The illusion of diets, alternate medicine & anti-ageing creams

Diets, anti-ageing products & cognitive dissonance

The last thing someone on a diet would logically want is a free lunch, but that is what the weight loss industry is trying to sell. The same can be said of the popular solutions for our collective obsession with slowing the ageing process or boosting virility. Much like gambling, the diet and beauty industry generally offers negative expected value, so what drives their continued growth, despite the absence of hard evidence that they deliver any tangible results?

The fundamentals of weight management are simple; if you consume more calories than you burn, you will put on weight, whereas burning more than you consume will result in weight loss. 

So if you want to lose weight, you need a net energy expenditure in the form of burned calories. Any attempt at weight loss that ignores that principle is the equivalent of throwing an apple in the air and expecting it not to come back down.

The obesity epidemic

Just because the fundamentals of human weight management are simple, it doesn’t mean losing weight is easy; far from it.

Our age, gender, genes and hormones all influence the rate at which we can burn calories at rest – our Basal Metabolic Rate – while certain medical conditions (such as underactive thyroid) and the after-effects of pregnancy also make weight loss harder. 

Layered on top of the laws of our biology are various factors influencing our calorie intake and willingness to burn excess calories through physical activity.

Western society has shifted towards more sedentary lifestyles where we scroll more than we stroll and do so while increasingly consuming highly calorific junk food; changes which are indexed toward lower socio-economic groups.

The impact of these changes has been stark:

  • Based on body mass index (BMI), 53% of adults in the European Union (EU) in 2019 were considered overweight (36% pre-obese and 17% obese). 1
  • In the USA, a staggering 42% of the population as of March 2020 was considered obese, with 9.2% severely obese – a category that doubled since 2017.2
  • $173bn – the estimated annual cost in the USA in 2019 for obesity-related medical care.2

Half the world is dieting

Given that we are collectively getting fatter, it should be no surprise that, according to Ipsos, 45% of the world’s population is trying to lose weight. The trouble is, we aren’t very good at dieting.

The average person will try 126 fad diets in their lifetime – two a year – typically abandoning their restraint after six days.

Though the provenance of that survey is questionable, there is no denying that when it comes to diets, ‘once bitten, twice shy’ doesn’t apply. We are both willing to ignore our failures and try again, as well as take more drastic and irrational measures.

The growth of the diet pill industry

From that poll of 2,000 participants, 1 in 20 would willingly ingest a tapeworm if it guaranteed they would shift some timber, but over-the-counter diet pills promise a less gruesome dietary short-cut.

There is a limited number of diet pills available by prescription in Europe and the USA – working by suppressing appetite or limiting your ability to absorb fat – and they are far from a magic bullet:

  • Diet pills are generally only prescribed for people in the morbidly obese category
  • Diet pills come with a whole host of nasty side effects
  • Weight loss through diet pills is minimal, and the effects only last as long as you keep taking them

The reality of prescription diet pills is difficult to swallow for many people whose desire for a shortcut to burning calories fuels a vast industry offering unregulated over-the-counter dietary supplements that promise a free lunch.

The global weight loss supplements market was valued at USD 33.4 billion in 2020 and is projected to expand at a compound annual growth rate (CAGR) of 16.6% from 2021 to 2028.

Businesswire – Global Diet Pills Market Forecast 2021-28

What does this seeming unwillingness to accept reality say about society? Are we so lazy and entitled that we expect to lose weight without doing the hard yards? The truth is more complicated.

The diet industry is an excellent example of how marketing has evolved to exploit the weakness in our ancient decision-making operating system. 

Today I saw an ad on social media for the “secret to six pack abs”. The word choice here is carefully designed. It’s intended to give you pause, against all your rational judgment. There’s a secret? All this time…if only I had known! Give me the key! Show me the way! You know there is not a secret. But you want to believe it just badly enough to give it a whirl.

Huffington Post

The way diets are advertised not only pushes all the right psychological buttons, selling us a new ‘secret’, but the messaging around diet and nutrition is also deliberately confusing.

At the same time, food manufacturers take advantage of the absence of universal rules for displaying the calories food contains to obfuscate what people are putting into their bodies.

To muddy the water further, the media amplifies our obsession with dieting pushing out a constant stream of contradictory instructions about diet and lifestyle based on flimsy evidence.

  • Dairy is good/bad for you
  • You should/shouldn’t cut out carbs
  • Alcohol is good/bad in moderation
  • Fat is good/bad for you
  • Sugar is the no.1 problem, or maybe it isn’t

These confusing messages are delivered alongside a steady stream of celebrity images promoting unrealistic body shapes.

Dieting is Satisficing

In the face of this steady diet of confusing messaging, our dietary behaviour should appear less surprising given the effort required to try and find a baseline of truth from the sea of information and misinformation. The covid pandemic has also made us more reluctant to accept the opinions of ‘experts’. 

Analysis of decision-making around dieting has highlighted a complex set of factors that are in addition to our innate struggles with analysing data. They include our emotional state and needs, perceived control, personal values, habits, and self-control.

Given the complexity of making an informed decision around dieting, reaching for the pill bottle promising a free lunch can actually be viewed as rational. 

