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.

1. Economic Shifts and Agricultural Policies
2. 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.
3. Rise of Convenient Snack Foods and Fast Food
4. 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.
5. The “Diet” Food Craze
6. 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.

1. Processed Food Production Surges
2. 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.
3. Caloric Intake Climbs
4. 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).
5. Obesity Rates Begin Their Upward Trajectory
6. 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.

1. Fast Food Reigns Supreme
2. 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.
3. Sugary Beverages Become a Staple
4. 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).
5. Caloric Intake Peaks
6. 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.

1. Obesity Reaches Public Health Crisis Levels
2. 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.
3. Calories from Ultra-Processed Foods Remain High
4. 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.
5. The Health Toll Beyond Obesity
6. 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.
7. Efforts to Combat Ultra-Processed Food Consumption
8. 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.

>> Dr. Terry Simpson: Mhm.

Today we're tackling a topic that's as big as the

problem itself. Obesity in

America. How did we go from starving in

the Mississippi Delta in the 1960s to

a nation grappling with an obesity

epidemic? It's a fascinating story

of policy, agriculture, culture itself and

food science. So grab a fork and or a

notebook and let's dig in.

I am um, your Chief Medical Explanationist, Dr. Terry

Simpson, and this is Forku

Fork University, where we make sense of the madness

in this case of obesity in America and

bust a few myths along the way.

In the early 1960s, America faced a

shocking paradox. The land of plenty was

also home to profound hunger.

Images of starving children in the Mississippi Delta

shocked the nation. Hunger wasn't just an

abstract concept. It was a grim

reality, especially for marginalized

communities in rural America. Not only the Mississippi Delta,

but also the Appalachians. During

his presidential campaign in 1964, President

Lyndon Johnson declared a war on

poverty, which included efforts to address

malnutrition, uh, through programs like food stamps and school

lunch initiatives. These programs were life

saving for many, but only

scratched the surface of a much larger

issue. Systemic inequality

in food access.

Forward to the 1970s, where a different

problem was brewing. Richard Nixon's secretary

of agriculture, Earl Butz, transformed

how America produced food.

Butts mantra was get big or get out.

And farms shifted to monocultural crops,

meaning corn, soybeans, wheat, all

heavily subsidized by the government. This

shift created a surplus of cheap

ingredients that became the building blocks of

ultra processed food. We had

ultra processed and highly processed food in the

1960s and and it consumed 6 to 10%

of our diet. But now we had an

abundance of them. High fructose corn

syrup, hydrogenated oils and refined

flours flooded the food supply,

making the ingredients for calorie dense

nutrient poor products that became affordable

and accessible. More so than ever

before. What started as a solution to

hunger inadvertently laid the

groundwork for obesity. Enter the age of

abundance. By the 1980s, portion

sizes in America began to balloon.

Fast food chains eager to attract customers started offering

larger servings for just a few cents more.

A strategy known as value marketing.

This trend extended to sit down restaurants and

even home cooking. What used to be a

reasonable portion became a laughingly small compared

to the norm. For example, the typical

hamburger at McDonald's was about two

and a half ounces. The

Junior Whopper today is

about double that.

Meanwhile, ultra processed foods,

foods that were packed with sugar, fat and

salt, began to dominate the shelves.

These foods weren't just cheap, they were Engineered

to be shelf stable, hyper palatable,

meaning they really taste good and

almost impossible to stop eating. You remember

the Lay's Potato Chip ad from the 1970s? I bet

you can't just eat one. The combination

of bigger portions and calorie dense,

nutrient poor foods begin the

process of obesity.

But as the waistlines expanded, and although at this

time, and not as much as they have become, so did

the backlash. The low carb movement championed

by the likes of Dr. Atkins, promised weight loss

by cutting out carbohydrates. Now

the trick is that when using the term

generic carbohydrates, he was mostly

referring to junk food, as opposed to

fruits, vegetables, beans,

whole grains, all of which aren't junk food,

but a part of a healthy balanced diet that are made of predominantly

carbohydrates, which do not tend to contribute to

obesity. So while this low

carb approach was effective for some, the diet

often led to an increased consumption of calorie

dense meats and fats, potentially

undermining its benefits for calorie control.

Meaning people who bought into the

low carb education

believed that meats and fats did not produce

fats and they were themselves in fact diet

foods. Nothing like a, uh, 1200

calorie steak thinking it's a diet

food. On the other end of the spectrum,

vegetarianism gained traction, partly again as

a response to the environmental and health concerns tied

to industrial agriculture. So by

focusing on whole food plant based,

the vegetarians attempted to counteract the over

processing of the modern diet. Both

movements were reactions to the rise of ultra processed foods, but

each had its own challenges in addressing the

obesity epidemic holistically.

So where does that leave us today? The obesity

epidemic isn't just a matter of personal

choice. It's deeply intertwined with

industrial practices and cultural norms.

Addressing it requires more than just telling people to eat

less and move more. It demands systemic

change, from reforming agricultural subsidies

to redesigning our food environments to make us

easily have more available, healthier

choices. But on an individual

level, awareness is the key.

Understanding the history of how we got here can empower us

to make more informed choices.

But hope also has arisen, as you know, because among the

obesity epidemic sciences introduced one promising

new tool besides surgery, which are the

GLP1 receptor agonists. Now

these were first introduced in 2005 by

the brand name of Bieta, which was

predominantly used for type 2

diabetes. Because they proved

remarkably effective in helping people

manage their diabetes by

decreasing insulin resistance. They did it by two

mechanisms. They increased the production of, uh,

insulin by the Pancreas, and

they increased sensitivity of insulin

from the tissue cells. What scientists

noticed when they started introducing these drugs to patients with

diabetes is that these patients started

to lose weight. And weight loss, as

you might think, is a remarkable option.

