Episode 58
From Starving to Stuffed
From Starving to Stuffed: The Evolution of Obesity in America
The rise of ultra-processed foods in the United States closely parallels the surge in obesity rates and increased caloric intake observed from the 1980s onward. Starting in the 1970s, shifts in food production and consumer habits paved the way for these foods to become dietary staples, ultimately contributing to the obesity epidemic we see today. Let’s explore how these changes unfolded and their direct link to America’s rising weight problem.
1970s: Setting the Stage for Ultra-Processed Foods
In the 1970s, the food industry underwent dramatic changes that laid the groundwork for the proliferation of ultra-processed foods.
- Economic Shifts and Agricultural Policies
- In 1973, new agricultural policies began to encourage farmers to produce more crops like corn, soy, and wheat. These policies made ingredients, particularly high-fructose corn syrup (HFCS) from corn, much cheaper for food manufacturers to obtain (Nestle, 2002). As a result, companies could produce food more cost-effectively and in larger quantities, leading to affordable, calorie-dense, ultra-processed foods.
- Rise of Convenient Snack Foods and Fast Food
- At the same time, the popularity of fast-food chains and processed snacks grew. Brands like McDonald's, Coca-Cola, and Frito-Lay expanded their offerings and marketed these convenient, hyper-palatable foods to the masses. They loaded these products with refined sugars, fats, and additives to enhance flavor and shelf life, making them hard to resist and easily accessible.
- The “Diet” Food Craze
- The 1970s also saw a surge in demand for high-protein diet products due to growing concerns about carbohydrates. Low-carb became the flavor, and at any given time, 10% of the country was on low-carbohydrate diets. Ironically, these “diet” foods often contained as many or more calories as regular options.
1980s: Ultra-Processed Foods Take Center Stage, and Obesity Rates Start to Climb
By the 1980s, ultra-processed foods had fully embedded themselves in American diets, creating a foundation for the obesity epidemic.
- Processed Food Production Surges
- Food companies expanded their product lines in the 1980s, launching a wide range of snack foods, frozen meals, and sugary drinks. These foods were not only inexpensive but also tasty, thanks to the addition of refined sugars and fats, as well as preservatives to prolong shelf life (Monteiro et al., 2013). Marketing highlighted their convenience, appealing to busy families and individuals.
- Caloric Intake Climbs
- Alongside the rise in ultra-processed foods, average daily caloric intake also increased. Between the late 1970s and early 2000s, Americans consumed over 200 more calories per day. This rise came largely from high-calorie processed snacks and sugary drinks that were easy to consume between meals (Wright et al., 2004).
- Obesity Rates Begin Their Upward Trajectory
- During the 1980s, obesity rates started climbing. From 1980 to 2000, the obesity rate in U.S. adults jumped from 15% to 30% (Flegal et al., 2012). Children and teenagers weren’t spared either; childhood obesity rates nearly tripled, aligning with the increased availability of ultra-processed foods.
1990s: Fast Food and Convenience Foods Dominate the American Diet
The 1990s brought even more ultra-processed foods, solidifying their role in the American diet.
- Fast Food Reigns Supreme
- Fast-food outlets exploded across the country in the 1990s, offering cheap, calorie-dense meals that were easily accessible. These chains embraced supersizing, encouraging customers to choose larger portions for just a small price increase. As a result, Americans began consuming more calories per meal, often in ultra-processed fast food.
- Sugary Beverages Become a Staple
- Consumption of sugar-sweetened beverages (SSBs) like sodas and sweetened teas, also skyrocketed during this decade. Many of these drinks relied on HFCS, delivering a heavy dose of empty calories without satisfying hunger. Studies show that sugary drinks don’t curb appetite the same way solid foods do, leading people to consume extra calories without feeling full (Malik et al., 2010).
- Caloric Intake Peaks
- By the end of the 1990s, Americans’ average daily caloric intake had reached new heights, with ultra-processed foods making up a significant portion of the diet. Research indicates that nearly 60% of Americans’ daily calories came from ultra-processed foods by the late 1990s (Monteiro et al., 2013). The rise in these calorie-dense, low-nutrient foods is directly correlated with increasing body weight and obesity rates.
2000s to Present: Ultra-Processed Foods and the Obesity Epidemic
As we moved into the 2000s, ultra-processed foods remained a dominant force in the American diet, pushing obesity rates even higher.
