Obesity WHY ARE WE SO FAT?

Whole books have been written (and movies made) about why Americans are becoming the obesity leaders of the Western world. Some people point to biology. Others blame the restaurants, particularly the fast-food ones. Yet others suggest that we are fat, and lazy, and unmotivated to take control of our weight. Each of these arguments has its merits, and there is probably a lot of truth to each one. But perhaps the problem is not quite so obvious. That could help explain why otherwise intelligent people don't notice that when they stuff their faces, they're stuffing their jeans as well.

Two very recent events have focused media attention on this issue. The first was the production of the movie "Supersize Me," where a man deliberately stuffed himself full of high-calorie food from McDonald's for a month, gaining 25 pounds in 30 days. The other was the arrival on the fast-food scene of the "Monster Burger" by Hardee's. These two events, occurring close in time as they did, provided a forced view of what we eat.

It is a very serious issue. In the April 24, 2003 issue of the New England Journal of Medicine, researchers looked at correlations between obesity and deaths from cancer. Overall they found that people who were markedly obese, with a body mass index (BMI) of more than 40 were more than 50% more likely to die of cancer than those whose weight was proportional to height. The risk came from many different types of cancer including cancer of the colon and rectum; liver; gall bladder; pancreas, kidney, and other sites and types. They concluded that obesity accounts for 14% of all cancer deaths in men, and 20% of all cancer deaths in women. This research didn't even include all the other risks that come with obesity. They include type 2 diabetes, heart disease, high blood pressure. Extra weight can put stress on the joints and cause or aggravate arthritis. The burden placed on our medical insurance costs is significant. In addition, it is a hidden but significant expense in our taxes. People are living longer, and those with illnesses stemming from being overweight are a significant part of those who are over 65 and receive Medicare.

Hardee's "Monster Burger" has 2/3 lb. (before cooking) of beef, three pieces of bacon, and three pieces of cheese. It has plenty of mayonnaise and the whole thing is served on a buttered bun. It serves up a monster load of 1,420 calories (Los Angeles Times). Other businesses have done similar things. Pizza Hut offers a "family sized" pizza (Los Angeles Times).

By carefully reading such articles, we note one problem with the discussion about Americans and over-eating. In this article, a huge serving of 1,420 calories (not including any side dishes, drink or dessert) has been compared to a pizza designed to feed many people. If one person eats all of Pizza Hut's biggest pizza, clearly that person has consumed too many calories. However, comparing the two in this article is misleading. What would matter with the Pizza Hut Pizza is whether they deliberately set out to get people to consume at least twice as much as they might have otherwise. According to this article they did not; they simply created a pizza that would serve more people. This could be praised in a different kind of article, because it would mean fewer cardboard boxes and presumably more efficient use of the fuel used to bake the pizzas. It's all in the slant of the article.

While it's easy to criticize both McDonald's and Hardee's (and Pizza Hut, apparently with less cause), the truth is that anyone can walk into any of these places and find ways to limit their caloric consumption -- by drinking water or a diet soda, and by eating more salad and less meat, cheese and bread. While some suggest that we should go further and curb advertising, the truth is that the Constitution allows companies to advertise their wares.

The answer to why Americans are getting fat may not be as simple as the size of Hardee's biggest hamburger or Pizza Hut's biggest pizza, because the truth is that every single American could march into Hardee's today and eat a Monster Burger, and it would never show on the scales -- if they only did it once. The question becomes, How much do we have to overdo it at McDonald's,...

When a customer orders a "small" side of French fries at McDonald's, what they really get is "medium." The small size is for "kid's meals," and not offered to adults. Once people have bought the food, they tend to eat all of it.
Others see all the weight gain as character flaws. People are too lazy too exercise and not willing to control what they eat and how much of it they have. However, two-thirds of Americans are overweight. Have of them are obese. It seems odd that one-third of the country would have such a significant lack of control when it comes to food while building one of the most successful countries the world has ever seen. It seems likely that the progression of weight gain isn't quite that simple.

Craig Lambert, the central person in "Supersize Me," gained 25 lb. In one month simply by eating all his food at McDonald's for one month. This merits some examination. This means he ate 90 meals at McDonald's. He could have spread his weight gain out over the year simply by eating an average of 7 1/2 meals a month at McDonald's. That's not really a lot: four lunches, two dinners and two breakfasts would do it, choosing the same types of food Lambert chose. In addition, it would only take a little over 3 such meals in a month to gain over 12 lb. In one year. In three years, that would make many people obese.

Most Americans now know that they have to balance exercise with calories to either maintain or lose weight. To burn off the "Monster Burger," according to the Los Angeles Times, would take a considerable amount of extra exercise -- more than most people might be willing to do to work off one meal. And, remember that the calories in the "Monster Burger" doesn't include any side order of fries, drink, etc. It would take almost 3 1/2 hours of walking at a fast rate, or nearly 2 hours of jogging, over 3 hours of basketball, almost 2 1/2 hours of aerobics. And what if a person ate two in the same month? All their exercise efforts would be soaked up by those two hamburgers.

Most people won't eat the equivalent of a Monster Burger every day. If they eat more than they usually do, however, they may or may not be aware of it. A larger portion of French fries may not look like the extra amount of food it really is. Most people would not intentionally do what Lambert did, but since it happens over a period of years instead of one month, they don't notice. People don't blow up as Tim Allen did in "The Santa Clause," inexplicably suddenly over-eating very fattening foods and then waking up the next day weighing 40 lb. more than they had the day before. The extra calories creep up, unnoticed.

We do need to be concerned about the images television is sending to our children, but legislation controlling ads about food for children will be hard to regulate. It has to be up to the parents to educate their children about good eating habits. This might well start at the drive-in window by parents saying, "I'm not going to supersize this meal because I don't need the food, and it won't' be good for me," instead of cheerfully calling out, "Supersize me!" They can limit portions in other ways. For instance, they could order one large order of French fries -- and have those be the French fries for everyone at the table. They can do simple things like ordering a smaller pizza and getting, or making, a salad to go with it. They could encourage their children to eat salads from very early in childhood by presenting salad ingredients cut very small as finger food for toddlers.

The fact is that restaurants, and especially the big fast food chains that have stockholders to whom they must answer, are big business. Their goal is to sell as much food as they can, and to get as much of the market share as they can. They do specifically target our children, not only with the hidden delights of a toy in the "kid's meal" but with cereal praised for its bright colors and odd flavors (chocolate, for instance) instead of the argument that they will be healthier and stronger if they eat nutritiously.

Parents must counter-balance this…