two different pills for two different ills when a consumer can have it all in one?    

Key words and phrases used in diet pill advertising

	Commercials (6)	Websites (11)	Total (17)	
(All) natural	0	6	6 	
Burns fat/fat burner/fat blocker	2	5	7	
Clinically proven/
studies show	3	4	7	
Control/suppress appetite	2	4	6	
Effective 	0	5	5	
Energy	1	7	8	
Ephedra/ephedra-free	0	4	4 	
Fat/body fat	3	5	8	
Increase/boost/
stimulate metabolism	0	5	5	
Lose weight/weight loss	5	9	14	
Obese	0	2	2	
Overweight	2	4	6	
Potent/powerful (formula)	2	7	9	
Pounds	4	6	10	
Rapid/fast/quick	1	5	6	
Safe/safely	0	5	5 	
Science/scientist/
scientific	1	5	6	

	I created this table to demonstrate how important it is for diet pill manufacturers to include in their advertisements key words and phrases intended to interest consumers in purchasing their products.  Certain words or phrases bring to mind specific connotations associated with those subsequent terms.  One of the many questions I was interested in finding an answer to was who exactly diet pill manufacturers were targeting for use of their product (in terms of weight status).  Thus, I paid careful attention to whether or not manufacturers used the terms obese or overweight when addressing their consumers.   Only two of the advertisements in my sample specifically mentioned obesity, whereas six referenced being overweight.  This leads me to several conclusions.  Perhaps overweight individuals are a more desirable target for diet pill manufacturers because overweight persons constitute a greater percentage of the population than do obese persons.  Similarly, when addressing overweight persons, obese persons are included under this category, whereas persons who are overweight would not be considered obese.  Thus, by using the term overweight instead of obese, a greater portion of the population may be addressed and included.  These conclusions seem plausible, and are likely what manufacturers have in mind when they advertise their products.
	Next, let’s take a look at the phrase “all natural.”  As I noted in my literature review, it is widely held among consumers that products that are all natural are believed to be 100% safe.  Consumers tend to equate the terms “all natural” with safety.  And consumers want to know and be ensured that the products they use are, above all, safe.  I found that six products in my sample made specific references to their product as being all natural, and five mentioned that their product was safe or could be safely used.  In a similar vein, there were a few products that made specific references to ephedra, which was once widely praised and is popularly known for its amazing capabilities for inducing weight-loss.  However, it has since been proven to be a hazardous substance as it has been shown to compromise health, and has even been attributed as the cause of death for many unfortunate individuals.  Because of the many negative connotations now associated with the term ephedra, several manufacturers made it a point to note that their products do not contain this dangerous ingredient.  By establishing the fact that their product does not contain this hazardous substance, it further verifies the safety of the product in the consumer’s mind.  Zantrex-3 even played off both associations ephedra has garnered.  Zantrex-3 promises consumers the same effective weight-loss ephedra is known for, without the harmful side effects.  Consumers who have become wary of diet pills since the FDA banned ephedra from the market are lulled into a false sense of security when diet pills are advertised as being safe because they are ephedra-free.  I found that one advertisement went even farther to ensure or demonstrate the safety of their product.  Upon first viewing the commercial for Lipozene, I was unaware that I was even watching an advertisement for diet pills because the initial topic was liposuction.  As the commercial begins, a middle-aged woman begins to discuss liposuction and the results one can expect from it.  But as the commercial progresses, she notes that liposuction can be an invasive and risky surgical procedure.  Because of this, she recommends that the consumer first try Lipozene, instead of attempting risky surgery.  This is a brilliant strategy.  By comparing the two methods of fat reduction, it is easy to lead the consumer to the conclusion that Lipozene is indeed much safer than the liposuction procedure.  The message is also sent that not only is Lipozene safer, the results also rival that of liposuction.  The commercial notes that in a clinical trial, 78% of the average person’s weight lost was pure body fat (which leaves me to ponder what the other 22% constituted).  When commercials use the strategy of comparing their products to other, more risky ones, they are further establishing and demonstrating the safety of their product.  When manufacturers make it a point to note that their product does not contain ephedra, but is just as effective, if not more so, they are ensuring to the consumer that not only are their products safe (at least in comparison to products that have been proven unsafe), but are effective as well.        
	To further prove the efficacy of their product, words such as effective and success can often be heard or read about in descriptions pertaining to a particular diet pill.  These terms have very positive associations and lead the consumer to believe that a product will work for them and they will be subsequently triumphant in their weight-loss.  Additional terms such as rapid, fast, and quick add more incentive for a consumer to try a particular product.  So do the references to potent and powerful formulas.  In regards to weight loss, people want results, and they want them quickly.  The quicker results can be seen, the better.  They want to believe that the product they are taking is powerful enough to affect great changes in their weight.  Consumers want to buy products that are effective and will work quickly.  When advertisements are able to convince consumers that they will be successful in their weight loss through the use of their product, they will be more inclined to purchase them.  When more legitimate terms are used such as clinically proven, studies show, science, scientific, and scientist(s), they contribute to the credibility of the efficacy, effectiveness, and safety of a product.  Consumers generally want some form of proof that a product works before they decide to buy.  Statements like “MetaboSpeed XXX’s proven clinically studied ingredients provide for powerful weight loss elements to drop the pounds” sound medically legit and contribute to the product’s overall credibility.  Consumers want to hear that a particular product they are considering purchasing has been studied by scientists and other medical professionals to further establish its effectiveness and safety.