The next generation of GLP receptor agonists, you know

the names of Ozempic or Wegovy,

Zapbound or Mounjaro,

they also began to come in and it showed

remarkable in diabetics that they were losing

weight. So they began to test them on people

who were simply overweight. And with

amazing results. They have now become

introduced. So how do they work?

As you know, GLP1 stands for glucagon. Like

peptide 1, it's a hormone that plays

a role in regulating appetite and digestion. They mimic

the action of actual GLP1 that

your body makes, which slows down gastric

emptying, signaling, uh, your brain that you're full.

So normally Your body makes GLP1

when it says, all right, we've had enough to eat, we're getting

some food here, so we're gonna slow down digestion so you're

gonna feel full. But it also works

in the brain. It signals the

brain that you're full. It is that head

hunger that gets shut down when you

eat food. Now here's what's

fascinating. The GLP one that

your body produces lasts just a few minutes.

But oftentimes these cells, which are

located in the distal part of the small intestine, are

destroyed by bacteria.

Bacteria that happen to thrive in an environment

of ultra processed

foods. Now, there's a lot of speculation in what

I'm going to say now, but we do know the following

facts for certain. Certain bacteria

clearly destroy the cells that make

GLP1. And

certain fibers, particularly fiber like

inulin, allow those cells

to thrive. Inulin is found in things

like Jerusalem artichoke, chicory, et

cetera. Also another group of fibers called

beta fructans, which are found in whole grains and

bananas. They allow these cells to thrive while the

ultra processed foods change the microbiome to bacteria

that actually kill those cells. Let's get

back to medication. These

medicines blunt

food noise, or what we call the hedonic

drive, the pleasure seeking, almost

compulsive craving for ultra, um, processed

foods. Bet you can't just eat one.

So while we like to think that big food is

tricking our brain into the reward system,

they simply discovered that if you

put salt and sugar and

fat together, you are going to love it,

especially with flavor. I mean, consider the book called the

Dorito Effect. Where we know that a Dorito has a lot more

flavor than bland chicken. That's

also why you can find yourself halfway through a bag

of chips or a pint of ice cream without even

realizing it. There's no fiber to stop you. You

have that hedonic effect. But the GLP1 medications

break this cycle. By reducing

or blunting the brain's response to these foods,

they enable the patient to regain

control over their eating habits.

So what's revolutionary about the GLP1 medications

is how they're helping shift the narrative around

obesity. For years, obesity was framed as

a failure of willpower, Even though those who studied it,

such as myself and the AMA, declared it a

disease as early as 2013.

These medications underscore the biologic

underpinnings of obesity, showing that it's not

just about eating less or exercising more. It's

about addressing the complex systems in our

bodies and brains that drive food

intake. For many,

GLP1s are creating a, ah, window of

opportunity. People who once felt powerless

against their cravings are finding it easier to make

healthier choices, helping them out not only to lose

weight, but sustain those

losses. This isn't a magic

bullet. These medications,

clearly in clinical studies, work best when

they are combined with diet and lifestyle.

But it is a powerful tool against a

problem that's decades in the making.

Imagine realizing that you don't need

to eat the pint of ice cream. A taste is enough.

Redesigning your relationship with food and

the lifestyle changes. By eating more foods

that contain fiber and contain the fibers like

inulin and beta fructans, allow your

own natural GLP1s to

repopulate. Now,

there is a huge leap between allowing your natural

GLP1s to repopulate to

not needing the medications. And I want you to

frame it in your brain this way. We

want you to build a healthier relationship with

food. We want you to enjoy whole

foods. We want you to realize that grains are

not the enemy. Whole grains actually reduce obesity, et

cetera. Refined grains are, uh, not necessarily the problem, but they

can be. But the closing

message is this. You didn't gain the weight

because of high fructose corn syrup or because of seed

oils. You gained the weight because all of these things were

processed together in a tightly wonderful package that

tastes delicious. But some ultra processed

foods are quite good for you. Take whole grain bread.

It's actually quite healthy. So

we can't lump all ultra processed foods

together. But with GLP medications, we are

seeing how science can help counteract the damage caused

by decades of ultra processed foods and

oversized portions. And it's a,

uh, reminder that solutions to obesity aren't

just about an individual effort.

They're about understanding the systems that created the

problem and leveraging modern medicine to

help reverse that trend. That's the

promise and the challenge of the road

ahead. Thank

you for joining me on this episode of Forku. You

can find references for this in my blog, which is@, uh,

yourdoctorsorders.com and

forku.com so if you like

today's discussion about obesity, ultra processed food and

GLP1 medications, hopefully it's given you something to

chew on. Please be sure and share and

describe. And always remember, your

fork is a tool. It's not a weapon.

Use it wisely. I'm

Dr. Terry Simpson, and while I am a, um, medical

doctor, I am not your

medical doctor. If you seek to have

GLP1 medications, I'm not the guy to ask about

them. I would ask you to please find a board

certified medical physician who specializes in

obesity medication. There are plenty of doctors

selling plenty of little GLP one like things out there

which may or may not be good for you.

So that's why I advocate people go to some place like

Accomplished health who, by the way, has not paid for that

endorsement. Today's podcast was distributed by

our friends at Simpler media and the pod

God, Mr. Evo Terra. Thanks

for listening, everybody. Until next time,

enjoy your food, don't feel guilty, and if you

need help, find a good board certified physician to

ask for it.

Hey, Evo, you know what I like about the new

GLP1 medications? I like that we're

empowering people to have a

way forward with their fork.

I kind of think it's fun.

So here's the thing, doc. You gotta stop

trying the, uh, food wordplay.

It just makes me dig deeper into bags

of, ultra processed, uh, potato chips.

You're not helping my problem.