Beauty2WellnessMitigating Barriers and Building Bridges

Research ReportJanuary 1, 2018

By Anjan Chatterjee, MD, FAAN Elliott Professor of Neurology Department of Neurology and the Center for Cognitive Neuroscience University of Pennsylvania, Philadelphia PA http://ccn.upenn.edu/chatterjee

Sponsored by the Global Wellness Institute

Table of Contents

Summary 1

Introduction 2

Study 1a. Mitigating barriers between beauty and wellness. Personality judgment. 3

Study 1b. Mitigating barriers between beauty and wellness. 7

Study 2. Building bridges between beauty and wellness. 12

References 17

Acknowledgment 18

Sponsors 19

About the Author

Anjan Chatterjee, MD, FAANAnjan Chatterjee is the Frank A. and Gwladys H. Elliott Professor and Chair of Neurology at Pennsylvania Hospital. He is a member of the Center for Cognitive Neuroscience, and the Center for Neuroscience and Society at the University of Pennsylvania. He received his BA in Philosophy from Haverford College, MD from the University of Pennsylvania and completed his neurology residency at the University of Chicago. His clinical practice focuses on patients with cognitive disorders. His research addresses questions about spatial cognition and language, attention, neuroethics, and neuroaesthetics. He wrote The Aesthetic Brain: How We Evolved to Desire Beauty and Enjoy Art and co-edited Neuroethics in Practice: Mind, Medicine, and Society and The Roots of Cognitive Neuroscience: Behavioral Neurology and Neuropsychology. He is or has been on the editorial boards of: American Journal of Bioethics: Neuroscience, Behavioural Neurology, Cognitive and Behavioral Neurology, Neuropsychology, Journal of Cognitive Neuroscience, Journal of Alzheimer’s Disease, Journal of the International Neuropsychological Society, European Neurology, Empirical Studies of the Arts, The Open Ethics Journal and Policy Studies in Ethics, Law and Technology. He was awarded the Norman Geschwind Prize in Behavioral and Cognitive Neurology by the American Academy of Neurology and the Rudolph Arnheim Prize for contribution to Psychology and the Arts by the American Psychological Association. He is a founding member of the Board of Governors of the Neuroethics Society, the past President of the International Association of Empirical Aesthetics, and the past President of the Behavioral and Cognitive Neurology Society. He serves on the Boards of The College of Physicians of Philadelphia, Haverford College, and the Associated Services for the Blind and Visually Impaired.

http://ccn.upenn.edu/chatterjee

Twitter: @Anjan435

SummaryBeauty animates many of our decisions, big and small. This pervasive role of beauty is also evident in business. From data gathered in 2015, the Global Wellness Institute (GWI) reports that Beauty has a $999B industry footprint. Evidence from psychology and neuroscience suggests that we respond automatically to beauty. Furthermore, we are biased to link beauty to goodness. This automatic link is potentially problematic and reveals that the connection between beauty and individual wellness is not straightforward. The research reported here is motivated to understand how best to strengthen the link between beauty and wellness. The strategy is to mitigate barriers and build bridges between the two.

In the first study, we found that people make personality judgments automatically when looking at faces. People with minor facial disfigurement are judged as having more negative personal attributes than if they do not have these disfigurements. These negative associations are made implicitly and likely have a negative impact on an individual’s wellness. This result means that facial makeup that minimizes the perception of minor facial anomalies probably has an impact beyond how someone looks. It probably has an impact on how people feel and are treated and mitigates threats to their well-being.

The second study used natural language processing to identify concepts that link beauty and wellness. Using 10 years of Google News as the linguistic corpus, we found that cluster of words form categories that link beauty and wellness. These categories comport well with most of the categories within the wellness economy identified by the GWI Economic analysis. One category, that we call Culture and Self-care, was not represented in this analysis. This area could be a future target for economic development. We also identified terms that convey elements of both beauty and wellness. These terms identify potential industry strategies and marketing approaches to link beauty and wellness.

1

IntroductionBeauty animates much of our lives. We make aesthetic decisions constantly, choosing how we wish to appear, who we wish to spend time with, what environments to inhabit, and which art and decorations to buy. GWI reports that beauty, an important pillar of the wellness industry, is a $999b commercial enterprise. Despite the importance that beauty plays in peoples’ lives and its substantial economic footprint, our knowledge of its scientific basis, how it is modulated, and its emotional effects on individuals and society is limited. While we know something about the biology and psychological effects of facial beauty, we know little about its relationship to wellness. The current scientific literature suggests that beauty can work in the service of or against individual wellness.

