Please cite:

Almenara, C. A., Aimé, A., & Maïano, C. (2020). Effect of online weight loss advertising in young women with body dissatisfaction: An
experimental protocol using eye-tracking and facial electromyography. In C. Stephanidis & M. Antona (Eds.), HCII 2020: 22nd International
Conference, Proceedings, Part III. Copenhagen: Springer. https://doi.org/10.1007/978-3-030-50732-9_19

Effect of Online Weight Loss Advertising

in Young Women with Body Dissatisfaction:
An Experimental Protocol Using Eye-Tracking
and Facial Electromyography

Carlos A. Almenara1(&) , Annie Aimé2 ,

and Christophe Maïano2
1
Universidad Peruana de Ciencias Aplicadas, Av. Alameda San Marcos, S/N,
Lima 15067, Peru
carlos.almenara@upc.pe
2
Université du Québec en Outaouais, 5, Rue Saint-Joseph, Saint-Jérôme,
Québec J7Z 0B7, Canada

Abstract. The weight loss industry is projected to reach USD$ 278.95 billion
worldwide by 2023. Weight loss companies devote a large part of their budget
for advertising their products. Unfortunately, as revealed by the Federal Trade
Commission (FTC), there are many deceptive ads. The effect of weight loss
advertising on consumer’s diet and eating behavior is so large that it has been
proposed a causal relationship between advertising and diet. Adolescents,
women with appearance concerns, and obese people, are the most vulnerable
consumers for this kind of advertising. Within the Internet, most weight loss
products are advertised under algorithmic rules. This algorithmic regulation
refers to the online advertising being established by a series of rules (i.e.,
algorithms). These algorithms collect information about our online identity and
behavior (e.g., sociodemographic characteristics, online searches we do, online
content we download, “liked” content, etc.), to personalize the content displayed
while we browse the Internet. Because of it, this algorithmic regulation has been
described as a “filter bubble”, because most content we see on the Internet is
reflecting our idiosyncratic interests, desires, and needs. Following this para-
digm, this study presents a research protocol to experimentally examine the
effect of online weight loss advertising in the attention (using eye-tracking) and
physiological response (using facial electromyography) of women with different
levels of body dissatisfaction. The protocol describes the methodology for:
participants’ recruitment; collecting weight loss ads; and the experimental study,
which includes the stimuli (ads) and the responses (eye fixations and facial
muscles activity).

Keywords: Weight loss
Online advertising
Eye-tracking
Body

dissatisfaction
Algorithmic regulation
Facial electromyography
Internet

© Springer Nature Switzerland AG 2020

C. Stephanidis and M. Antona (Eds.): HCII 2020, CCIS 1226, pp. 139–148, 2020.
https://doi.org/10.1007/978-3-030-50732-9_19
140 C. A. Almenara et al.

1 Introduction

According with Orbis Research, the global market of the weight loss industry was
USD$ 168.95 billion in 2016 and it is projected a growth to USD$ 278.95 in 2023 [1].
These companies have a large budget for advertising their weight loss products,
although, as has been identified by the Federal Trade Commission (FTC), there are
many deceptive ads within them [2–4].
Many consumers are aware and can identify deceptive weight loss ads. However,
even the skeptic consumers are prone to buy weight loss products in Internet with the
hope to lose weight [2]. For instance, adolescents, women with appearance concerns,
and obese people, are the most vulnerable consumers for this kind of advertising [2, 5,
6]. Specifically, the most representative segment of consumers for these products are
young adult women (below 30 years), representing up to 40% of all consumers [7]. In
most of these cases, the consumers are buying these weight loss products because of
their concerns with their body weight and shape.
These concerns with body weight and shape are studied under the term of body
dissatisfaction, i.e., individual’s cognitive and affective negative evaluations of his/her
own body and its characteristics [8]. Unfortunately, body dissatisfaction is considered
an important predictor in the development of eating disorders as well as risky eating
behaviors and patterns, such as extreme diets for weight loss [9].
As evidenced by previous studies, the effect of advertising on consumer’s diet and
eating behavior is so large that it has been proposed a causal relationship between
advertising and diet [10]. Particularly in the case of women with high levels of body
dissatisfaction, it is important to highlight that the continuous exposure to this kind of
advertising in Internet and other media, can promote unhealthy eating patterns and even
the relapse in women recovering of the treatment for an eating disorder [10–13]. For
that reason, it is necessary to scientifically examine the effect of the online advertising
of diet and weight loss products in the most vulnerable individuals, such as young
women with body dissatisfaction.
Several studies have explored the effect of online advertising on body image atti-
tudes and eating behaviors to lose weight, in both cross-sectional and experimental
studies [14]. However, to the best of our knowledge, there is not such study as the one
we present here, which includes a biomarker, a behavioral marker, and experimental
stimuli established by computer algorithms.
In this study, the biomarker is obtained by measuring facial muscles activity
(physiological response), using facial electromyography (fEMG), whereas the behav-
ioral marker is obtained by measuring eye movements (eye fixations), using eye
tracking. fEMG has been used in media and advertising research, being considered a
useful measure of emotional valence and arousal [15, 16]. Similarly, eye tracking has
been used in studies of digital online advertising, and it is considered an objective
measure of gaze patterns [17, 18]. Regarding computer algorithms, most online
advertising is established by a series of rules (i.e., algorithms) that personalize the
content for each Internet user. These algorithms collect information about our online
identity and behavior (e.g., sociodemographic characteristics, online searches we do,
online content we download, “liked” content, etc.), to personalize the content displayed
 Effect of Online Weight Loss Advertising in Young Women 141