- Obesity Reaches Public Health Crisis Levels
- By 2020, nearly 42% of American adults and 20% of children were considered obese (Hales et al., 2020). Studies have consistently linked this trend with ultra-processed foods, which are designed to be “hyper-palatable” and, thus, difficult to resist. Their addictive taste profile has fueled a snacking culture, where more people consume larger portions and eat more frequently throughout the day.
- Calories from Ultra-Processed Foods Remain High
- Research shows that 60-70% of the average American’s daily calories now come from ultra-processed foods (Juul & Hemmingsson, 2015). These foods are often low in fiber, protein, and essential nutrients, which leaves people unsatisfied and more likely to overeat. Additionally, foods high in refined carbs and sugars cause blood sugar spikes and crashes, leading to frequent hunger pangs and cravings.
- The Health Toll Beyond Obesity
- Ultra-processed foods haven’t just contributed to obesity; they’ve also been linked to type 2 diabetes, cardiovascular disease, and certain cancers. Their high-calorie density, poor nutritional profile, and use of additives have been shown to negatively impact health, making them a major public health concern.
- Efforts to Combat Ultra-Processed Food Consumption
- Despite public health campaigns promoting whole foods, ultra-processed options remain attractive for many Americans due to their affordability and convenience. In many low-income areas, they’re also more readily available than fresh, whole foods, perpetuating health disparities.
Conclusion: Ultra-Processed Foods and America’s Obesity Epidemic
Since the 1970s, the rise of ultra-processed foods in the United States has closely tracked with an increase in calorie consumption and obesity rates. As companies produced more of these convenient, highly palatable foods, Americans’ eating habits changed, leading to greater calorie intake through frequent snacking, sugary drinks, and supersized portions. The dominance of ultra-processed foods in the diet has not only contributed to rising obesity rates but also to an increase in related health issues like diabetes and heart disease.
Although efforts to reduce ultra-processed food consumption continue, their deep-rooted presence in American culture and food systems makes reversing the trend challenging. For a healthier future, we need a multifaceted approach that includes improved access to nutritious foods, public health policies, and greater awareness about the risks associated with ultra-processed foods.
References:
- Malik, V. S., et al. (2010). Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care, 33(11), 2477-2483.
- Monteiro, C. A., et al. (2013). Ultra-processed products are becoming dominant in the global food system. Obesity Reviews, 14(S2), 21-28.
- Nestle, M. (2002). Food Politics: How the Food Industry Influences Nutrition and Health. University of California Press.
- Hales, C. M., et al. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief, (360), 1-8.
Transcript
>> Dr. Terry Simpson: Mhm.
Speaker:Today we're tackling a topic that's as big as the
Speaker:problem itself. Obesity in
Speaker:America. How did we go from starving in
Speaker:the Mississippi Delta in the 1960s to
Speaker:a nation grappling with an obesity
Speaker:epidemic? It's a fascinating story
Speaker:of policy, agriculture, culture itself and
Speaker:food science. So grab a fork and or a
Speaker:notebook and let's dig in.
Speaker:I am um, your Chief Medical Explanationist, Dr. Terry
Speaker:Simpson, and this is Forku
Speaker:Fork University, where we make sense of the madness
Speaker:in this case of obesity in America and
Speaker:bust a few myths along the way.
Speaker:In the early 1960s, America faced a
Speaker:shocking paradox. The land of plenty was
Speaker:also home to profound hunger.
Speaker:Images of starving children in the Mississippi Delta
Speaker:shocked the nation. Hunger wasn't just an
Speaker:abstract concept. It was a grim
Speaker:reality, especially for marginalized
Speaker:communities in rural America. Not only the Mississippi Delta,
Speaker:but also the Appalachians. During
Speaker:his presidential campaign in 1964, President
Speaker:Lyndon Johnson declared a war on
Speaker:poverty, which included efforts to address
Speaker:malnutrition, uh, through programs like food stamps and school
Speaker:lunch initiatives. These programs were life
Speaker:saving for many, but only
Speaker:scratched the surface of a much larger
Speaker:issue. Systemic inequality
Speaker:in food access.
Speaker:Forward to the 1970s, where a different
Speaker:problem was brewing. Richard Nixon's secretary
Speaker:of agriculture, Earl Butz, transformed
Speaker:how America produced food.