This report presents our findings that address a fundamental question: how might beauty contribute meaningfully to wellness? We propose that tipping the balance for beauty to weigh in for wellness requires mitigating barriers between beauty and wellness and building bridges to enhance connections between the two.

2

Study 1a. Mitigating barriers between beauty and wellness. Personality judgments.

People respond to beauty automatically. This response is seen in people’s behavior and their neural responses. Good-looking people receive many advantages in life: they are more likely to be hired, given more pay, lesser punishments, and assumed to be more intelligent and trustworthy (Langlois et al., 2000). We previously reported that the human visual cortex responds automatically to beauty (Chatterjee, Thomas, Smith, & Aguirre, 2009). That is when people judge the identity of faces, their brains still respond to the beauty of these faces. Another research group found that our reward systems also respond automatically to beauty (Kim, Adolphs, O’Doherty, & Shimojo, 2007). Taken together, these results demonstrate that we have automatic beauty detectors in the brain that link vision and pleasure even when people are not thinking about a person’s beauty.

Automatic brain responses in the human visual cortex when people see attractive faces, even when making an identity judgment, as shown in the right panel. From: (Chatterjee et al., 2009)

3

We also have a “beauty is good” stereotype. Parts of our reward systems respond to both beautiful faces and to morally good acts (Wang et al., 2015). This convergence of neural activity may be the biological trigger for the beauty is good stereotype, which expresses itself in social settings. We sought to determine if people’s judgments are biased against individuals with facial disfigurement using natural images. We predicted that individuals who had received treatment for their disfigurement would be perceived as having more positive attributes than before their treatment. We also examined the effects of gender of the observers making these judgments (Jamrozik, Oraa Ali, Sarwer, & Chatterjee, 2017).

MethodsParticipants (N = 145, 62 female, mean age = 35.39) were recruited online through Amazon Mechanical Turk. Materials consisted of 26 sets of pictures of faces (one face pre-treatment, one post-treatment) collected from craniofacial and dental surgery atlases. The pre-treatment faces were affected by one of the following disfigurements: carcinoma, hyperpigmentation, birthmark, scar or small wound, facial paralysis, isolated weight loss, bone disfigurement, or facial trauma. Pre-treatment and post-treatment pictures were chosen to have matched facial expressions when possible, and cropped and color-corrected to match in size and coloring. Following instructions, participants were shown one picture (either pre-treatment or post-treatment) from each of the 26 sets of faces. Each face was presented for 2.5 seconds, as gathered participants’ initial impressions of the face.

Thirty 5-point semantic differential scales were used to gather people’s perceptions of the pictured individuals. Ten scales assessed personality attributes (e.g., introverted vs. extraverted; emotionally stable vs. emotionally unstable), twelve scales assessed internal attributes (e.g., unhappy vs. happy, lazy vs. hard-working), and seven scales assessed social attributes (e.g., submissive vs. dominant, unlikeable vs. likeable). As a manipulation check, we also included a scale to measure attractiveness (unattractive vs. attractive).

We used linear mixed-effects analyses to model the effect of treatment across items (i.e., faces) and across participants. In addition to the main effect of interest (treatment: pre- vs. post-), we examined the effects of gender (face gender and participant gender) in secondary analyses. Given the large number of dependent variables, we conducted a principal component analysis (PCA) to understand how the ratings might group together. We also used these component scores as dependent variables in a linear mixed model.

4

ResultsPost-treatment faces were judged as having more positive personality traits than pre-treatment faces. They were rated as more conscientious, emotionally stable, open to experiences, and extraverted. They were also rated as more agreeable (more supportive).

Pre-treatment Difference Post-treatmentValence (Observer’s) 3.65 2.39 6.03

Arousal (Observer’s) 4.44 -0.82 3.62

Careful 3.26 0.27 3.53

Emotionally stable 2.95 0.76 3.71

Happy 3.06 0.71 3.77

Intelligent 3.39 0.20 3.59

Trustworthy 3.30 0.43 3.73

Popular 2.84 0.96 3.81

Pre-treatment Difference Post-treatmentValence (Observer’s) 3.28 1.49 4.77

Arousal (Observer’s) 4.17 -1.09 3.08

Careful 3.17 0.48 3.66

Emotionally stable 3.04 0.56 3.60

Happy 2.28 0.58 2.86

Intelligent 3.03 0.38 3.41

Trustworthy 3.17 0.47 3.64

Popular 2.46 0.37 2.83

Two example pairs of faces pre- and post-treatment. Estimates for each face are derived from models estimating the effect of treatment on observers’ ratings. These models included by-item (i.e., face) intercept and slope estimates. People made more positive inferences about post-treatment individuals’ personality traits (e.g., conscientious, emotionally stable), internal attributes (e.g., happy, intelligent), and social attributes (e.g., trustworthy, popular). From: (Jamrozik et al., 2017)

