An empire of fat

FOR MOST OF THE twentieth century, the Soviet Union stood as the greatest obstacle to the worldwide spread of American values and the American way of life. The collapse of Soviet Communism has led to an unprecedented “Americanization” of the world, expressed in the growing popularity of movies, CDs, music videos, television shows, and clothing from the United States. Unlike those commodities, fast food is the one form of American culture that foreign consumers literally consume. By eating like Americans, people all over the world are beginning to look more like Americans, at least in one respect. The United States now has the highest obesity rate of any industrialized nation in the world. More than half of all American adults and about one‑quarter of all American children are now obese or overweight. Those proportions have soared during the last few decades, along with the consumption of fast food. The rate of obesity among American adults is twice as high today as it was in the early 1960s. The rate of obesity among American children is twice as high as it was in the late 1970s. According to James O. Hill, a prominent nutritionist at the University of Colorado, “We’ve got the fattest, least fit generation of kids ever.”

The medical literature classifies a person as obese if he or she has a Body Mass Index (BMI) of 30 or higher – a measurement that takes into account both weight and height. For example, a woman who is five‑foot‑five and weighs 132 pounds has a BMI of 22, which is considered normal. If she gains eighteen pounds, her BMI rises to 25, and she’s considered overweight. If she gains fifty pounds, her BMI reaches 30, and she’s considered obese. Today about 44 million American adults are obese. An additional 6 million are “super‑obese”; they weigh about a hundred pounds more than they should. No other nation in history has gotten so fat so fast.

A recent study by half a dozen researchers at the Centers for Disease Control and Prevention found that the rate of American obesity was increasing in every state and among both sexes, regardless of age, race, or educational level. In 1991, only four states had obesity rates of 15 percent or higher; today at least thirty‑seven states do. “Rarely do chronic conditions such as obesity,” the CDC scientists observed, “spread with the speed and dispersion characteristic of a communicable disease epidemic.” Although the current rise in obesity has a number of complex causes, genetics is not one of them. The American gene pool has not changed radically in the past few decades. What has changed is the nation’s way of eating and living. In simple terms: when people eat more and move less, they get fat. In the United States, people have become increasingly sedentary – driving to work instead of walking, performing little manual labor, driving to do errands, watching television, playing video games, and using a computer instead of exercising. Budget cuts have eliminated physical education programs at many schools. And the growth of the fast food industry has made an abundance of high‑fat, inexpensive meals widely available.

As people eat more meals outside the home, they consume more calories, less fiber, and more fat. Commodity prices have fallen so low that the fast food industry has greatly increased its portion sizes, without reducing profits, in order to attract customers. The size of a burger has become one of its main selling points. Wendy’s offers the Triple Decker; Burger King, the Great American; and Hardee’s sells a hamburger called the Monster. The Little Caesars slogan “Big! Big!” now applies not just to the industry’s portions, but to its customers. Over the past forty years in the United States, per capita consumption of carbonated soft drinks has more than quadrupled. During the late 1950s the typical soft drink order at a fast food restaurant contained about eight ounces of soda; today a “Child” order of Coke at McDonald’s is twelve ounces. A “Large” Coke is thirty‑two ounces – and about 310 calories. In 1972, McDonald’s added Large French Fries to its menu; twenty years later, the chain added Super Size Fries, a serving three times larger than what McDonald’s offered a generation ago. Super Size Fries have 610 calories and 29 grams of fat. At Carl’s Jr. restaurants, an order of CrissCut Fries and a Double Western Bacon Cheeseburger boasts 73 grams of fat – more fat than ten of the chain’s milk shakes.

A number of attempts to introduce healthy dishes (such as the McLean Deluxe, a hamburger partly composed of seaweed) have proven unsuccessful. A taste for fat developed in childhood is difficult to lose as an adult. At the moment, the fast food industry is heavily promoting menu items that contain bacon. “Consumers savor the flavor while operators embrace [the] profit margin,” Advertising Age noted. A decade ago, restaurants sold about 20 percent of the bacon consumed in the United States; now they sell about 70 percent. “Make It Bacon” is one of the new slogans at McDonald’s. With the exception of Subway (which promotes healthier food), the major chains have apparently decided that it’s much easier and much more profitable to increase the size and the fat content of their portions than to battle eating habits largely formed by years of their own mass marketing.