Speaker:Butts mantra was get big or get out.
Speaker:And farms shifted to monocultural crops,
Speaker:meaning corn, soybeans, wheat, all
Speaker:heavily subsidized by the government. This
Speaker:shift created a surplus of cheap
Speaker:ingredients that became the building blocks of
Speaker:ultra processed food. We had
Speaker:ultra processed and highly processed food in the
Speaker:1960s and and it consumed 6 to 10%
Speaker:of our diet. But now we had an
Speaker:abundance of them. High fructose corn
Speaker:syrup, hydrogenated oils and refined
Speaker:flours flooded the food supply,
Speaker:making the ingredients for calorie dense
Speaker:nutrient poor products that became affordable
Speaker:and accessible. More so than ever
Speaker:before. What started as a solution to
Speaker:hunger inadvertently laid the
Speaker:groundwork for obesity. Enter the age of
Speaker:abundance. By the 1980s, portion
Speaker:sizes in America began to balloon.
Speaker:Fast food chains eager to attract customers started offering
Speaker:larger servings for just a few cents more.
Speaker:A strategy known as value marketing.
Speaker:This trend extended to sit down restaurants and
Speaker:even home cooking. What used to be a
Speaker:reasonable portion became a laughingly small compared
Speaker:to the norm. For example, the typical
Speaker:hamburger at McDonald's was about two
Speaker:and a half ounces. The
Speaker:Junior Whopper today is
Speaker:about double that.
Speaker:Meanwhile, ultra processed foods,
Speaker:foods that were packed with sugar, fat and
Speaker:salt, began to dominate the shelves.
Speaker:These foods weren't just cheap, they were Engineered
Speaker:to be shelf stable, hyper palatable,
Speaker:meaning they really taste good and
Speaker:almost impossible to stop eating. You remember
Speaker:the Lay's Potato Chip ad from the 1970s? I bet
Speaker:you can't just eat one. The combination
Speaker:of bigger portions and calorie dense,
Speaker:nutrient poor foods begin the
Speaker:process of obesity.
Speaker:But as the waistlines expanded, and although at this
Speaker:time, and not as much as they have become, so did
Speaker:the backlash. The low carb movement championed
Speaker:by the likes of Dr. Atkins, promised weight loss
Speaker:by cutting out carbohydrates. Now
Speaker:the trick is that when using the term
Speaker:generic carbohydrates, he was mostly
Speaker:referring to junk food, as opposed to
Speaker:fruits, vegetables, beans,
Speaker:whole grains, all of which aren't junk food,
Speaker:but a part of a healthy balanced diet that are made of predominantly
Speaker:carbohydrates, which do not tend to contribute to
Speaker:obesity. So while this low
Speaker:carb approach was effective for some, the diet
Speaker:often led to an increased consumption of calorie
Speaker:dense meats and fats, potentially
Speaker:undermining its benefits for calorie control.
Speaker:Meaning people who bought into the
Speaker:low carb education
Speaker:believed that meats and fats did not produce
Speaker:fats and they were themselves in fact diet
Speaker:foods. Nothing like a, uh, 1200
Speaker:calorie steak thinking it's a diet
Speaker:food. On the other end of the spectrum,
Speaker:vegetarianism gained traction, partly again as
Speaker:a response to the environmental and health concerns tied
Speaker:to industrial agriculture. So by
Speaker:focusing on whole food plant based,
Speaker:the vegetarians attempted to counteract the over
Speaker:processing of the modern diet. Both
Speaker:movements were reactions to the rise of ultra processed foods, but
Speaker:each had its own challenges in addressing the
Speaker:obesity epidemic holistically.
Speaker:So where does that leave us today? The obesity
Speaker:epidemic isn't just a matter of personal
Speaker:choice. It's deeply intertwined with
Speaker:industrial practices and cultural norms.
Speaker:Addressing it requires more than just telling people to eat
Speaker:less and move more. It demands systemic
Speaker:change, from reforming agricultural subsidies
Speaker:to redesigning our food environments to make us
Speaker:easily have more available, healthier
Speaker:choices. But on an individual
Speaker:level, awareness is the key.
Speaker:Understanding the history of how we got here can empower us
Speaker:to make more informed choices.