5

Post-treatment faces were judged as having more positive internal attributes: they were rated as nicer, more honest, happier, and calmer than pre-treatment individuals. They were also rated as more intelligent, competent, and hardworking. Post-treatment individuals were judged as having more positive social attributes than pre-treatment individuals. They were rated as more trustworthy, likeable, popular, and confident, among others. Men were more biased than women in judging how intelligent, competent, and hardworking, and optimistic people were with disfigurements.

Results of PCA revealed that these various judgments grouped into five components, with four of them affected by treatment (pre- vs. post-). Prior to treatment, individuals were judged by raters as less sociable and happy, less dominant, and less emotionally stable than they were after treatment. In addition, prior to treatment individuals were more likely to appear as an object of curiosity to observers as compared to after treatment.

ImplicationsOur results confirm the hypothesis that a “disfigured-is-bad” bias exists. Observers judged people with minor disfigurement negatively, perceiving them as having undesirable personality traits (e.g., emotional stability, conscientiousness), internal attributes (e.g., happiness, intelligence) and social attributes (e.g., trustworthiness, popularity). Men are more susceptible to this bias of making negative inferences about a person based in facial physical anomalies.

Ratings on specific attributes of faces that differed between the pre- and post-treatment faces.

pre

post

6

Study 1b. Mitigating barriers between beauty and wellness.

At what level do people associate disfigured with bad? Are people aware of harboring such biases? It is possible that people are explicit in their bias. They are aware of and acknowledge associating disfigured with bad. Alternatively, the bias might only be implicit. They are unaware of having a bias, which is still evident in their behavior. We gave people a questionnaire that asked about their biases explicitly. We also adapted the Implicit Association Test (IAT) to assess their implicit biases against people with facial disfigurement. The IAT that has been used extensively in identifying racial and ethnic biases (Greenwald, McGhee, & Schwartz, 1998). Understanding the range and depth of such biases is critical to understanding how we might overcome them and contribute to an egalitarian society that supports individual wellness.

Methods80 participants (55 female, mean age = 23 years, SD = 6.4, range 18-56) were enrolled. One participant was excluded because of unreliable responses. Data from 79 participants were used for the final analysis (55 female, mean age = 23 years, SD = 6.4, range 18 – 56).

Participants saw images and words and categorized them into two groups as they appeared on the screen. The order of images and words was randomized and presented sequentially in the center of the computer screen. The images were shown on a white background and were sized to fill 35% of the screen width and 60% of the height. The words were presented in black text (18-point size, Courier New font). The IAT consists of 7 blocks. Blocks 1, 2 and 5 are practice, and blocks 3, 4, 6, and 7 are there for taking the main measurement. In blocks 3 and 4, participants sort the images and words into “bad words or disfigured faces” (‘e’-key) or “good words or non-disfigured faces” (‘i’-key). In blocks 6 and 7, the categories are shuffled to “bad words or non-disfigured faces” (‘e’- key) or “good words or disfigured faces” (‘i’-key). The labels were shown in the top left and right corners of the screen in green text (8-point size, Courier New font). The order of test blocks 3/4 and 6/7 was counterbalanced across participants. Images and words remained on the screen until the participant responded with either the press of the “e” or “i” key. Response times were collected for each image or word from the time of its onset until the button press.

7

After each response to a stimulus, there was a 5 second inter-stimulus interval in which participants’ received feedback on the correctness of their response. Participants were encouraged to respond as quickly as possible.

Images for the IAT consisted of the photographs of people with facial disfigurements before and after corrective surgery. The stimulus set consisted of 28 faces, of which 22 were female and 6 were male. 16 of the faces were oriented frontally, 10 were oriented in a three-quarters portrait view, and 2 were profiles. Sixteen words were used. Eight were positive words (attractive, happy, approachable, friendly, adore, lovely, spectacular, excellent), and 8 were negative words (ugly, evil, sickening, rotten, disaster, disgust, pain, despise).

