I am the poster boy for super-sizing. I grew up in the 1960’s when McDonald’s corporate plan was to put a store on every block. Yes, I am picking on McDonald’s,  but only because this was the fast food that I grew up with and the only fast food I really knew until I was an adult.  I remember the first McDonald’s in my neighborhood.  With its golden arches, glass enclosed lobby, and gleaming stainless steel counters, we thought an alien space ship had landed that served burgers, fries, sodas, and shakes. And actually that was ALL that McDonald’s served when it first opened; small, portion controlled hamburgers, small portion controlled fries and small sodas. McDonald’s celebrated their grand opening by putting a coupon in the local paper for a free milkshake. In those days everyone subscribed to the local daily paper, so my friend and I went door to door the next day and collected the previous days papers from our neighbors. We each downed a dozen free milkshakes and suffered an evening of severe stomach cramps. But in our minds unlimited milkshakes was worth the pain.

I was reflecting on this when I recently analyzed the McDonald’s menu for the drive-thru diet posts on this blog. In those days, a meal of a McDonald’s hamburger, small fry, and small coke ran 685 calories. Hardly a healthy meal, but manageable. Fast forward to 2009. Hardly anyone orders a McDonald’s hamburger  or a small fry anymore. That sandwich is considered so small that it is relegated to the children’s Happy Meal. And McDonald’s recently ran a promotion where the 32 ounce drink was 99 cents, which was actually less than the small size. In 2009 ,the typical average adult meal at McDonald’s consists of a Big Mac, large fry, and large coke, and comes in at a whopping 1,370 calories, exactly double my satisfying fast food treat from 1963. And although I am using McDonald’s as an example, it is only the prototypical example of all corporate fast food and sit down restaurants. The bottle of Coca-cola that I grew up with was 6.5 ounces. The average bottle that you purchase in a convenience store is between 20 and 32 ounces, a four fold increase.

Given these facts, it is actually amazing that only 1/3 of Americans are classified as obese and only 2/3 are overweight. It is popular for us to blame our obesity on stress eating, depression, or unhappiness. From my point of view our obesity is caused by our evolutionary craving for food that drove our hunter-gatherer ancestors to spend their entire existence looking for food, combined with our scientific ability to engineer artificial foods that satisfy our most basic cravings without the satiation that comes with nutrients. Add to that cocktail the unbelievable ability of humans to market to each other, and the unlimited (relatively speaking) ability of the average American to afford to purchase calories, and it’s actually amazing that obesity isn’t closer to 100%.

Although hunting for food with a gun is still practiced in parts of our country, the most common weapon for hunting now is the automobile.  We cruise the suburban savannah in our SUV’s, spotting our food sources grazing on the edges of the boulevard.  Our prey aren’t camoflaged by their surroundings, they invite us to hunt them with signs that brag about the billions and billions of their kind that have been downed before.  And there are no limits to the amount of our prey that we can take home. Our limits are our pocketbooks, and as obesity statistics show, money is not a limiting factor for calorie consumption.

So the question is, what human motivation is stronger than our evolutionary need to binge on food, stronger than the easy accessibility of calories, stronger than multi-billion dollar advertsiing budgets?  What motivates people to engage in a  healthy lifestyle in the face of all that is stacked against us? Are most of us doomed by our DNA controlled  propensity for instant gratification? Maybe not. The obesity rate in Japan is about 3.5% compared to over 30% in the U.S. The average citizen of Japan consumes over 200 caloires less per day than the average American. It seems to me that we have created a culture of unhealthy eating in our country. Over the last year, we have focused the debate in this country on our health care delivery system and costs. But the number one health care problem in this country is obesity. Obesity by itself is the source of the majority of our country’s health care costs. And this problem has gotten little attention from the government.  A few years ago, we declared a government sponsored “war on drugs”.  And although this war has not been successful, we have been fairly successful in indoctrinating our children in the dangers of drugs through the DARE school drug education programs.

Until we recognize that obesity is a severe national problem, as severe as cigarette smoking and drugs, we cannot begin the cultural change that is required for us to slim down.  For example, I have noticed that it is not politically correct to criticize people who are obese. In the 1960’s smoking was part of our culture. It was promoted through advertising and protected by the government. It would have been unthinkable to outlaw smoking in public places. Has the time finally come for us to treat obesity like cigarettes? It is a choice that turns into an addiction. It causes severe health problems, costs our country billions of dollars that we cannot afford, and if we don’t prevent our children from getting hooked, then they all become unhealthy obese adults.

I came to realize over a period of time that being fat made me less attractive, less able to do the active things I wanted to do, and was going to become more and more of a problem as I grew older.  But we are all fighting an uphill battle living in a culture that promotes obesity and doesn’t treat it for what it is. Until we can turn our culture around, each of us are fighting the battle as an army of one.

To comment on this post, click on the title, or email the author dennis@healthjag.com