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I know that a lot of focus on this board is spent on pointing out the deficiencies of the SAD diet. All true. I for one believe that eating a variety of whole, unprocessed foods is the way to go for optimal health. We may all have our disagreements on which food to include or not but that is just quibbling over the fine print. That is not the purpose of this thread. I am hoping to start a discussion and share ideas on how to address a rising epidemic that we are all, as a nation, paying for in some way.

The nation, as a whole, has gotten more overweight at a near constant rate since 1976. Before that, the obesity/overweight level was constant back to 1960 (seems they did not track it before that). This line graph created by the CDC (Center for Disease Control) illustrates this point: (http://upload.wikimedia.org/wikipedia/commons/8/82/USObesityRate1960-2004.svg)

The available data suggest that large portions of energy-dense foods are contributing to the obesity epidemic (The Supersizing of America: Portion Size and the Obesity Epidemic Rolls, Barbara J. PhD).

Multiple hierarchal regressions revealed that square miles per fast food restaurants and residents per restaurant accounted for 6% of the variance in state obesity rates after controlling for population density, ethnicity, age, gender, physical inactivity, and fruit and vegetable intake. The entire model explained 70% of the total variance in state obesity rates (The relationship between obesity and the prevalence of fast food restaurants: state-level analysis. University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA).

The per‐capita number of fast‐food restaurants in the United States doubled from 1972 to 1999 with the obesity rate increasing from 13.9 percent to 29.6 percent− 113 percent increase in the obesity rate [SS‐AAEA Journal of Agricultural Economics; Who Consumes Fast‐Food and Why? By Zeke Bryant]

Now the next part is somewhat anecdotal...portion sizes at fast food restaurants have dramatically increased. From statements from elders (aka my parents), watching older movies or movies set in the 50's (think American Graffiti), the portion sizes at fast food restaurants has increased dramatically. A regular burger is now a junior burger. A regular fry is now the small!

I recognize this is correlation and not causation but the link cannot be ignored between Fast Food and Obesity.

Instead of trying to change the nations diet (an almost impossible task with feasibility issues), or doing something draconian like outlawing fast food (which would help a lot!), would it not make more sense to make fast food companies limit the portions they serve to fight the obesity epidemic? What are your thoughts?

I want to say thank your for the fun discussion and those that participated. I think that sharing ideas and even being critical can be an enlightening process.

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 I think a better start would be for various governmental and medical organizations to stop lying about what food is healthy and what isn't. Give people correct information and better choices will ensue. Stop subsidizing corn/HFCS so that sodas aren't so cheap in the first place. Taxing it at the back end only gives more money to the fat cats. – Dave S. Jul 12 at 14:22
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 Wrong about what type 2 diabetes people are told. They are told to restrict fat, eat whole grains and maintain. If they were told to cut back on their whole grain carbs, then they would be cured, if they weren't too damaged. – RaiseFitness Jul 12 at 14:47
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 You should definitely watch the BBC doco "The Men Who Made Us Fat" they talk about the rise of super-size meals. Really interesting actually. Companies brought it in thinking if they offered more, then people would spend more at their restaurant/chain and that'd increase profits. The increase in the size of the meal wasn't meant to increase appetite, they thought people would eat more now, and eat less later...but that's the exact opposite of what happened...it actually saw people wanting more...all. the. time. – mzrdnan Jul 12 at 15:17
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 What we eat now affects what we eat later. Lets stop subsidizing unhealthy corn, wheat and soy, and take all that money and use it to spread the word that those things are inherently UNHEALTHY! – RaiseFitness Jul 12 at 15:21
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 Does anyone seriously think a govt ban would work? Prohibition didn't end alcohol use, it just boot-strapped organized crime. Drug bans haven't ended drug use, they've just funded drug cartels. Gun bans haven't lowered gun related crimes, they've just created an illegal black market for guns. Banning 2-for-1 happy hours just made bars offer double-sized drink happy hours. Limiting candy bar sizes only resulted in 2 smaller bars in 1 package. Limit portion sizes? Anyone think this will actually work? Anyone think people WON'T find a way around this? Why do something that won't work? – Talldog Jul 12 at 18:12
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12 Answers