while we browse the Internet [19]. Because of it, this algorithmic regulation has been
described as a “filter bubble”, because most content we see on the Internet is actually
reflecting our idiosyncratic interests, desires, and needs [20].
Following the algorithmic regulation paradigm, this study presents a research
protocol to experimentally examine the effect of online weight loss advertising in the
attention (eye fixation) and physiological response (electrodermal activity) of women
with different levels of body dissatisfaction. The current protocol describes the
methodology for: participants’ recruitment; collecting weight loss ads; and the exper-
imental study, which includes the stimuli (ads) and the responses (eye fixations and
fEMG).

2 Methodology

Regarding the research design, we propose an experimental design with a matched

control group. In this scenario, participants are randomly assigned to either the control
or experimental condition and the control group will match with the experimental
group in their sociodemographic characteristics [21].

2.1 Participants
Sampling is non-random and participants (young women between 18 and 30 years old)
are invited to participate in the experiment. The invitation is sent by email to university
students and it is also posted on Facebook groups of students.

2.2 Instruments

Sociodemographic Questionnaire. Participants are asked to report their age, highest

educational attainment, current occupation, weight, and height. The latter two are used
to calculate the body mass index (BMI).
Body Dissatisfaction. In this study we will use three measures of body dissatisfaction.
The first measure is the Photographic Figure Rating Scale (PFRS), which consists of
pictorial stimuli composed by gray scale photographic figures of women [22]. Partic-
ipants are asked to choose an image that represents their ideal body, and an image that
represents their actual body. Thus, this instrument measures the discrepancy between
the ideal body and the perceived body (i.e., body dissatisfaction), using culturally
neutral stimuli. The second instrument includes a single-item measure of global body
dissatisfaction (“How satisfied are you with the physical appearance of your body?”)
that uses a 5-point Likert scale (from “Not satisfied at all” = 1 to “Absolutely satis-
fied” = 5). Moreover, this instrument asks the same to participants but regarding dif-
ferent body parts (e.g., stomach, buttocks, etc.). The third instrument is the Body
Dissatisfaction subscale of the Eating Disorders Inventory - 3, which is a renowned
instrument used in hundreds of studies [23].
142 C. A. Almenara et al.

Eye-Tracking. To measure eye movements, we propose the use of Pupil Labs

binocular glasses (https://pupil-labs.com), which have good accuracy and precision
[24]. Moreover, this eye tracker has a sampling frequency of 200 Hz, which is an
acceptable sampling rate for available algorithms to detect eye fixations [25]. Although
most studies apply mathematical and statistical procedures to handle eye tracking data
[26], for this protocol we propose using also visualization techniques that allow, for
example, to identify areas of interest [27]. The protocol of data acquisition follows
recommended guidelines for eye tracking research [28].
Facial Electromyography (fEMG). fEMG data is obtained by locating gold cup
electrodes in specific facial muscles (zygomaticus major, corrugator supercilia, and
levator labii), and a ground electrode on the left mastoid, according to recommended
guidelines [16, 29, 30].

2.3 Procedure
First, the research follows ethical guidelines for the study of human subjects [31],
which implies the approval of this protocol by the Institutional Review Board (IRB) of
our university. This also includes asking participants to sign an informed consent, in
which we explain them about the experiment and all possible consequences of it.
Moreover, all information gathered from participants is anonymized, to take care of the
privacy of participants.
Collection of Experimental Stimuli. The procedure to collect weight loss advertising
images from the Internet is presented in Fig. 1. First, seed terms are identified from
previous studies [32–35], and are used for the acquisition of other terms [36] in Google
trends, YouTube, Instagram, Twitter, Pinterest, and Facebook, through an iterative
process. For example, the terms “diet” and “weight loss” are seed terms found in
previous literature, whereas “intermittent fasting” is a term that can be found in Google
trends while searching for “diet” in the geographical location of our interest. The
iterative process finishes by considering keyword grouping relevant to the original seed
keywords, a technique used in sponsored search advertising [37, 38].
Next, to perform the Internet searches, four virtual machines are configured, and
four digital personae are created. A digital persona refers here to the digital data
consolidation regarding the characteristics and attributes of a particular consumer [39].
In our case, we propose assigning the following sociodemographic characteristics to
our digital personae: young women between 18 and 30 years, born and living in Lima,
Peru. We propose four digital personae (one for each virtual machine), considering that
word grouping in topic modeling is parsimonious between two and five (more could be
considered overclustering) [40]. Moreover, four groups of keywords are also an
appropriate number in online advertising. In other words, one group of keywords is
assigned to each of the four digital personae.
A virtual machine is an operating system (virtually) installed within a host (native)
operating system [41]. Considering the popularity of Microsoft Windows and Ubuntu
Linux distribution, we propose configuring several virtual machines with Microsoft
Windows (one for each digital persona), installed within a host Ubuntu operating
system. Each virtual machine is configured and used in a way that has a unique Internet
 Effect of Online Weight Loss Advertising in Young Women 143

