The Commodification of Celebrity Health

On January 17, 2012, celebrity chef Paula Deen went on the Today Show to clear up rumors about her health and publically announce that she had been diagnosed with Type II diabetes in 2009. In the days that followed, Deen did not receive the support and encouragement she had hoped from colleagues and fans. Instead, she was met with tremendous backlash from the American public who questioned her motives for hiding her illness for so long. Many accused the “Butter Queen” of being a hypocrite for continuing to glamorize an unhealthy eating lifestyle (deep fried-cheesecake anyone?) while knowing full well its detrimental health effects. Adding insult to injury, Deen also announced her multi-million dollar contract to become the spokesperson for Novo Nordisk Pharmaceuticals’ diabetes drug, Victoza, leading people to wonder if she was using her celebrity status to somehow exploit her illness. While this story has the elements of the usual celebrity scandal (rumor, deceit, money, etc.), what sets it apart is the subject matter. After all, we aren’t talking about an extramarital affair or insider trading - we are talking about the personal process of managing an illness. So why are countless fans, fellow chefs, diabetics, doctors and the media so invested in Paula Deen’s health?

One reason is that Deen’s celebrity status may have a substantial impact on the social image of diabetes as an illness and the reification of prescription drugs as an effective treatment. Medicalization scholars argue that actors, athletes and other public figures are expected to reflect cultural ideals of body image and health. Their wealth and status afford them access to the best medical expertise and care and as a result, consumers place particular value on their healthcare decisions. In a consumer-driven economy, it is not surprising that pharmaceutical companies invest in the reputation of these celebrities to promote their products to potential consumers. Following the theme of this issue, I want to reflect on this strategy which I am calling the "commodification of celebrity health." That is, how the (perceived) health, medical expertise, and treatment decisions of a celebrity can become a commodity which embodies larger social relationships between the public, healthcare providers, and the pharmaceutical industry.

The commodification of celebrity health has both positive and negative implications. One the one hand, actors such as Christopher Reeves and Michael J. Fox have been able to leverage their fame in order to raise public awareness and funds for medical research on their conditions. By openly discussing their private medical issues with the public, celebrities have also been able to address the misconceptions and stigmas attached to certain illnesses. One of the most famous examples of this is Bob Dole’s endorsement of Viagra, a drug manufactured by Pfizer to treat the symptoms of erectile dysfunction. In the 1998 television commercial, Dole admitted that he suffered from the condition and encouraged viewers to work up the “courage” to ask their doctors about the drug. Mamo and Fishman (2001) argue that as a political figure, Dole represented a hegemonic ideal of masculinity, and as a result was able to not only de-stigmatize erectile dysfunction, but legitimize it as a biomedical condition which should be treated with a prescription drug.

Once a celebrity has signed on to endorse a product, their reputation and credibility is, to a degree, tied to that product. This is especially true in the case of pharmaceutical endorsements because of the implications drug failures can be costly. For example, in 2004, Merck Pharmaceuticals withdrew their arthritis drug, Vioxx from the worldwide market after receiving information from the FDA that it significantly increased the risk of heart attack and stroke among users. While Merck quickly initiated a damage control campaign for their company, celebrity athletes Bruce Jenner and Dorothy Hamill found themselves under public scrutiny for promoting the unsafe medication. Jenner explained to ESPN that “Dorothy (Hamill) is not a scientist and I’m not a scientist… we had no idea what was happening behind the scenes. They never told us.” Instances such as this calls to question the ethics of allowing celebrities to offer health advice to viewers, especially when they do not know or understand the risks associated with the products they endorse.

The misrepresentation of medical expertise in pharmaceutical advertisements was also a concern in 2008 when a congressional committee was created to investigate the questionable tactics used by Pfizer Pharmaceuticals in the campaign for their cholesterol drug, Lipator. Celebrity scientist and creator of the Jarvik artificial heart, Dr. Robert Jarvik appeared in a series of Lipator advertisements where he offered medical knowledge and advice on the heart health. However, Jarvik is not a cardiologist nor does he have a license to practice medicine. Futhermore, it was discovered that a stunt double was used in commercials featuring the scientist performing impressive athletic activities. These tactics demonstrate how misleading pharmaceutical advertisements are in presenting the expertise and health of their celebrity affiliates in order to fill prescriptions.

