Healthy Menu Items May Sabotage Your Diet

Researchers Say Good Options Actually Lead to Bad Food Choices

By Bill Hendrick
WebMD Health News

Reviewed By Louise Chang, MD

April 23, 2009 -- Maybe next time you see a tossed salad in a restaurant you should look the other way
-- especially if you're on a diet -- because just seeing the healthy food on a menu may induce you to make a fattening choice, new research indicates.

Yes, that's counterintuitive, but it happens again and again, says Gavan Fitzsimons, PhD, professor of psychology and marketing at Duke University, who led the startling study of what he calls "vicarious goal fulfillment."

The team's findings are published online in the October issue of the Journal of Consumer Research.

"We've found that the presence of a healthy item leads people to choose the one that is the least healthy on the menu," Fitzsimons tells WebMD. "Just seeing the healthy item and considering it makes you feel you've done your duty. It's crazy, but it's human."

Participants in a study who'd scored high on measures of self-control relating to food avoided french fries and other unhealthy choices when they had only unhealthy items from which to choose. But if a side salad was added to the selection list, even the most disciplined were more likely to take the fries, the researchers say.

"The one takeaway from this that I think is important is that consumers have to be really conscious of this tendency to lower their self-control and indulge when a healthy option is available," researcher Keith Wilcox, a doctoral student at Baruch College, City University of New York, tells WebMD. "It appears that by simply considering a healthy option, consumers are being more indulgent. So consumers have to recognize that considering something good may lead to bad behavior."

Self-Control vs. Temptation

The researchers asked participants to select a food item from one of two pictorial menus. Half saw a menu of only unhealthy items, including fries, chicken nuggets, and a baked potato with butter and sour cream. The rest were given the same options plus the choice of a side salad.

More went straight for the most unhealthy choice when the salad was an option compared to when it wasn't.

Ironically, Wilcox says, "the effect was strongest among those consumers who normally had high levels of self-control."

Fitzsimons says the presence of a salad on the menu had a "liberating effect," freeing even the self-disciplined "to give in to temptation and make an unhealthy choice. In fact, when this happens, people become so detached from their health-related goals, they go to extremes and choose the least healthy item on the menu."

What's going on "is happening outside our conscious awareness," he tells WebMD. "People believe they are high in self-control, then walk up, see the healthy option, and somehow satisfy the health goal; then they have no goal and make an unhealthy choice. That's what we want to get out to the world -- that knowing your vulnerability gives you ammunition to resist."

Laurie Mintz, PhD, an associate professor of psychology at the University of Missouri-Columbia and an expert on eating and sex disorders, tells WebMD that people might be able to overcome vicarious goal fulfillment by constantly reminding themselves of their intentions. She suggests wearing a rubber band around the wrist and snapping it before ordering in a restaurant to practice self-control.

"If you see a salad and it doesn't look as good, it almost makes the other stuff look better," says Mintz, who is also a clinical psychologist. "There's a freeing effect, and you say, 'I might as well.'"

Norman Pollock, PhD, a nutrition professor at the Medical College of Georgia, says the study "provides us with another snapshot of the complex nature of eating habits. These observations provide additional information regarding possible factors involved in the etiology of obesity."

The research, he tells WebMD, suggests that "interventions to enhance self-control and delay of gratification may be beneficial in the prevention of excessive weight gain."

At its core, the study "confirms that we are sometimes our own worst enemies," Koert van Ittersum, a marketing professor at the Georgia Institute of Technology, tells WebMD. "Once we feel we have done something right -- as in thinking about eating a salad -- we feel we deserve more. The mind plays tricks on us. We go in a coffee shop and pick up a muffin, which in our minds is something small, but in reality is huge, but our minds don't see that."

Fitzsimons says that since fast-food restaurants increased so-called healthy choices, sales have grown, but from "increases in sales of burgers and fries" and other fattening items.

"This is one of those human quirks that we may be able to overcome if we are conscious of it and make a concerted effort to stick to the healthy choices we know we should be making," Baruch College researcher, Lauren Block, PhD, says in a news release.

The researchers also found that participants also made unhealthy choices in other experiments. Most chose a bacon cheeseburger over a healthier veggie burger and also chose fattening chocolate-covered Oreos over cookies in a labeled 100-calorie pack.

"What [the study] shows is that adding one or two healthy items to a menu is essentially the worst thing you can do," Fitzsimons says. "This is all brand new research, showing that much of what we do is happening outside our consciousness."

SOURCES: News release, Duke University. Wilcox, K. Journal of Consumer Research, October 2009; vol 36. Laurie Mintz, PhD, University of Missouri, Columbia. Norman Pollock, PhD, Georgia Prevention Institute, Medical College of Georgia. Koert van Ittersum, PhD, Georgia Institute of Technology. Gavan Fitzsimons, PhD, Duke University. Keith Wilcox, Baruch College, City University of New York.

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