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The problem is not portion size, it is educational and poor food recommendations by the government and any government affiliated agence, Such as AHA, ADA, NIH, etc. When I go to a restaurant, I order as much food as I can eat. If I don't get enough I order more. McDonald's got rid of Supersize meals and we did not suddenly have a decrease in obesity. Now if the government wants to legislate what we eat, they can change what is served in school cafeterias.....that would be a positive change. My mom works in a cafeteria in Alabama, and the pizza sauce is considered a serving of vegetables. They feed kids garbage and call it nutritious. It is no better, and probably worse than fast food! People know what is healthy when they see it, but our government subsidizes the most unhealthy foods such as wheat, soy and corn to artificially lower their prices causing them to end up in everything. Get rid of subsidies or subsidized real vegetables and edible meat would make more of a difference than going after fast food.

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 Because Mark food is addictive. It's like a drug. Except unlike a drug addiction, you cannot abstain from food, and thus it becomes a life battle for the obese. Especially those who have type II diabetes and who are sold by the government that they have to eat "whole grains" to lower their blood sugar levels...do you see where the educational system is wrong there? and that the government endorses this form of education? I suggest you have a look at the BBC Documentary "The Men Who Made us Fat" and it looks a lot at the history and policies that are in place which affect the nation's weight.. – mzrdnan Jul 12 at 15:15
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 Mark, they don't choose to remain unhealthy and fat, a lot of them follow the government diet to a T and they don't become healthier and skinner. Case in point, my wonderful dad who ended up dying of a heart attack. My mom eschewed our Portuguese diet when cooking (his plate only) to make sure he ate the recommended diet. Yeah, that worked alright... @_@ – a mesmerizing trickster Jul 12 at 15:25
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 @Mark your co-worker wants the easy option...as do most people...we are brought up in a world where everything comes way too accessibly....food, drugs, medicines...it's easier to take pills and put a bandaid over the problem for your coworker than it is for him to deal with the cause. Unfortunately we are brought up believing we can have it all...cakes, disease, and medicines to balance it all out ... Weight watchers doesn't teach anyone about anything but a points system, I question whether it would have taught your coworker about health in the real-world outside of WW.... – mzrdnan Jul 12 at 15:30
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 But it's definitely hard...how do you help someone who doesn't want to help themselves... – mzrdnan Jul 12 at 15:32
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 And as an insulin resistant woman who has fought the weight issue very, very hard for many years, I can tell you that it really isn't as simple as you seem to think. – Karen Jul 12 at 18:04
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I think you are asking the wrong question.

The question should be: why do these large portion sizes not satisfy people's hunger?

  • large Big Mac value meal = 1,360 calories (hamburger=550, fries=500, coke=310)
  • medium Big Mac value meal = 1,140 calories (hamburger=550, fries=380, coke=210)
  • small Big Mac value meal = 930 calories (hamburger=550, fries=230, coke=150)

I can speak from experience on this one. The drive through at McDonald's used to be my best friend. Big Mac meal and a Coke; ate it for years. But, invariably come 4:00, I'd be hungry again and thinking "just wait till you get home for dinner." Often I couldn't wait and would raid the candy machine.

How could I eat over half my daily calorie requirement at Noon, and then just 4 hours later be so hungry I couldn't make it home without a snack?

  • Don't say will-power. I've lost 43 pounds since Jan 1 and my will-power hasn't increased one iota.

  • Don't say I wasn't aware enough of the calories. I was, I just hate to live like life is a math problem. I've lost 43 pounds since Jan 1, and I haven't counted a single calorie--not one. Fact is, I don't a clue how many calories I eat every day--no idea at all.

  • Don't say it was lack of portion control. I've lost 43 pounds since Jan 1, and I haven't exercised the fist bit of portion control. I eat any amount I feel like. I don't think at all about how much I'm eating, much less worry about if I'm eating too much.

  • Don't say I've developed discipline or am no longer a glutton. I still relish food as much as I ever did, and my mouth waters just as much over a juicy steak as it ever did.

  • Don't say it's exercise. I don't exercise at all, and I work a desk job.

This is the first time in 20 years I've been even close to a normal weight (despite having tried numerous diets). The only thing--the one and only thing--that has changed has been the TYPE of food I'm eating.

It's the food. The question is: what is there about the McDonald's food that caused it not to keep my hunger at bay? Answer that and you'll have the answer to why fast food leads to obesity.