The presentation of medical expertise is particularly relevant in Paula Deen’s case. In her Today Show interview, she admitted that she was not familiar with the illness and didn’t want to tell her fans without being able to offer some sort of program to that could help others who suffered from diabetes. However, the website for her new campaign Diabetes in a New Light is a far cry from the expert medical resource she claimed it would be. The homepage features a contest for members (yes, you have to pay) where you can win a chance to meet Deen in her hometown of Savannah, Georgia. You will also get full access to her new recipe book “Delicious Living Y’all”; cooking tips from her family members; and ideas on how to work with your doctor to develop a treatment plan that works for you. Most importantly, it features a link to her primary sponsor, Norvo Nordisk Pharmaceuticals. Although the site does include some rudimentary suggestions on eating healthy and being active, it prominently features Victoza as a necessary part of a successful diabetes management plan.

When it comes down to it, critics of Paula Deen feel as though she is setting a poor and even dangerous example to other diabetics of how they should be managing their illness. Donna Shaft, a marketing consultant who also suffers from Type II diabetes explains to Fox News that “We of course don't know the terms of her contract with the drug company, but it seems either stupid or hypocritical of them to be endorsing the eating lifestyle she advocates. For her to publicly facilitate the illusion that a T2 [medication] can consume the quantities of fats and carbs and sugars she showcases, even occasionally, is nothing short of a dangerous abuse of the trust many in her audience place in her as an influential public figure.”

While the degree to which Deen actually influences other diabetics is yet to be determined, her celebrity status has made her an asset to Novo Nordisk and in turn helped her brand her Diabetes in a particular way. Specifically, that she has pulled together all of her star power to bring you a fool-proof program to live a “diabetes friendly” lifestyle - all you need to do is purchase her recipes and ask your doctor for Victoza.

As easy as it is to vilify Deen as an irresponsible role model for diabetes management, the value and commodification of her health decisions is the result of a larger shift towards this consumer-driven economy of health. And although she is not the first celebrity to come under scrutiny for her affiliation with the pharmaceutical industry, it is safe to say she won’t be the last.

Tazin Karim

References

Mamo, Laura and Jennifer Fishman. 2007. Potency in All the Right Places: Viagra as a Technology of the Gendered Body. Body & Society, December, Issue 7: 13-35.

Passing with Pills: Redefining Performance in the Pharmaceuticalized University

"Adderall," by Flickr user AlexDoddPhotography.

College is a complex cultural object - it is simultaneously a physical place, a social institution, a time frame, a mindset, and an experience. For many Americans, it has also become a rite of passage into adulthood, where students are ritually removed from their pre-college life; faced with certain social, academic and even physical hardships; and then reintroduced to society with the anticipated rights and privileges of a college graduate. In this process, students are experimenting with prescription stimulants, namely Adderall, in order to manage and maximize their college experience. Despite the medical and legal risks involved with unsupervised use of these drugs, prevalence rates have been recorded as high as 35% and continue to grow (Wilens et al. 2008). In this piece, I want to use Adderall as a lens to look more closely at the modern university and how it is reflecting and/or reshaping what it means to a successful student in a pharmaceuticalized culture.

Anthropologists have argued that the increasing availability of pharmaceuticals has generated a sense of agency among healthy Americans who feel they could benefit from these technologies for non-medical purposes. For example, Vuckovic (1999) suggests that America is experiencing a “time famine” which encourages individuals to take medications to increase health and by extension, efficiency. In particular, the demand for prescription stimulants signals a desire for “flexible bodies” which work harder, needless rest, and can adapt quickly to new situations (Martin 2001). Given the rigorous schedules most students face in college, it is not surprising that many are turning to pharmaceuticals to help them keep up.

