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

problem itself. Obesity in

America. How did 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 um,

I am 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

it away.

In the early 1960s America faced a

shocking paradox. The land of plenty was

also home to profound hunger.

Images of 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

presidential campaign. In 1964, President

Lyndon Johnson declared a war on

poverty which included efforts to address

malnutrition through uh, programs like food stamps and school

lunch initiatives. These programs were life

saving for many but

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 Secretary

of Agriculture 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 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 it consumed 6 to 10% of

our diet. But now we had an

abundance. 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,

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 larger

servings for just a few cents more. A

strategy known as value marketing.

This trend extended to sit down restaurants,

uneven home cooking. What used to be

a reasonable portion became a laughingly small

compared 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 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. 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.

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 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

carbohydrate, 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.

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, ah, 1200

calorie 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,

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.

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

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 power 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 uh, the GLP1 receptor agonists

were first introduced in 2005 by

the brand name of Baeda, 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

insulin by the pancreas and

they increased sensitivity of insulin

from the tissue cells. What scientists

know producing 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, uh, receptor agonists, you know

the names of Ozempic, Zap

found 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, um, on people who were simply

overweight and with amazing

results 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

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 going to slow down digestion so you're going to feel

full. So 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

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

foods. