Why Are Americans So Fat? Obesity, Fast Food, and Habits

Introduction: America's Obesity Problem

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 restaurants, particularly fast-food chains. Yet others suggest that Americans are simply fat, lazy, and unmotivated to take control of their weight. Each of these arguments has its merits, and there is probably a great deal of truth in each one. But perhaps the problem is not quite so obvious. That could help explain why otherwise intelligent people fail to notice that when they overindulge, the consequences eventually show up in their waistlines.

Two relatively recent events focused media attention sharply on this issue. The first was the documentary film Supersize Me, in which a man deliberately ate only high-calorie food from McDonald's for an entire month, gaining 25 pounds in 30 days. The other was the arrival on the fast-food scene of the "Monster Burger" from Hardee's. These two events, occurring close together in time, forced a public conversation about what Americans eat and how much of it they consume.

Health Risks and the Scale of the Crisis

This is a very serious public health issue. In the April 24, 2003 issue of the New England Journal of Medicine, researchers examined correlations between obesity and deaths from cancer. Overall, they found that people who were markedly obese — with a body mass index (BMI) greater than 40 — were more than 50% more likely to die of cancer than those whose weight was proportional to their height. The elevated risk came from many different cancer types, including cancers of the colon and rectum, liver, gallbladder, pancreas, kidney, and other sites. The researchers concluded that obesity accounts for 14% of all cancer deaths in men and 20% of all cancer deaths in women.

That research did not even include all the other risks associated with obesity. These include type 2 diabetes, heart disease, and high blood pressure. Excess weight places stress on the joints and can cause or aggravate arthritis. The burden on medical insurance costs is significant. Obesity also represents a hidden but substantial expense in public taxes: as people live longer, those with illnesses stemming from being overweight make up a significant portion of Americans over 65 who receive Medicare.

Fast Food Portions and the Calorie Creep

Hardee's Monster Burger contains two-thirds of a pound of beef (before cooking), three strips of bacon, and three slices of cheese, all served on a buttered bun with generous amounts of mayonnaise. It delivers a staggering 1,420 calories, according to the Los Angeles Times. Other chains have pursued similar strategies. Pizza Hut, for example, offers an oversized "family-sized" pizza.

One problem with much of the media discussion about Americans and overeating is the quality of its comparisons. Placing a single serving of 1,420 calories next to a pizza designed to feed multiple people is misleading. If one person eats an entire large Pizza Hut pizza alone, that person has clearly consumed far too many calories — but that is not what the pizza was designed for. The family-size pizza could actually be praised from a different angle: fewer cardboard boxes and more efficient use of the energy needed to bake the pizzas. The framing of such comparisons matters enormously.

While it is easy to criticize McDonald's, Hardee's, and Pizza Hut, the truth is that anyone can walk into any of these restaurants and find ways to limit caloric consumption — by drinking water or a diet beverage, and by choosing salad over extra meat, cheese, and bread. Some advocates suggest that we should go further and restrict food advertising, but the Constitution permits companies to advertise their products.

The answer to why Americans are getting heavier may not be as simple as the size of Hardee's biggest hamburger, because every American could eat a Monster Burger today and it would never register on the scale — if they only did it once. The real question is: how much does a person have to overindulge, over time, to end up buying clothes in a larger size? The clue lies in the story of Supersize Me.

One major cause is the steady growth in portion sizes. When a customer orders a "small" side of French fries at McDonald's, what they actually receive is effectively a medium portion. The small size is reserved for children's meals and is not offered to adults. Once people buy food, they tend to eat all of it — regardless of whether they are still hungry.

The central subject of Supersize Me gained 25 pounds in one month by eating all of his meals at McDonald's — a total of 90 meals. That weight gain could have been spread over an entire year simply by eating an average of seven and a half McDonald's meals per month: four lunches, two dinners, and two breakfasts, choosing the same types of food. In fact, eating just over three such meals per month would result in gaining more than 12 pounds in a single year. Over three years, that pace would make many people clinically obese.

To burn off the Monster Burger alone — not counting any side order of fries or a drink — would require nearly three and a half hours of brisk walking, almost two hours of jogging, more than three hours of basketball, or nearly two and a half hours of aerobics, according to the Los Angeles Times. If a person ate two Monster Burgers in the same month, the exercise needed just to offset those two meals would consume all of their typical physical activity for that period.

Most people, of course, will not eat the equivalent of a Monster Burger every day. But if they eat more than usual, they may not even be aware of it. A larger portion of French fries may not look significantly different from a smaller one. People do not gain weight the way characters do in the movies — waking up one morning suddenly 40 pounds heavier. The extra calories accumulate slowly, unnoticed, over months and years.

Conclusion: Reversing the Trend

Parents need to raise the next generation to be more aware of what they eat and why, so that excess calories do not accumulate by accident. They also need to model and teach an entirely healthy lifestyle — raising children to enjoy salads, fresh fruits, and vegetables from an early age, and ensuring that television does not substitute too heavily for active play. If parents embrace this responsibility, the next generation may be able to reverse the current trends in which ever-larger portions of food lead inevitably to ever-larger clothing sizes.