Speaker:But hope also has arisen, as you know, because among the
Speaker:obesity epidemic sciences introduced one promising
Speaker:new tool besides surgery, which are the
Speaker:GLP1 receptor agonists. Now
Speaker:these were first introduced in 2005 by
Speaker:the brand name of Bieta, which was
Speaker:predominantly used for type 2
Speaker:diabetes. Because they proved
Speaker:remarkably effective in helping people
Speaker:manage their diabetes by
Speaker:decreasing insulin resistance. They did it by two
Speaker:mechanisms. They increased the production of, uh,
Speaker:insulin by the Pancreas, and
Speaker:they increased sensitivity of insulin
Speaker:from the tissue cells. What scientists
Speaker:noticed when they started introducing these drugs to patients with
Speaker:diabetes is that these patients started
Speaker:to lose weight. And weight loss, as
Speaker:you might think, is a remarkable option.
Speaker:The next generation of GLP receptor agonists, you know
Speaker:the names of Ozempic or Wegovy,
Speaker:Zapbound or Mounjaro,
Speaker:they also began to come in and it showed
Speaker:remarkable in diabetics that they were losing
Speaker:weight. So they began to test them on people
Speaker:who were simply overweight. And with
Speaker:amazing results. They have now become
Speaker:introduced. So how do they work?
Speaker:As you know, GLP1 stands for glucagon. Like
Speaker:peptide 1, it's a hormone that plays
Speaker:a role in regulating appetite and digestion. They mimic
Speaker:the action of actual GLP1 that
Speaker:your body makes, which slows down gastric
Speaker:emptying, signaling, uh, your brain that you're full.
Speaker:So normally Your body makes GLP1
Speaker:when it says, all right, we've had enough to eat, we're getting
Speaker:some food here, so we're gonna slow down digestion so you're
Speaker:gonna feel full. But it also works
Speaker:in the brain. It signals the
Speaker:brain that you're full. It is that head
Speaker:hunger that gets shut down when you
Speaker:eat food. Now here's what's
Speaker:fascinating. The GLP one that
Speaker:your body produces lasts just a few minutes.
Speaker:But oftentimes these cells, which are
Speaker:located in the distal part of the small intestine, are
Speaker:destroyed by bacteria.
Speaker:Bacteria that happen to thrive in an environment
Speaker:of ultra processed
Speaker:foods. Now, there's a lot of speculation in what
Speaker:I'm going to say now, but we do know the following
Speaker:facts for certain. Certain bacteria
Speaker:clearly destroy the cells that make
Speaker:GLP1. And
Speaker:certain fibers, particularly fiber like
Speaker:inulin, allow those cells
Speaker:to thrive. Inulin is found in things
Speaker:like Jerusalem artichoke, chicory, et
Speaker:cetera. Also another group of fibers called
Speaker:beta fructans, which are found in whole grains and
Speaker:bananas. They allow these cells to thrive while the
Speaker:ultra processed foods change the microbiome to bacteria
Speaker:that actually kill those cells. Let's get
Speaker:back to medication. These
Speaker:medicines blunt
Speaker:food noise, or what we call the hedonic
Speaker:drive, the pleasure seeking, almost
Speaker:compulsive craving for ultra, um, processed
Speaker:foods. Bet you can't just eat one.
Speaker:So while we like to think that big food is
Speaker:tricking our brain into the reward system,
Speaker:they simply discovered that if you
Speaker:put salt and sugar and
Speaker:fat together, you are going to love it,
Speaker:especially with flavor. I mean, consider the book called the
Speaker:Dorito Effect. Where we know that a Dorito has a lot more
Speaker:flavor than bland chicken. That's
Speaker:also why you can find yourself halfway through a bag
Speaker:of chips or a pint of ice cream without even
Speaker:realizing it. There's no fiber to stop you. You
Speaker:have that hedonic effect. But the GLP1 medications
Speaker:break this cycle. By reducing
Speaker:or blunting the brain's response to these foods,
Speaker:they enable the patient to regain
Speaker:control over their eating habits.
Speaker:So what's revolutionary about the GLP1 medications
Speaker:is how they're helping shift the narrative around
Speaker:obesity. For years, obesity was framed as
Speaker:a failure of willpower, Even though those who studied it,
Speaker:such as myself and the AMA, declared it a
Speaker:disease as early as 2013.