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 And the reason the food doesn't keep you feeling satieted is because it is not natural food. Ever see obese animals in the wild. Deer living near farms with unlimited food supply stay a healthy weight on their natural diet. We are no different. – RaiseFitness Jul 12 at 17:51
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 I agree--it's the food. Discussion like this one frustrate me, because people are talking about everything except the underlying root problem. They're spending all their time killing mosquitoes (fly swatters, sprays, etc...) instead of focusing on WHY there are a lot mosquitoes (breeding grounds like swamps, standing water, etc...) Eliminate the breeding grounds and you eliminate the mosquito problem. The problem is the type of food, not the portion size. – Talldog Jul 12 at 18:37
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 You lost weight because you ate less calories than you used to eat before that point. You found it easier to eat less because you're not eating crap food. The two ideas are not mutually exclusive. Portion size in this country is too big. The better quality stuff you consume the easier it is to moderate what you eat, and thus you may very well end up eating less whether you intend to or not. Remember, intending to eat less doesn't matter; actually eating less or eating more is what matters. – ben61820 Jul 12 at 20:33
If you reduce portion sizes of crap food, it just means people will eat two smaller portions of crap food instead of one big portion of crap food. Thus, reducing the portion sizes of crap food won't the total number of calories people consume. – Talldog Jul 12 at 21:19
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 @RaiseFitness: Two reasons you do not see obese animals in the wild. 1) Wild aniomals generally have short lives 2) An obese animal is generally unfit and will be killed. Obesity and survival do not mix, and when you are a wild animal, it is all about survival. – Chinaeskimo Jul 13 at 6:28
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I'll give you two other things that happened near 1976:

GMO high gluten wheat was approved by the FDA and just about everyone switched because of the high yield (hence low cost).

The Nixon administration got in the business of telling us what to eat.

In fact, when you look at an inflection point like that you have to account for it with a dramatic change, and I attribute it to the GMO wheat, which basically was an overnight change.

Even with government "education", it still takes a while for the message to sink in and people's habits to change. Likewise portions didn't balloon up over night, they slowly increased. Both of those would be on a timescale longer than what is suggested by the plot you link to.

And to answer your question, the government should not be involved in anyway telling the market what to sell. They have the science wrong now and there's nothing to say they'll ever get it right. I'd rather be left to my own to decide whats good for me.

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I think that the rise of fast food restaurants and the GMO high gluten are interlinked. The availability of cheap wheat led to 'them' injecting gluten into EVERYTHING. A hamburger should really be called a gluten burger. This has allowed fast food to be an inexpensive option (obesity among the poor is the highest) compared to whole foods/traditional restaurants. Also, there is a correlation with the density per square mile of fast food chains and higher obesity. Your statement about markets is an absolute one, should all drugs be legal since their is a market for it? – Mark Jul 12 at 15:14
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 I recognize that most on this board are more than capable to make informed decisions when it comes to food. What about the large percentage of the population that is not? The obesity epidemic has costs for the entire tax base of the USA. Do we not have specific taxes on cigarettes, alcohol, and other consumables we deem unhealthy? – Mark Jul 12 at 15:17
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 The problem is drawing the line. Government would want to tax saturated fat, which is NOT unhealthy. They would not tax cereal grains which ARE unhealthy for most. – RaiseFitness Jul 12 at 15:32
@RaiseFitness...I never once advocated taxing a specific macronutrient or fat. I think you take aim at the fast food companies and focus on total calories. – Mark Jul 12 at 15:46
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 How about taking on the crop subsidies instead. That's a lot of our tax dollars going to support corporate farming and increase corporate profits. The cheap grains then lead to cheap, crappy fast food. Limiting peoples consumption by some restrictive laws isn't going to work. See: prohibition. – Karen Jul 12 at 18:10
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I'm going to take issue with a couple of your comments. First, you've said a few times that the issue is clearly overeating. Eat too much = gain weight is NOT a well known fact of life. I completely disagree with that statement with a very strong qualifier, which is that if you eat too much LOW QUALITY food you will gain weight. I believe that if you eat correct high quality food, quantity becomes unimportant. Do not state things as absolutes when they are not, whether you agree with my statement or not. To me, it's not how much low quality food they eat, but that all most people eat is low quality food. If you eat a lot of high quality food, even a supersized double whatever at a fast food place isn't going to cause much harm if it's done in wildly small proportion. Second, I disagree that people know what's healthy and what isn't, when the government tells them it's cereal grains and other harmful things. Most people actually trust the government, ridiculous as that is.