Fig. 1. Visualization of the methodology to obtain weight loss advertising images.

protocol (IP) address, and a unique media access control (MAC) address. Moreover,
each virtual machine has a web browser configured by default. Google Chrome and
Mozilla Firefox are the chosen web browsers given their popularity in desktop com-
puters running Microsoft Windows.
Then, within each virtual machine (one at a time), we launch the web browser to
create email and social media accounts (Google Gmail, Facebook, Instagram, Pinterest,
Twitter), using the sociodemographic information that better describes our participants
(young women from Lima, Peru). Next, being logged in in all these websites, we start
searching the Internet using the groups of search terms we previously found. Similarly,
we start to “like” the web pages devoted to weight loss and dieting that we previously
identified as the most popular in social media websites. Finally, we start to collect diet
and weight loss advertising images that we encounter during our web surfing in the
previous step. Considering that consumers tend to prefer skyscrapers [42], only this
type of advertising is selected. This process finishes after clicking on all of the first five
non-sponsored links, because 90% of all clicks usually occur there [43], or until we
have an appropriate number of ads to fit into a 1920  1080 pixels screen.
To evaluate the saliency of these pictorial stimuli, we will do a quasi-experimental
pilot study with 20 university students (young women between 18 to 30 years). The
participants will be in front of a projector screen displaying all collected ads which
shuffle randomly every 10 s to avoid the confounding effect of their position (see
preview available online: https://cybermind.ai/eye-tracking-stimuli-one). Saliency will
144 C. A. Almenara et al.

be evaluated evaluating visual fixation time (with eye tracking) and a brief interview
asking the participant “which advertising image was the most pleasant for you?”. At
the end, only one weight loss advertising image is going to be selected for the final
experimental procedure.

Experimental Procedure. First, an online survey containing the sociodemographic

questionnaire and the instruments assessing body dissatisfaction, is created in a dedi-
cated website. The online survey is designed to automatically classify participants in
“satisfied” or “no satisfied” based on the responses, and randomly assigns participants
to either the experimental or control condition. The experimental and control conditions
consist on a website page displaying an email message and next to it: an empty ad
(control condition), or the selected weight loss advertising image (experimental con-
dition) (see preview available online: https://cybermind.ai/eye-tracking-stimuli-two).
Reading and replying an email was chosen because it resembles a natural context that
most Internet users are familiar with [44].
Next, each participant is invited to the experimental room and asked to sit on a
comfortable chair in front of a desktop computer. Once the informed consent and the
research debriefing is provided, the calibration of devices (eye tracker glasses and
electrodes for fEMG) is performed. Finished this step, the participant is asked to start
the experiment by following the instructions provided on the computer screen. First,
participants must provide the responses to the online survey containing the sociode-
mographic questionnaire and the instruments assessing body dissatisfaction. For the
experimental/control condition, participants are given the following instruction:
“Please, read the email message and reply to the sender writing at least three lines of
text”.
Previous studies have identified weight-related attentional bias in people with body
dissatisfaction [45]. Therefore, it is hypothesized that participants classified as dissat-
isfied with their bodies will display a longer total fixation time on the weight loss ad
compared with their matched counterparts in the control group.
On the other hand, previous studies in young women have found that images of
overweight bodies elicit facial muscle activation indicating disgust (corrugator
supercilii and levator labii), whereas images of thin bodies do not [46]. Therefore, we
hypothesize that participants exposed to the weight loss advertising image will display
facial muscle activation indicating pleasantness.
Once collected the data, it will be analyzed with R Statistical Software 3.6.3 and
Python 3.8.2.

3 Discussion

The current study was aimed to present an experimental protocol for the study of body-
related attentional bias within the algorithmic regulation paradigm of online advertis-
ing. The weight loss industry devotes a large amount of money in online advertising.
However, deceptive marketing strategies and weight loss products can have hazardous
 Effect of Online Weight Loss Advertising in Young Women 145

effects on vulnerable people such as young women with body dissatisfaction. The
current study taps into this problem by providing a detailed procedure to gather weight
loss ads, and an experimental protocol to examine the effect of weight loss advertising
in young women with different levels of body dissatisfaction.
Although this study has strengths, is not exempt of limitations. The largest limi-
tation is that this protocol has not been proved yet, and therefore we expect in the near
future to provide further improvements along with the final results of the experiment.
Meanwhile, future studies can improve this methodology by adding other neuro-
physiological measures and self-reports. For example, a multimodal experimental study
can use galvanic skin response (electrodermal activity), facial recognition software, and
self-reports of attention and bias.

Acknowledgements. This study was funded by Dirección de Investigación de la Universidad

Peruana de Ciencias Aplicadas (C-04-2019).

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