There is no getting away from the calories-in, calories-out maxim, but given the effort required to try and uncover the nuances beneath that biological reality, it is far easier to employ a little cognitive dissonance, illustrated through traits such as unit bias.

We prefer to take at face value cleverly worded claims around readily available diet products, especially when promoted via social media influencers.

There is little perceived short-term downside to trying over-the-counter diet pills and supplements. They are priced to be affordable and straightforward to use, generally requiring you to use either a meal-replacement shake or pop a pill.

Looking at it from this perspective, we shouldn’t be surprised that people are increasingly drawn to the free lunch approach of dietary supplements or extreme weight-loss regimes, despite personal experience and basic biological rules telling us they are unlikely to work.

Our obsession with virility & mortality

Though losing weight might be a 20th-century problem, our obsession with our own mortality and seeking any means to slow down the visible effects of the ageing process, or better still, stop it altogether, is as old as written fiction.

The Epic of Gilgamesh, dating back to 2100 BC in Mesopotamia, is regarded as the earliest surviving piece of notable literature. It’s a series of poems describing the adventures of a King called Gilgamesh, part of which focuses on his quest for eternal life.

“Life, which you look for, you will never find. For when the gods created man, they let death be his share, and life withheld in their own hands”

The Epic of Gilgamesh

The ancient Egyptians, famed for mummification, weren’t obsessed with death but rather the continuation of life after death. This belief explains why tombs like King Tutankhamun’s contained thousands of items deemed essential in the afterlife, buried in a dry and cool environment that was ideal for preservation.

The search for longevity is a constant theme across legends in almost all cultures, pervading everyday life for the rich and powerful. The divine right of Kings often convinced those wearing the crown that they deserved the ultimate free lunch –  the ability to cheat death.

China has a cultural obsession with alternative medicine that goes back to the early years of the Han Dynasty (202 BC-AD 220) and the myth of Chang’e.

Chang’e was the wife of an archer, Hou Yi, who shot down nine of the ten moons and was rewarded by Xiwangmu, the mother goddess, with the elixir of life. Hou Yi gave the elixir to his wife, who swallowed it to save it from being stolen, floating up to the moon where she remains.

The story of Chang’e is credited with many Chinese Emperors and noblemen seeking a potion that would give eternal life. Despite advances in modern science, the Chinese appetite for supplements and remedies that might extend our life, reverse the ageing process or confer virility is insatiable. 

The supplement market in China alone is worth $45bn and growing at around 6% annually, yet there doesn’t seem to be a corresponding impact on national health. Fertility has declined by 3.5% since 1960, obesity is rising, and the nation was the epicentre of the Covid pandemic casting doubt on the value of alternate medicines like Pangolins scales curing all fevers.

It’s unfair to single out China as being seduced by supplements and alternative remedies into believing they can somehow offer solutions that modern medicine cannot.

A similar culture exists across South Asia and many parts of Africa, which has the knock-on effect of fuelling the trade in exotic animals for the medicinal value of specific body parts.

The scale of the exotic animal trade

The Pangolin is the most widely trafficked mammal, prized in Vietnam and China for its meat and the medicinal properties of its scales. In 2019, the Independent reported that the equivalent of 400,000 pangolins was seized in related products. 

Not only is there zero evidence that Pangolin scales or Rhino horns have any unique medicinal properties, but the obsession with their scales also pushes them to extinction. The same is true of a long list of exotic creatures, which begs the question of why this behaviour persists from an evolutionary perspective.

Both Pangolin scales and Rhino horns are made from keratin, so you could produce a similar effect by simply biting your fingernails. Bizarrely, some studies have shown that the more expensive and exclusive these products are, the greater the demand. A phenomenon known as the Veblen Effect.

Drinking the potion

This conspicuous consumption behaviour is most noticeable within the market for wrinkle creams. The cheapest products are often shown to provide the most significant benefit. Nevertheless, consumers are instead drawn to the most expensive, convinced by pseudo-science, giving ingredients impressive names and believing that price must correlate to efficacy.

But in Western society, we’re increasingly willing to experiment with more than creams to roll back the years. The case of former supermodel, Linda Evangelista, is a perfect example.

Evangelista was disfigured by a non-surgical fat reduction procedure called CoolSculpting intended to reduce fat deposits using cold temperatures, which unfortunately has the opposite effect.

If I had known side-effects may include losing your livelihood and you’ll end up so depressed that you hate yourself… I wouldn’t have taken that risk…I drank the magic potion, and I would because I’m a little vain. So I went for it – and it backfired

British Vogue

Linda Evangelista’s story hit the headlines because she went from model to recluse, but her behaviour is no different to millions of people trying to cheat father time.

Viewed objectively, it is tough to understand the growing demand for diet pills, alternative medicine or anti-ageing procedures, but our decision-making processes are complex and frequently irrational. 

Just as we continue to play lotteries which boil down to indirect taxation, our psychological wiring makes us susceptible to products that promise shortcuts to problems that either have no solution – like ageing – or in the case of dieting, where the answer is more demanding or complex than we are willing or able to accept.


1 – Businesswire report on the Global Diet Pill industry

2 – Adult Obesity Facts – Centre for Diseases Control & Prevention