Speaker:These medications underscore the biologic
Speaker:underpinnings of obesity, showing that it's not
Speaker:just about eating less or exercising more. It's
Speaker:about addressing the complex systems in our
Speaker:bodies and brains that drive food
Speaker:intake. For many,
Speaker:GLP1s are creating a, ah, window of
Speaker:opportunity. People who once felt powerless
Speaker:against their cravings are finding it easier to make
Speaker:healthier choices, helping them out not only to lose
Speaker:weight, but sustain those
Speaker:losses. This isn't a magic
Speaker:bullet. These medications,
Speaker:clearly in clinical studies, work best when
Speaker:they are combined with diet and lifestyle.
Speaker:But it is a powerful tool against a
Speaker:problem that's decades in the making.
Speaker:Imagine realizing that you don't need
Speaker:to eat the pint of ice cream. A taste is enough.
Speaker:Redesigning your relationship with food and
Speaker:the lifestyle changes. By eating more foods
Speaker:that contain fiber and contain the fibers like
Speaker:inulin and beta fructans, allow your
Speaker:own natural GLP1s to
Speaker:repopulate. Now,
Speaker:there is a huge leap between allowing your natural
Speaker:GLP1s to repopulate to
Speaker:not needing the medications. And I want you to
Speaker:frame it in your brain this way. We
Speaker:want you to build a healthier relationship with
Speaker:food. We want you to enjoy whole
Speaker:foods. We want you to realize that grains are
Speaker:not the enemy. Whole grains actually reduce obesity, et
Speaker:cetera. Refined grains are, uh, not necessarily the problem, but they
Speaker:can be. But the closing
Speaker:message is this. You didn't gain the weight
Speaker:because of high fructose corn syrup or because of seed
Speaker:oils. You gained the weight because all of these things were
Speaker:processed together in a tightly wonderful package that
Speaker:tastes delicious. But some ultra processed
Speaker:foods are quite good for you. Take whole grain bread.
Speaker:It's actually quite healthy. So
Speaker:we can't lump all ultra processed foods
Speaker:together. But with GLP medications, we are
Speaker:seeing how science can help counteract the damage caused
Speaker:by decades of ultra processed foods and
Speaker:oversized portions. And it's a,
Speaker:uh, reminder that solutions to obesity aren't
Speaker:just about an individual effort.
Speaker:They're about understanding the systems that created the
Speaker:problem and leveraging modern medicine to
Speaker:help reverse that trend. That's the
Speaker:promise and the challenge of the road
Speaker:ahead. Thank
Speaker:you for joining me on this episode of Forku. You
Speaker:can find references for this in my blog, which is@, uh,
Speaker:yourdoctorsorders.com and
Speaker:forku.com so if you like
Speaker:today's discussion about obesity, ultra processed food and
Speaker:GLP1 medications, hopefully it's given you something to
Speaker:chew on. Please be sure and share and
Speaker:describe. And always remember, your
Speaker:fork is a tool. It's not a weapon.
Speaker:Use it wisely. I'm
Speaker:Dr. Terry Simpson, and while I am a, um, medical
Speaker:doctor, I am not your
Speaker:medical doctor. If you seek to have
Speaker:GLP1 medications, I'm not the guy to ask about
Speaker:them. I would ask you to please find a board
Speaker:certified medical physician who specializes in
Speaker:obesity medication. There are plenty of doctors
Speaker:selling plenty of little GLP one like things out there
Speaker:which may or may not be good for you.
Speaker:So that's why I advocate people go to some place like
Speaker:Accomplished health who, by the way, has not paid for that
Speaker:endorsement. Today's podcast was distributed by
Speaker:our friends at Simpler media and the pod
Speaker:God, Mr. Evo Terra. Thanks
Speaker:for listening, everybody. Until next time,
Speaker:enjoy your food, don't feel guilty, and if you
Speaker:need help, find a good board certified physician to
Speaker:ask for it.
Speaker:Hey, Evo, you know what I like about the new
Speaker:GLP1 medications? I like that we're
Speaker:empowering people to have a
Speaker:way forward with their fork.
Speaker:I kind of think it's fun.
Speaker:So here's the thing, doc. You gotta stop
Speaker:trying the, uh, food wordplay.
Speaker:It just makes me dig deeper into bags
Speaker:of, ultra processed, uh, potato chips.
Speaker:You're not helping my problem.