Participants also completed an explicit facial disfigurement bias questionnaire so we could assess individual explicit biases people might have towards people with facial disfigurement. The questionnaire included 28 questions to which participants responded on a 7-point scale ranging from 1 to 7. Sample questions included “State how strongly you agree or disagree with the statement, People with facial disfigurements are more happy, confident, assured, and cheerful than others” where 1 = strongly disagree and 7 = strongly agree, as well as “Indicate how you would describe people with facial disfigurements on a scale where 1 = sad and 7 = happy.” One additional question asked about participants’ prior exposure to facial disfigurement and was rated on a 5-point scale with 1 = very rarely and 5 = often

Response times were collected for each block. Only the response times from test blocks 3, 4, 6, and 7 were used to calculate D scores (blocks 1, 2, and 5 were practice blocks). An IAT D score was calculated for each participant according to an improved scoring algorithm (Greenwald, Nosek, & Banaji, 2003). The data were pre-processing, as is common, to determine the individual D scores: (1) Trials shorter than 300 ms and greater than 10,000 ms were deleted. (2) Subjects for whom more than 10% of trials have latency less than 300 ms were excluded from analysis. (3) Mean of correct latencies was computed for each block. (4) Pooled SDs for all trials in block 3 and block 6, as well as for block 4 and block 7 were estimated. (5) Latencies of incorrect responses were replaced with the block mean plus a 600 ms penalty. (6) Mean RTs were computed per block. (7) Two differences were computed: block 6 mean – block 3 mean and block 7 mean – block 4 mean. (8) Each difference was divided by its pooled- trial SD. (9) The two quotients from the previous step were averaged.

Responses to the 28 EBQ questions were coded using a 7-point scale ranging from -3 to +3. A single explicit score was calculated for each participant by averaging these responses. In addition, each participant reported his or her prior exposure to facial disfigurement on a 5-point scale ranging from 1 to 5 (1 = very rarely and 5 = often).

8

Descriptive statistics characterized the sample and are reported for both implicit (D scores) and explicit measures. D scores range from -2 to +2, with zero indicating no bias for non-disfigured vs. disfigured faces. A positive D score suggests implicit bias favoring non-disfigured faces while a negative D score suggests implicit bias for disfigured faces.

Explicit scores range from -3 to +3 with zero indicating no bias for non-disfigured vs. disfigured faces. A positive explicit score suggests explicit bias for non-disfigured faces while a negative explicit score suggests explicit bias for disfigured faces. One-sample t- tests were used to determine whether mean implicit and explicit scores were significantly different from zero. Cohen’s d, a standardized effect size measure, was calculated for the implicit and explicit scores for all participants as well as by gender with the following guidelines for interpreting Cohen’s d scores: d of 0.2 = small effect, d of 0.5 = medium effect, and d of 0.8 = large effect (Cohen, 1988). One-way ANOVAs were performed to see if a participant’s level of prior exposure to facial disfigurement affected their implicit and explicit preferences. Pearson’s correlation coefficient (r) was used to characterize the relationship between implicit and explicit measures.

ResultsExplicit Measures. Participants as a group did not show an explicit bias for non- disfigured as compared to disfigured faces (mean explicit score = 0.02; SD = 1.02; min = -3.00; max = 1.02.168; t(78) = 0.17; 95% CI = -0.21 to 0.25; p = 0.866; Cohen’s d = 0.02). Male participants, however, did show a moderate explicit bias for non-disfigured faces (mean explicit D score = 0.39; SD = 0.76; min = -1.46; max = 2.16; t(23) = 2.50; 95% CI = 0.07 to 0.70; p = 0.02; Cohen’s d = 0.51). Prior exposure did not predict explicit scores as tested by a one-way ANOVA.

Implicit Measures. Participants showed a strong implicit bias for non-disfigured faces (mean IAT D score = 0.90; SD = 0.58; min = -0.26; max = 2.00; t(78) = 13.80; 95% CI = 0.77 to 1.03; p <.001; Cohen’s d = 1.55). Women demonstrated less, although still robust, implicit biases for non-disfigured faces (mean IAT D score = 0.77; SD = 0.56; min = -0.26; max = 2.00; t(54) = 10.18; 95% CI = 0.62 to 0.92; p <.001; Cohen’s d = 1.37) than men (mean IAT D score = 1.18; SD = 0.52; min = 0.07; max = 2.00; t(23) = 11.25; 95% CI = 0.97 to 1.40; p <.001; Cohen’s d = 2.30). Implicit and explicit did not correlate.