Most students who try Adderall for the first time do it out of desperation or curiosity, usually both. They see a friend taking the drug and studying for 6 hours straight, or it is offered to them on a silver platter the night before a big deadline. The fetishism over the drug stems from narratives of success, legends of the superhuman feats one can achieve in a matter of hours while on the wonder drug. Hence, it is not surprising that students begin to experiment with Adderall in order to mitigate the stresses of their own academic work. Michael, a non-prescription user explains that before he took Adderall, he had a difficult time studying:

It’s not like I didn’t make time, I would sit at the library for 10 hours and just stress out about how much I had to get done. I studied 30 minutes, and stressed for 9 and a ½ hours... but now I just pop an Adderall and I feel like ‘Hell yes, let’s do this!’ Then I just do it. It might be placebo or something, but for me, it works.

For Jenelle, a sophomore in biology, Adderall allows her to turn school work into a recreational activity and describes it as euphoric experience. She tells me:

When I am on Adderall, calculus is the most fascinating thing in the world to me. I don’t want to stop reading my textbook… solving math problems becomes a game that I have to win no matter how long it takes.

So, while Adderall use may not necessarily increase cognitive function for everyone, it can still generate the motivation, stamina and confidence necessary to complete academic work.

As Adderall continues to become a normative, and even anticipated part the college experience, prior notions of academic performance are being transformed. In the process, the types of work that are logically and ethically appropriate for pharmaceutical interventions come into question. Some students argue that Adderall is best for writing papers or even enhancing artistic abilities, while others are emphatic that it suppresses creativity and is only useful for basic memorization. As Jason, junior in physics puts it,

Adderall is only good for holding onto to information in your head, not its alteration. You just push it into your brain and reproduce it on the exam.

Even then, the length of time Adderall allows the user to commit information to memory rarely appears to be long-term. So while students work under more flexible notions of time, they must also navigate around the fleeting nature of the information Adderall makes available to them.

Stories of success with Adderall are also accompanied by cautionary tales of cognitive tradeoffs such as misplaced focus and quality of work. As a result, students rely on experimentation to directly inform what constitutes both the optimal drug and study experience, as well as when and how they register the usefulness of Adderall. Elizabeth, a freshman in chemistry tells me:

Adderall will make you want to work, but you can’t control the work you actually do. If you are lucky, you spend 10 hours writing a paper, but maybe you end up spending 10 hours cleaning your room or obsessing over making the perfect iTunes playlist.

She goes on to tell me that:

Now when I use Adderall, I make sure I am not in my dorm room, instead I go to the second floor of the main library where it is dead silent… I make sure that I close all the other windows in my computer and leave my cell phone at home so I don’t have any more distractions… I also make an outline of what I need to get done so once I am on the Adderall, all I need to do is fill in the blanks.

Josh, a non-prescription user in psychology argues that while it allows you maximize the quantity of work you can do, the quality of the work suffers greatly. He explains:

Once I wrote a 15 page paper in one night, I thought it was so good! And then I read it the next morning, it was complete rambling BS… but I turned it in and got a 2.5 so whatever, at least I got it done.

According to my informants, it is quite common to experience a false sense of euphoria, invincibility, and grandeur while completing academic work on the drug. In fact, many professors I have spoken with claim they can spot a paper fueled by Adderall based on these self-important narratives. It makes sense than that for students like Josh, Adderall is only used in a pinch for general education classes which are less important to his overall academic goals. Other students who recognize this tradeoff of Adderall use develop strategies to use the drug for long term goals and assignments. Kaitlyn, a junior in journalism tells me:

After turning in three or four shitty papers, I get that I can’t just use it last minute… Adderall gives me the kick start I need to get going on a paper, but now I make sure I have at least two days to revise a paper while I am sober to make sure it actually makes sense.

