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Supersize me

It's time to stop blaming fat people for their size, says Alison Motluk

WHETHER it is undertakers introducing a new range of extra-large coffins or airlines planning to charge passengers by the kilo, these days our expanding waistlines are rarely out of the news. It is hard to ignore the fact that body shape has changed dramatically over the past few decades.

In 1992 about 13 per cent of Americans were clinically obese. Only 10 years later that figure had rocketed to 22 per cent and in the three fattest states, Alabama, Mississippi and West Virginia, it was over 25 per cent. As the UK, Australia and many other western countries follow the US lead, the epidemic of obesity is now seen as one of the developed world鈥檚 biggest public-health problems.

It is tempting to blame fat people for the state they鈥檙e in. But health officials have recently begun to focus on a different culprit: the so-called 鈥渙besogenic鈥 environment. In the US, goes the argument, the prevailing culture actually promotes obesity, making an unhealthy lifestyle the default option.

Take diet. 鈥淐alorie-dense foods are far more readily available than ever before,鈥 says Martin Binks, a psychologist at Duke University鈥檚 Diet and Fitness Center in Durham, North Carolina. Thanks to widespread affluence and agricultural subsidies, food in the US is cheap and plentiful. Because fewer households have a stay-at-home parent to prepare meals from scratch, families increasingly turn to highly processed convenience foods, takeouts or fast-food restaurants. Half the average American food budget goes on food eaten outside the home, much of which is high-fat.

Another insidious influence on the American diet has been the gradual increase in portion sizes. 鈥淵ou eat more,鈥 says Judith Stern, a nutritionist and physician at the University of California at Davis, 鈥渆ven if you don鈥檛 finish it.鈥 Restaurants and processed-food manufacturers can boost their profits by racheting up portion size and charging a little more because the price of food ingredients is so low relative to other costs such as packaging and transport. The original 1960s McDonald鈥檚 meal of a hamburger, fries and a 12-ounce Coke contained about 590 calories. But today, a quarter-pounder with cheese, supersized fries and Coke 鈥 a meal that some kids consider an after-school snack 鈥 racks up a whopping 1550 calories. That鈥檚 about three-quarters of the recommended daily calorie intake for an average woman.

The supersized diet is becoming the norm just as activity levels are dropping to an all-time low. 鈥淭here鈥檚 a great deal less access to physical activity than ever before in history,鈥 says Binks. The problem starts young. One-third of US secondary-school students fail to get enough physical activity and over a tenth get none at all, according to recent figures from the Centers for Disease Control in Atlanta, Georgia. 鈥淭he average child doesn鈥檛 have any physical activity in school any more,鈥 says Binks. Many schools no longer even have breaks, let alone structured physical education, he says. 鈥淧hysical activity is put on the back burner in favour of test results.鈥

And thanks to the way that most US towns and cities are designed, it is becoming increasingly difficult to get anywhere without driving. 鈥淲e have suburbs without sidewalks,鈥 laments Stern.

Ironically, the US鈥檚 obesogenic environment is one that societies through the ages have dreamed of: tasty cheap food in abundance, and barely a lick of hard work to be done. Who would have thought that it would one day hasten our demise?

Supersize me

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