9

Explicit and implicit biases for non-disfigured over disfigured faces.

Mean Male Explicit Preference

Mean Female Explicit Preference

Mean Male Implicit Preference Mean Female Implicit Preference

-0.30

-0.20

-0.10

0.00

0.10

0.20

0.30

0.40

Expl

icit

Pref

eren

ces

for

Non

-dis

figur

ed F

aces

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

Impl

icit

Bias

for

Non

-dis

figur

ed F

aces

10

Poor correlation between explicit and implicit biases for non-disfigured faces over disfigured faces. Blue dots represent men, red dots represent women.

ImplicationsThese results show that people make inferences about a person’s personality when they look at a face. These inferences happen automatically even when no other information about the person is available. People cannot help but make deep judgments about a person based on superficial features. Men are especially susceptible to responding to faces with such adverse biases. In this study, we used images of faces with minor but obvious medical disfigurements. It is reasonable to expect that people also make such judgments automatically on faces with minor flaws. These intrinsic biases are further exaggerated by media portrayals of villains with facial disfigurement (Croley, Reese, Wagner, & Jr, 2017). The preoccupation with facial beauty has this ugly side. Flawed faces are regarded as flawed people. Here the application of cosmetics could play an important role. The role is not simply to produce a superficial effect. Cosmetics, by limiting observable facial flaws, mitigate automatic adverse judgments that observers are biased to make. Such automatic judgments are likely to adversely affect individuals’ well-being at work and at play.

Expl

icit

Bias

(sco

red

on th

e sc

ale

-3 to

+3)

Implicit Bias (scored on the scale -2 to +2)

11

Study 2. Building bridges between beauty and wellness.

If an automatic preoccupation with beauty can contribute to unfairness, how do we shift responses to beauty to emphasize wellness? We wished to uncover meaningful connections between beauty and wellness by identifying concepts that bridge the two. To do so, we examined the patterns of natural language use in English. The general idea is that words that behave similarly in an environment of other words will have related or similar meaning. This idea can be understood using the analogy that similar people demonstrate similar patterns of behavior. A person who likes Thai food, runs in races, goes to concerts, and vacations in the mountains, will be more like another person who enjoys those same activities than a person who likes steak and potatoes, plays football, goes to the movies, and vacations at the beach. Words also exhibit patterns of behavior, such as the grammatical constructions and the neighborhood of other words in which they are found.

There are two different ways in which words might be similar. One way is their sets of associations and the other is their meaning. For example, the word “doctor” might be associated with words like “hospital” or “medication.” These words are related because a doctor might engage in activities that involve hospitals and medications. On the other hand, “doctor” might also be related to a word like “nurse” because the word nurse co-occurs with other such words in a similar pattern as found with the word doctor. A nurse would also engage in activities that involve hospitals and medications.

12

MethodsFor this natural language processing analysis (Chowdhury, 2003), we used Google news dataset (100 billion words) over 10 years. The model contained 300-dimensional vectors for 3 million unique words and phrases.

We used two approaches to obtain word clusters:

1. We computed the top 1,500 word vectors most similar (using cosine similarity) to the vector obtained by adding the vectors of ‘beauty’ and ‘wellness’. We then used a K-means algorithm to cluster these words into 20 clusters.

2. We first computed the top 10% (300K) most frequently appearing words and then computed ~700 word vectors from this list most similar (cosine similarity) to the vector obtained by adding the vectors of ‘beauty’ and ‘wellness’. We then used a K-means algorithm to create 20 cluster of these words.

ResultsAn inspection of the word clusters reveals that the following categories of words are associated with beauty and wellness. These categories are:

1. Products. Associated words include fragrance, perfume, makeover, cosmetic, cosmetic surgery, shampoo, soaps, healing.

2. Spa/salon. Associated words include salon, spa, grooming, massage.

3. Activities. Associated words include gym, fitness, dieting, weight loss, pilates, yoga, cardio, meditation.

4. Nutrition. Associated words include diet, nutrition, nutritional supplements, nutritionalist, foods, herbs, essential oils.

5. Health care. Associated words include care, lifestyle, health, health care, natural.

6. Culture and self-care. Associated words include culture, entertainment, educational, cuisine, arts, recreation, leisure, enjoyment.

7. Environment. Associated words include scenery, landscape, amenities, tourism, hospitality, boutiques, sustainability, garden.