	Consumers also want to know how a particular diet pill will work to make them lose weight.  I found that all of the advertisements for diet pills in my sample made it a point to mention just how, exactly, their product produced results.  References to methods such as controlling or suppressing appetite, burning or blocking fat, increasing, boosting, or stimulating metabolism, and creating energy were all popularly mentioned.  A consumer is likely to choose to purchase a diet pill that fits their needs and works in such a way that they feel will prove to be the most effective for them.  Take Relacore for example.  Relacore works specifically on belly fat reduction and does so by helping to reduce and manage stress.  A stressed-out individual who is tired of their pot-belly will likely purchase Relacore because it suits their needs.  Similarly, the more methods integrated into a product, the more marketable and attractive it is to customers.  If a pill can promise weight loss through a combination of means, such as by burning fat while boosting metabolism, the more likely the consumer will formulate the idea that not only will it work more effectively, but it will also likely work more quickly as well.  
	Pounds was also a term that received considerable mention as 10 advertisements out of my sample utilized this term.  Pounds were mentioned most frequently in conjunction with testimonials as successful, satisfied consumers relayed how much weight they had lost as a result of using a particular product.  Demonstrating a product’s effectiveness in terms of units such as pounds is effective because it provides the consumer with a more concrete idea of how much weight loss one can expect, instead of trying to abstractly conceptualize percentages of body fat lost.  Hearing a testimonial about a consumer who lost 30 pounds sounds more impressive than the equivalent …. percent body fat reduction.  This can also be seen when we evaluate the number of times the terms fat or body fat were used compared with the phrases lose weight and weight loss.  The terms fat or body fat were specifically used by 8 advertisements, whereas references to losing weight and weight loss appeared in 14 advertisements.  Lose weight and weight loss appeared nearly twice as often among advertisements in my sample than did fat or body fat.  While the reduction of body fat is certainly an important element to advertise as many consumers are concerned with the elimination of unsightly fat, it seems likely that manufacturers find it more effective to sell their pills in terms of weight loss.  While reduction of body fat and weight loss are similar and overlapping concepts, it is easier for consumers to more concretely envision results in terms of specified units such as pounds.  
	My main goal in conducting this particular research project was to answer the many questions and concerns I had regarding the increasing use of diet pills as weight loss aids in response to the increasing medicalization of obesity.  The question that I was most anxious to have answered was simply how were diet pill manufacturers able to convince consumers that they needed their product in order to lose weight.  Through a careful content analysis of official diet pill websites and commercials, I think I found the answer.  Diet pill manufacturers use several key advertising strategies to incite consumer interest in their products.  This is largely done through the establishment of medical legitimacy, blaming and shaming, and through validation and empowerment.  These strategies have proven successful and are clearly reflected in manufacturer’s large profits.  A lesser goal in desiring to conduct this research was to inform and forewarn consumers not only about the manipulative advertising strategies manufacturers commonly use to interest consumers in their products, but also about the dangers of using diet pills themselves.  The current literature available about diet pills is modest.  Relatively little is known about diet pills, and I feel that is extremely unfortunate.  This is a subject of study that is under-researched in all fields.  A tremendous amount of research is in dire need of being conducted concerning diet pills, and I hope that my research project will inspire others to take up the cause.  Until then, we shall remain a nation of misinformed consumers.  

Works Cited
Berg, Frances.  (1999).  “Health Risks Associated with Weight Loss and Obesity 	Treatment Programs,” Journal of Social Issues 55(2): 277-297.
Chananie, Ruth.  (2005). “Psychopharmaceutical Advertising Strategies: 
Empowerment in a Pill?” Sociological Spectrum 25: 487-518.
Chang, Virginia and Christakis, Nicholas.  (2002).  “Medical Modeling of Obesity: 
A Transition from Action to Experience in a 20th Century American Medical Textbook,” Sociology of Health and Illness 24: 151-178.
Conrad, Peter and Schneider, Joseph.  (1992).  “Deviance and Medicalization: 
From 	Badness to Sickness.”  Philadelphia: Temple University Press.
DeEugenio, Deborah and Henn, Debra.  (2005).  “Diet Pills.”  Philadelphia: 
Chelsea House.
Mitchell, Deborah and Dodson, David.  (2002).  “The Diet Pill Guide: The 
Consumer’s 	Book of Over-the-Counter and Prescription Weight-Loss Pills and Supplements.”  New York: St. Martin’s Press.
Montagne, Michael.  (1992).  “The Promotion of Medications for Personal and 
Social 	Problems,” Journal of Drug Issues 22: 389-405.