The other part of your question is essentially political, and there I think the key is freedom of information. I don't think you can force people to be healthy, and honestly I don't think companies that produce these foods are doing anything wrong. They provide a service and people want what they provide. To me it's all about individual responsibility. In regards to the societal cost of nationwide health degredation, unless you're willing to stop caring for those people (which would be a near impossible line drawing exercise) you're stuck.

I recognize that you don't believe education is the answer, but I believe it to the best of poor alternatives.

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 Strong statements, but very accurate and well said! – RaiseFitness Jul 12 at 15:19
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 You are still missing the point that what you consume affects what you burn and what you will consume later. I eat more on Paleo than I did before, but I weigh less, and have much less bodyfat. I do not want government screwing things up anymore than they already have. – RaiseFitness Jul 12 at 15:53
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 Mark, have you considered that maybe excess consumption of calories isn't the cause but rather the result of something else? Like metabolic syndrome? The dates you point out which correlate the rise of obesity with the rise of fast food, also matches with when our fat intake switched from mostly saturated and linolenic-acid based to linoleic-acid, and when corn syrup and other cheap derivatives from corn and soy were discovered for mass use. – Walcott Jul 12 at 16:38
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 @everyone....Yes, eating too much will make you fat. Problem is we view the equation wrong. It is what we eat that causes us to eat to much. Our bodies do not break the laws of thermodynamics. But what you eat can determine if you are hungry again, or if you become addicted to certain foods, or if your blood sugar drops and you need to eat again soon, etc. – RaiseFitness Jul 12 at 19:09
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 Yes eating too much makes us fat, but its an oversimplification of how the body functions. Here's a neat analogy I read earlier: Calories are comparable to a final score in a football game. But the score says nothing about the various plays, players, their injuries, and other details of the game. Calories In Vs Out is definitely NOT a commonly held understanding within Paleo and other alternate diet circles. It's hotly debated. Because people want to know WHY people overeat. And people want to know WHY certain people are at a metabolic disadvantage. – Walcott Jul 12 at 21:10
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You, You're the One.

The entire food distribution system is tuned to deliver mass quantities. Drive thrus and fast inexpensive food - and marketing to deliver same - are part of a super-reward mechanism.

Shamefully there are no brakes on the thing. By participating in it we lose our ability to prepare food. Overconsumption has been made so simple and acceptable that you have to intentionally resist it.

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My first thought is the above mentioned libertarian no.

My second thought is that the people who will be setting up the rules you want are idiots. They believe fat and salt are evil. Do you really think they'll be content to ban super size meals and call it a day?

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I don't know exactly what the ban would be. I think that a meal would have an upper caloric restriction on meals...say 500-700 calories for burger+fries+drink (consider that now it can be 1200-2000 for the same). Some people would order more than one meal. Most (I believe) would accept what was offered and that would be that. – Mark Jul 12 at 14:41
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 Maybe fast food workers should be held responsible like bartenders are for serving alcohol to a drunk. Fat guy comes in and orders a triple burger, fries and a milkshake, and worker gives them a bland chicken salad instead. – RaiseFitness Jul 12 at 15:10
Fair point RaiseFitness! If it's in the best interest of the nation. However, then they would lose a huge customer base, which means a loss of income, which means less money for the government so I don't know that policy would be so supportive of that – mzrdnan Jul 12 at 15:16
lol I wish that would happen! – Mark Jul 12 at 15:32
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I suppose the libertarians will say no. The government shouldn't tell you what to do. The catch is that Americans are dumb as bricks and with out a rule like you're saying they'll eat crap, and too much of it.

I think that portions acros the board in the US are too big. I choose not to eat them. You choose the same prolly. But there are so many babies having babies. These kids don't know right from wrong. They don't know healthy food, even if it is available. They're not going to teach their kids how to eat well. Rules like the OP mentions may help people in this type of situation.

Lustig says a lot of things that are silly but his point that legislation is needed to start resolving our health woes isn't too far off.