8. Similar meaning. These words include glamour, timeless, aesthetic, gorgeous, goodness, beautiful, fabulous, unique.

13

To visualize the relation of these words, we took representative words from each cluster and performed multidimensional scaling (MDS) on the word vectors for the selected words. MDS preserves relative distances between points in the data. Running such an algorithm provides a spatial display of the words that preserves relative distances on a 2-dimensional space. In the display, we show both “Beauty” and “Wellness” as anchor words. Every other word is related to both Beauty and to Wellness. Words that are physically closer in distance to Beauty are in fact more closely related to Beauty semantically, and vice versa. Words that reside in between, equidistant from both target words, are equidistant from the concepts of Beauty and Wellness.

Thus, the display shows that Products lie closer to Beauty than to Wellness. Nutrition and Activities lie closer to Wellness than to Beauty. Health Care, Spas, and Culture are about equidistant from both.

Clustering of words shown on the MDS display.Products, Spa/salon, Activity, Nutrition, Health Care, Culture and Self-care, Environment, Similar Meaning

Healingsoaps

fragrance

perfume

makeover

Cosmetic

shampoo cosmetic_surgery

grooming

massagespa

salon

fit

gyms

dieting

Weight_Loss

fitness

yoga

Pilates

cardiomeditation

Tai_Chidiet

Nutrition

nutritionist

nutritional_supplements

herbalherbs

essential_oils

foods

nutraceutical

Naturalcare

lifestyle

health

healthcare

Healthy

healthier

Wellness

Beauty

glamour

timelessaesthetic

gorgeous

goodnessbeautiful

fabulous

fashion Style

unique

scenery

sustainability

landscapes

amenities

tourismhospitality

boutiques garden

culture

cultural

entertainment

educational

recreation

arts

enjoyment leisure

excellence

cuisine

3

2

1

0

-1

-2

-3

-4

-3 -2 -1 0 1 2 3 4

14

We took each of these categories and compared them to the Global Wellness Economy Report of economic trends from 2015. There was a remarkable concordance between these linguistically derived categories and the categories identified in the GWI Report.

Global Wellness Economy: $3.7 trillion in 2015Concordance between the categories that link beauty and wellness from the linguistic analysis of Google News from the last 10 years and report of the Global Wellness Institute Economy Monitor.

Word Category Global Wellness Economy Category Economic WorthProducts Beauty & Anti-Aging $999b

Spa/salon Spa Industry, Thermal/Mineral Springs $150b

Activities Fitness & Mind-Body $542b

Nutrition Healthy Eating, Nutrition & Weight Loss $648b

Health Care Preventitive, Complementary Medicine $733b

Environment Wellness Tourism, Wellness Lifestyle Real Estate $682b

Environment

Health Care

NutritionActivities

Products

Spa/salon

15

ImplicationsThe categories of concepts derived from natural language processing using 10 years of Google news as the linguistic corpus was in concordance with the economic categories identified by the GWI Economic Monitor. One category of word clusters is not represented in the global wellness categories. This is the category of Culture and Self-care. This category includes, arts, education, entertainment, and cuisine, for example. Culture, arts, and activities driven to care for one’s self and to flourish, represent a domain that could be a focus of Global Wellness Economy analyses.

The second category of note are words with meanings that embody elements of both beauty and wellness. The following 12 words are related to both beauty and wellness: aesthetic, allure, elegance, fabulous, glamour, goodness, radiant, sensual, simplicity, style, uniqueness, and vitality. These words serve as a semantic bridge capturing some of the meaning of beauty and some of the meaning of wellness. These concepts highlight strategic targets for the Wellness Industry and could be used for marketing if one wishes to link beauty and wellness.

16

ReferencesChatterjee, A., Thomas, A., Smith, S. E., & Aguirre, G. K. (2009). The neural response to

facial attractiveness. Neuropsychology, 23(2), 135-143. doi:10.1037/a0014430

Chowdhury, G. G. (2003). Natural language processing. Annual Review of Information Science and Technology, 37(1), 51-89. doi:10.1002/aris.1440370103

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.