This shows that although students may feel “enhanced” while doing their school work, Adderall alone does not necessarily result in increased academic performance. Despite the variable experiences students have with the drug and questions of its actual efficacy, Adderall has become a normative part of the college social experience, where students take the pill together in order to get through the rigors of college in solidarity. Josh, a senior in sociology tells me that during finals week, his roommates ritualistically make breakfast, pop a few Adderall and lock themselves in the student union for hours. He tells me:

We know that once we are blasting on Adderall, no one else will be on our level or understand where our minds are at… so we developed a system so that we are in together, you know? Like we can all be blasting together and get shit done.

Sharing one’s acquired Adderall is another way to demonstrate solidarity among students. Allison, a senior in marketing tells me:

When I first met my best friend Kenny, he was standing outside of the lecture hall and he looked exhausted. I asked him what was wrong and he told me he forgot to take his Adderall before the test, so I offered him one of mine. After that, we were best friends for the rest of the semester, it’s the funniest thing!

During my participant observation at the library, I have heard students who are studying together tell each other “I am exhausted, want to split an Adderall and start the next chapter”? In most cases, the recipient is excited to get access to the drug and consumes it quickly. However, in some cases students turn down the offer of Adderall say but it is still taken as a gesture of good will, rather than an illegal proposition.

While questions of morality and merit remain central to neuro-ethical debates around cognitive enhancement, illicit Adderall use has become so normalized that many students admit to never considering these issues. Adam, a non-prescription user says to me:

Is it cheating? I don’t know, I never thought about it... Do people seriously think like that? Like does it whisper the answers in my ear? Or does it just write the paper for me while I sleep? No. What the hell does that even mean...is it cheating?

Abby, a senior in Economics tells me:

I definitely don’t consider it cheating. Your grade still reflects how well you know the material, whether you learned it in 10 weeks or 48 hours.

These rationalized claims over intellectual performance are rooted in a larger rhetoric of responsibility over one’s own academic future - an agenda that most students admit they developed during their college years. For example, Evan, another non-prescription user tells me that before college, he never considered taking Adderall. He explains that:

It wasn’t until I was mature enough to understand that grades actually mattered that I saw the value of something like Adderall. I think that’s why if my parents ever found out, they wouldn’t be pissed, they would be proud of me for taking initiative.

He goes on to tell me:

Everyone here has the opportunity to take Adderall to study if they really want to - so if they choose not to take it, that’s on them.

***

While these brief narratives capture only a snapshot from the lives of these students, they demonstrate how the circulation and use of Adderall on campus is more than just a risky drug behavior. It is a deeply moralized negotiation of health, performance, and social capital, which has become a part of this rite of passage. As educators and anthropologists working in this context, it is our responsibility to recognize shifting expectations that are placed on college students to take these drugs in order to survive college and move onto the “real world”. As society continues to value performance over learning, we distance ourselves from these individuals when they need our understanding and guidance the most.

While there is no hard and fast solution to this drug behavior, we can start by educating ourselves and having an open and honest dialogue with students about why they feel they need to use the drug. Next, we must take that knowledge and implement it into our own teaching strategies -in some cases may mean replacing finals week with more regular and diverse assessments throughout the semester. It may also mean more work on our part to make our courses relevant, exciting and worth their time because most students will never take an Adderall to study or write for a class they enjoy or care about. And finally, we need to have an open dialogue with each other and not assume the worst about our students (those lazy, cheating, drug users). We are a fundamental influence of this rite of passage and unless we acknowledge the problem to ourselves, we only supporting the notion that Adderall use is a legitimate strategy to achieving successful college experience.

Tazin Karim

Michigan State University

Works cited

Martin E. 1994. Flexible bodies: tracking immunity in American culture from the days of polio to the age of AIDS. Boston: Beacon Press. xxiii, 320 p. p.

Vuckovic N. 1999. Fast Relief: Buying Time with Medications. Medical Anthropology Quarterly 13(1):51-68.

Wilens T, Lenard A, Adams J, Sgambati S, Rotrosen J, Sawtelle R, Utzinger L, and Fusillo S. 2008. Misuse and diversion of stimulants prescribed for ADHD: a systematic review of literature Journal of American Academy of Child Adolescence and Psychiatry 47(1):21-31.