The cost of America’s obesity epidemic extends far beyond emotional pain and low self‑esteem. Obesity is now second only to smoking as a cause of mortality in the United States. The CDC estimates that about 280,000 Americans die every year as a direct result of being overweight. The annual health care costs in the United States stemming from obesity now approach $240 billion; on top of that Americans spend more than $33 billion on various weight‑loss schemes and diet products. Obesity has been linked to heart disease, colon cancer, stomach cancer, breast cancer, diabetes, arthritis, high blood pressure, infertility, and strokes. A 1999 study by the American Cancer Society found that overweight people had a much higher rate of premature death. Severely overweight people were four times more likely to die young than people of normal weight. Moderately overweight people were twice as likely to die young. “The message is we’re too fat and it’s killing us,” said one of the study’s principal authors. Young people who are obese face not only long‑term, but also immediate threats to their health. Severely obese American children, aged six to ten, are now dying from heart attacks caused by their weight.

The obesity epidemic that began in the United States during the late 1970s is now spreading to the rest of the world, with fast food as one of its vectors. Between 1984 and 1993, the number of fast food restaurants in Great Britain roughly doubled – and so did the obesity rate among adults. The British now eat more fast food than any other nationality in Western Europe. They also have the highest obesity rate. Obesity is much less of a problem in Italy and Spain, where spending on fast food is relatively low. The relationship between a nation’s fast food consumption and its rate of obesity has not been definitively established through any long‑term, epidemiological study. The growing popularity of fast food is just one of many cultural changes that have been brought about by globalization. Nevertheless, it seems wherever America’s fast food chains go, waistlines start expanding.

In China, the proportion of overweight teenagers has roughly tripled in the past decade. In Japan, eating hamburgers and french fries has not made people any blonder, though it has made them fatter. Overweight people were once a rarity in Japan. The nation’s traditional diet of rice, fish, vegetables, and soy products has been deemed one of the healthiest in the world. And yet the Japanese are rapidly abandoning that diet. Consumption of red meat has been rising in Japan since the American occupation after World War II. The arrival of McDonald’s in 1971 accelerated the shift in Japanese eating habits. During the 1980s, the sale of fast food in Japan more than doubled; the rate of obesity among children soon doubled, too. Today about one‑third of all Japanese men in their thirties – members of the nation’s first generation raised on Happy Meals and “Bi‑gu Ma‑kus” – are overweight. Heart disease, diabetes, colon cancer, and breast cancer, the principal “diseases of affluence,” have been linked to diets low in fiber and high in animal fats. Long common in the United States, these diseases are likely to become widespread in Japan as its fast food generation ages. More than a decade ago a study of middle‑aged Japanese men who had settled in the United States found that their switch to a Western diet doubled their risk of heart disease and tripled their risk of stroke. For the men in the study, embracing an American way of life meant increasing the likelihood of a premature death.

Obesity is extremely difficult to cure. During thousands of years marked by food scarcity, human beings developed efficient physiological mechanisms to store energy as fat. Until recently, societies rarely enjoyed an overabundance of cheap food. As a result, our bodies are far more efficient at gaining weight than at losing it. Health officials have concluded that prevention, not treatment, offers the best hope of halting the worldwide obesity epidemic. European consumer groups are pushing for a complete ban on all television advertising directed at children. In 1991 Sweden banned all TV advertising directed at children under the age of twelve. Restrictions on ads during children’s programming have been imposed in Greece, Norway, Denmark, Austria and the Netherlands. The eating habits of American kids are widely considered a good example of what other countries must avoid. American children now get about one‑quarter of their total vegetable servings in the form of potato chips or french fries. A survey of children’s advertising in the European Union (EU) found that 95 percent of the food ads there encouraged kids to eat foods high in sugar, salt, and fat. The company running the most ads aimed at children was McDonalds.