Croley, J., Reese, V., Wagner, R. F., & Jr. (2017). Dermatologic features of classic movie villains: The face of evil. JAMA Dermatology, 153(6), 559-564. doi:10.1001/jamadermatol.2016.5979

Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: The implicit association test. Journal of Personality and Social Psychology, 74(6), 1464-1480. doi:10.1037/0022- 3514.74.6.1464

Greenwald, A. G., Nosek, B. A., & Banaji, M. R. (2003). Understanding and using the Implicit Association Test: I. An improved scoring algorithm. Journal of Personality and Social Psychology, 85(2), 197-216. doi:10.1037/0022-3514.85.2.197

Jamrozik, A., Oraa Ali, M., Sarwer, D. B., & Chatterjee, A. (2017). More Than Skin Deep: Judgments of Individuals With Facial Disfigurement. Psychology of Aesthetics, Creativity, and the Arts, No Pagination Specified-No Pagination Specified. doi:10.1037/aca0000147

Kim, H., Adolphs, R., O’Doherty, J. P., & Shimojo, S. (2007). Temporal isolation of neural processes underlying face preference decisions. Proceedings of the National Academy of Sciences, 104(46), 18253-18258. doi:papers2://publication/doi/10.1073/pnas.0703101104

Langlois, J. H., Kalakanis, L., Rubenstein, A. J., Larson, A., Hallam, M., & Smoot, M. (2000). Maxims or myths of beauty? A meta-analytic and theoretical review.Psychological Bulletin, 126(3), 390-423. doi:papers2://publication/uuid/C0EFC95F-9886-4893-99F1-E5F12EE86ECE

Wang, T., Mo, L., Mo, C., Tan, L. H., Cant, J. S., Zhong, L., & Cupchik, G. (2015). Is moral beauty different from facial beauty? Evidence from an fMRI study. Social Cognitive and Affective Neuroscience, 10(6), 814-823.

17

AcknowledgmentMiriam Rosen and Franziska Hartung collected and analyzed data for Study 1b.

Lyle Unger helped design and Rohan Ghuge conducted the analysis for Study 2.

18

Sponsors

“At Biologique Recherche, we observe our customers making the complex and obvious connections between Beauty and Wellness. Therefore, it was highly motivating for us to support this piece of research, with a scientific and consumer centric angle, delving into the why and the how. This will help our brand and the industry overall, to better anticipate the future of an integrative approach between Beauty and Wellness.”

- Pierre-Louis Delapalme and Rupert Schmid, Co-Chairmen, Biologique Recherche

ABOUT BIOLOGIQUE RECHERCHE: For over 35 years Biologique Recherche’s unique methodology has built a strong reputation for astounding effectiveness based on a clinical approach to skincare, delivering immediate and long-lasting results. Combined with highly customized protocols and meticulous procedures which recondition the epidermis, Biologique Recherche’s extensive range of skincare products are highly concentrated in botanical, marine and biological active ingredients that are cold formulated in its own laboratory in France. Biologique Recherche is the partner of choice in over 70 countries for exclusive medical spas and day spas in addition to the world’s premiere luxury hotel spas. Visit Biologique Recherche at www.biologiquerecherche.com.

“Sustainability and Performance: these are the values we stand for. Our reference and inspiration for our two skin care brands, designed and manufactured in Italy. Comfort Zone, a spa skin care brand with 20-year heritage, appreciated for its integrated approach and Science-based Conscious Formulas and Skin Regimen, a Modern Plant Chemistry™ approach we are launching in 2018 as an advanced response to Pollution, Stress and Lifestyle aging.”

- Davide Bollati, Group Chairman of Davines, a certified B Corporation

ABOUT [comfort zone]: The [ comfort zone ] brand was conceived and launched in 1996 as the skincare division of the Davines Group, which was founded in Parma, Italy, in 1983 by the Bollati family. What began as a research laboratory for the development of high-quality, highly effective products has grown into an internationally successful professional spa brand with a diverse range of product and treatment offerings. [ comfort zone ] represents a complete system of care for the skin, body, and soul. Our exclusive collection of products, treatments, and rituals has been created with an unwavering commitment to finding the most powerful ingredients and delivering the most effective results. We believe in working from the inside out and from the outside in to improve the human condition and treat the whole body. We seek to promote a holistic, healthy and sustainable lifestyle, based in science and strengthened by passion. Visit [comfort zone] at www.comfortzone.it.

19

“The HydraFacial Company is proud to partner with the Global Wellness Institute on the “Beauty2Wellness” study to achieve our goal of promoting skin wellness around the world. As a leader in skin health, we pioneered Hydradermabrasion because we understand the power of hydration to achieve healthy, radiant skin. With the results of the study, we look forward to expanding our knowledge and strengthening our message that skin health is the foundation of beauty.”

