Candy at the Cash Register

Last week, the New England Journal of Medicine published an interesting editorial titled "Candy at the Cash Register-- a Risk Factor for Obesity and Chronic Disease."  This fits in well with our discussion of non-homeostatic eating, or eating in the absence of calorie need.

There are a few quotes in this article that I find really perceptive.

A basic misconception has stymied our response to the obesity epidemic: the belief that food-related decisions are consciously and deliberately made. Our reluctance to interfere with or regulate the food environment is a direct consequence of the belief that people's food choices reflect their true [conscious] desires....

The reality is that food choices are often automatic and made without full conscious awareness. In many cases, they may even be the opposite of what the person deciding would consciously prefer. What and how much people eat are highly influenced by contextual factors that they may not recognize and therefore cannot easily resist. A clear example of this influence is the placement of candy at the cash register, which is widely acknowledged to be a promotional strategy called “impulse marketing.” Impulse marketing encourages spur-of-the-moment, emotion-related purchases that are triggered by seeing the product or a related message. 

The authors then go on to describe the tactics that grocery stores use to catch your eye and drive purchase, such as placing certain products at the end of aisles.  This is so effective that vendors pay a fee to the retailer to have their products placed at the end of the aisle.

Even if many people acknowledge that food placement can attract attention, they think that those who respond to impulse marketing simply lack self-control and should learn how to resist such marketing strategies....

Even when people are consciously trying to make healthful choices, their ability to resist palatable foods in convenient locations wanes when they are distracted, are under stress, are tired, or have just made other decisions that deplete their cognitive capacity. Once cognitive capacity is depleted, automatic processing that relies on heuristics and other shortcuts dominates, and under these circumstances people are more likely to choose foods high in sugar and fat. Often people regret their purchases of candies, sodas, chips, and cookies. They may recognize that they were impulsive but have no way of avoiding being confronted with these goods, even if they initially went into the store seeking other products. 

Contrary to our favored perception of ourselves, we are not purely conscious beings; we're driven by many unconscious impulses that have a strong impact on every aspect of our lives, including food selection and consumption.  When a person is placed in an environment that promotes increased food intake, food intake will generally increase, often inadvertently.  That's how an obesity epidemic can result from changes in food culture without requiring a massive society-wide "moral failure".  Morality and willpower have very little to do with it.  It's simply a natural result of the food environment interacting with our hard-wired brain circuitry.

It's worth noting that this is multi-factorial.  No one would buy plain boiled potatoes and eat them in the car because they were placed next to the cash register.  We're eating more because highly tempting foods are marketed in ways that maximize purchase and consumption, often inadvertently.  I'll explore this concept a bit more as we proceed through the series "Why Do We Eat?"