More Junk Food, Ever-Larger Portions and More Hours Spent in Front of the Television Have Made the United States the Fattest Nation in the World. Is It Too Late to Reverse the Trend?

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Should fat people be denied medical treatment because they have allowed themselves to become fat? The idea was first floated by the British Labour Party, and discussed in last week's NS by Richard Reeves, who wrote that the growth rate of obesity in Britain is now close to that in the US. I find this hard to believe. Yes, people are getting fatter in Britain--but, from my own completely unscientific survey, it is much, much worse here. And there is one indisputable fact: America is the most obese nation on earth.

It's getting worse, too: each year, about 300,000 Americans die prematurely because they are overweight; children, on average, are 20-30 per cent heavier than they were a decade ago and, as a result, type-two diabetes is increasing. All told, 120 million Americans are overweight or obese. For such people, hospital and outpatient care is 36 per cent higher than for those in the average weight range--and medicines cost 77 per cent more. Outside a middle-class belt where attitudes to food and drink are almost obsessively puritanical and people are the ideal weight, Americans are eating and drinking too much and getting too fat.

The plentifulness of food, and junk food in particular, is one obvious reason why. Young Latina women brought up on frugal but healthy diets in their home countries succumb to junk when they come here. The food industry spends $30bn a year advertising processed, fat-laden food--compared with the $10m a year spent by the government to push the virtues of fruit and vegetables. Eighty per cent of this food advertising is targeted at children, and the other 20 per cent at their mothers: no wonder McDonald's, one of the obvious offenders, is now introducing yoghurt and (sweetened) fruit as a sop to the health freaks.

But there has also been a change in the eating habits of Americans. Thirty years ago, Americans spent two hours on average preparing dinner each night; now it is just 15 minutes. Restaurants are offering ever-larger portions, which in turn makes people think they must do so at home: people now consume between 50 and 100 more calories at one sitting than they did 20 years ago. The Journal of the American Dietetic Association found that people now eat larger portions than in 1977 of 107 key foods, including bread, biscuits, cereal, chips, coffee, wine and fruit juice.

In a nation culinarily dominated by chips, crisps and burgers, the results have been devastating. Men older than 40 have increased their beer-drinking by one-third. …