- Clint Carnell, CEO, The Hydrafacial Company

ABOUT HYDRAFACIAL: The HydraFacial MD® resurfacing procedure thoroughly cares for your skin, providing cleansing, exfoliation, extractions, and hydration, including Vortex-Fusion® of antioxidants, peptides, and hyaluronic acid. The HydraFacial MD® is a non-invasive, non-surgical procedure that delivers instant results with no discomfort or downtime. The procedure is immediately effective. Visit HydraFacial at www.HydraFacial.com.

“As the beauty industry continues to evolve in the face of consumer demands for cleaner, healthier products, we as a brand must be able to respond mindfully and with greater efficiency. The notion that products be made to address only a singular issue like the prevention of fine lines and wrinkles, rather than the overall health and wellness of the skin first and foremost, is antiquated. By supporting organizations like the Global Wellness Institute, along with our continual investment in research and development, we’ve dedicated ourselves to the continual evolution of this principle. Immunocologie is a brand founded out of necessity and desire through one woman’s personal journey. The necessity to understand the skin as the body’s largest organ and first line of immunological defense; the desire to create a skincare offering as luxurious as it is healthy, natural and effective.”

- Karen Ballou, CEO, Immunocologie

ABOUT IMMUNOCOLOGIE: Immunocologie is a skincare brand with its foundations rooted in one woman’s personal journey. Following a diagnosis of cancer, and with over 30 years of experience in the skincare industry, Karen Ballou understood that the skin is the first line of the body’s immunological defense – and wanted to create a skincare offering as luxurious as it is healthy, natural and effective. These principles are the basis of the Immunocologie brand, which is uniquely focused on the source of the skin’s performance and wellbeing: its immune health. Visit Immunocologie at www.immunocologie.com.

20

“The connection between beauty and wellness is far more than a superficial proposition, at OM4 Organic Male our mission is to help men understand the importance of skin health and wellness, and make the connection between looking good, feeling good and achieving results. OM4 is a proud sponsor of the GWI Beauty2Wellness research and helping partners translate data into strategies for capturing a greater percentage of the largest yet untapped market in spa.”

- Mike Bruggeman, CEO and Chief Formulation Officer, OM4 Organic Male

ABOUT OM4 ORGANIC MALE: OM4 Organic Male is the first skin type and condition-specific professional men’s line to launch in the US. On the leading edge of performance-based, green science organics, OM4 globally sources clinically-advanced, socially-responsible ingredients to target the unique biological skin differences and concerns of men. The brand mantra: 4 PRODUCTS | 4 STEPS | 4 MINUTES | 4 MEN. Color coded by skin type with each step numbered, OM4 is intuitively designed to be fast, easy and effective. OM4’s core business is to help partners: (1) grasp the psychology of selling to men, and (2) capture a greater percentage of the fastest growing market in spa. Visit OM4 Organic Male at www.om4men.com.

“At Performance Health, we are committed to research on multiple levels. We admire the Global Wellness Summit for the research investments they have made and will continue to make via the Global Wellness Institute; investments that create positive impact and shape a future that will benefit us all. And with so many of our brands utilized in wellness, we also applaud them for addressing the very important topic of beauty and wellness.”

- Lynda Solien-Wolfe, LMT, Vice President, Massage and Spa

ABOUT PERFORMANCE HEALTH: Headquartered in Akron, Ohio, Performance Health is a leading designer, manufacturer and marketer of branded massage, spa, rehabilitation, and wellness products sold into a variety of U.S. clinical markets, leading national retailers and in over one hundred countries through a multi-national network of distribution partners. The Company’s product offering includes an innovative line of market-leading topical analgesics, professional massage products and a broad range of rehabilitation and wellness products. Performance Health markets its diverse product offering under the well-known and highly recognized TheraBand®, Biofreeze®, Cramer®, Bon Vital’®, Thera°Pearl® and Perform® brand names. Visit Performance Health at www.performancehealth.com.

21

ABOUT THE GLOBAL WELLNESS INSTITUTE: The Global Wellness Institute (GWI), a non-profit 501(c)(3), is considered the leading global research and educational resource for the global wellness industry, and is known for introducing major industry initiatives and regional events that bring together leaders to chart the future. GWI positively impacts global health and wellness by advocating for both public institutions and businesses that are working to help prevent disease, reduce stress, and enhance overall quality of life. Its mission is to empower wellness worldwide. Visit the Global Wellness Institute at www.globalwellnessinstitute.org.

22

333 S.E. 2nd Avenue, Suite 2048Miami, FL 33131, USA

www.globalwellnessinstitute.orgTwitter: @Global_GWI