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Hey, are you an American? – RaiseFitness Jul 12 at 15:21
I am anything but a libertarian, and I think this is a really, really crappy and ineffective way to go about instituting change in peoples food habits. – Karen Jul 12 at 18:23
Yes American. Born and bred – ben61820 Jul 12 at 18:29
@ben61820....are you as dumb as a brick? I am just using your own assumptions. – RaiseFitness Jul 12 at 19:15
Does "Mikey Likes It" and "You You're The One" work anywhere but the USA to get people to eat more cr#p? What part of dumb as bricks don't you get RaiseFitness? I used to eat that way and I'm sure ben was raised to do the same. I revered Captain Yoby and his burgers, fries and shakes. The pinnacle of eating whan I was 10. – thhq Jul 12 at 19:59
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I do agree very much about the potion sizes today, they are getting quite ridiculous. I think it started getting bad when the base of fast food and to-go cups had to shrink just so that they could fit in cup holders! Larger portions are definitely a factor in the obesity epidemic, but alot of it has to do with the crap that's in fast food, too. Most of the foods in McDonald's are above 70 in the Glycemic Index.

Now I have to admit, I have always been in pretty good physical shape, but I would go eat fast food alot in college. I would typically, after working out or running, would say "That was an exhausting workout, I'm going to go get a Big Mac", and would struggle with reaching my fitness goals (duh...). My problem then, as is alot of people's problem's now, is that they let themselves get hungry and that giant Whopper looks like the only thing that can satisfy them.

I think limiting the portion size of fast food items would be a start but it wouldn't be enough. I think the way it needs to be approached is through better education of consumers and parents making healthy eating a habit for their children.

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 How about taxing the weapons of mass obesity: drive through architecture and marketing? – thhq Jul 12 at 14:47
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 But those things are quantifiable. Higher calorie is not. When I eat dinner, whether at home or out, I eat a higher calorie dinner. I eat a minimum 1200-1500 kcal at dinner every night. Would you tax the fatty burnt ends I get for dinner at least once a week inside the local whole foods? It is more kcal than a large big mac combo. – RaiseFitness Jul 12 at 15:15
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 And it's another reason why our tax code is so fucked up and requires so many monkeys in suits to figure it out. Taxing people who make poor choices is not the answer. Raising taxes on tobacco didn't stop people from buying horribly expensive cigarettes. I'm very anti-smoking, but I have never voted to increase taxes on that very specific audience. Total bullshit! – MathGirl72 Jul 12 at 16:14
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 Have you ever been poor? There was a time in my life when it was cheaper eat a basic McD's hamburger than it was to buy a head of lettuce. Poor choice? Definitely. You want to tax me into eating a head of lettuce instead when that 29 cent hamburger kept my son from being hungry? And, let me tell you, the 29 cents I scraped together was from discarded pennies I found on the ground. I am blessed enough to be in a situation that allows me to feed my family so much better, but taxing those that make unhealthy choices (by your standards) is a very flawed concept. – MathGirl72 Jul 12 at 17:50
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 The taxes on cigarettes were ineffective because tobacco is addictive. Sugar (carbs) is also effectively addictive, because the up and down blood sugar swings trigger severe hunger cravings in many people. Extra taxes and restrictions at the consumer level will just make people pay more to get their fix, just as people who smoke keep paying more and more for tobacco. Taxing the consumers didn't work there, education and hitting the corporations did. – Karen Jul 12 at 18:21
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People eat porridge for breakfast, low fat sandwhich for lunch and quorn spaghetti bolognese for dinner, go for a jog 3 times a week and think they're being healthy as hell

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 Eat eggs for breakfast, a huge salad with some protein in it for lunch, and some veggies and more meat for dinner, and take or leave the jog....and you will be fine – RaiseFitness Jul 12 at 19:14
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I disagree with those that believe government intervention will help ameliorate the problem. It is actually quite arrogant (ignorant as well), to think that you could possibly centralize all the ever evolving and esoteric information into one place and create a regulation that would not immediately have a secondary and thirtiary consequences that you could not plan for. Regulations have unintended and unforeseen consequences, which generate negative externalities so large they ultimately result in a deadweight loss upon society. For just two examples, one could look at the role of the Basil I and Basil II accords and the effect GSEs which together precipatet the massive decline in wealth we as a nation were recently afflicted by. What needs to happen first is for the government to cease the subsidies towards crops like wheat, corn, and soy, as well as halt tariffs on goods like sugar. What we need is a properly incentivized system that allows individuals to freely choose which foods to produce and consume, and whether they choose to drive or walk to work, etc. To paraphrase a section of *HUman Actio*n where Mises describes the market process, a properly incentivized market will not "directly prevent anybody from arbitrarily inflicting harm" upon himself or his fellow citizens, but will exact "a penalty upon such conduct." The problem is that nowadays the market is so stifled with regulations, that the incentive system has been corrupted, so people have less and less incentive to, for instance, take good care of their health (we have drugs for that now, and with universal health care, everyone can reach into their wealthier neighbors pocket to pay for them). I am sure this will get a lot of flack, but I don't care. Doctor's do pro-bono work when it's needed, not when it is not need (my father is a doctor, I know this happens regularly). We can all expect to see the number of Americans who could benefit from non-medicinal intervention being over-treated and overprescribed medications. Oh, but hey, look you're insurance covers it! Personal responsibility, self-reliance and ingenuity are lost qualities in the micro-managed macro-economy that we live in today. Unfortunately it is a far cry from the Classical, Walrasian competitive model that would foster such qualities and spontaneously bring about proper incentives, personal health being just one of many.

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I agree that doing anything in a complex system will have unintended consequences. I am for ending the farmer subsidies. But an unintended consequence would be virtually eliminating every small farm in the USA. Thousands if not tens of thousands stripped of their income and homes. You mention a properly incentivized system...what would that use if you are not going to use the monetary cost of something to change people's behaviors? – Mark Jul 12 at 20:32
I agree that the tax paying base (just over 50% of the eligible population) foots the bill for the non-tax payers and skews people to bad results. The Type II diabetes example above...if the patients had to pay the full cost of the medication, more would opt to lose weight. I agree that if we allowed people to live with the actual consequences of their choices, then more people would make better choices. But do you let a child with a curable disease die because here parents chose not get insurance? This is obviously a multi-faceted issue with ethical concerns, not simple economics. – Mark Jul 12 at 20:37
Interesting insight! – RaiseFitness Jul 12 at 20:37
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 To be stripped of an unsustainable income is not a bad thing. Just like foreclosing on a house is not a bad thing if you can't afford it. We don't need more farmers growing corn, wheat or soy. If you are going to subsidize farmers, subsidize kale farmers, or squash, or anything that has any health benefit, not the standard three of corn wheat and soy. – RaiseFitness Jul 12 at 20:39
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 @Foreveryoung...I'm just an armchair general on my best day who is bored at work. The only field I have extensive knowledge in is hydrology. I like learning and playing Devil's Advocate is often the best way to pull ideas and gain insight from other people. – Mark Jul 12 at 21:06
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I believe that COST is a HUGE issue for many people. I know so many people that eat fast food because it is cheap. If you're trying to feed a family of four, MacDonalds or KFC is the cheapest way to do it.

Let's face it, good food is expensive!

I used to work in a Chinese restaurant adjacent to a Wendy's. Say what you want about Chinese food, but it is basically unprocessed. So many people come in, look at the menu, complain about cost and then go to Wendy's for the dollar menu. I could see them through the front window walking right across.

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I was raised thinking McDonalds was a treat. Eating at home was, and still is, cheaper; but eating packages of macncheese, hot dogs and canned soup wasn't any healthier. Those "homemade" processed foods, and my sedentary behavior, made me fat. Over the decades McDonalds has taken away even the small bit of home cooking, which over time helped me when I started to think about what I ate. A generation that expects drive thru and snack foods has lost the connection to home cooking completely. – thhq Jul 13 at 11:41
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I was actually talking to someone about the idea of fast food yesterday. She was recounting a trip to Thailand, where high quality, plentiful, and cheap food was everywhere. So much so, that cooking for herself would have cost more than eating out.

The fastness and portion size have nothing to do with it, it is the low quality of ingredients, some of which I'm not sure can even be considered food, at fast food chains in the states that is the problem. Our bodies have to take in actual nutrients to be satiated. Much of the world has abundant, hyperpalatable, instantly available street food, without the ballooning waistlines we have here, we just screwed up on our ingredients list.

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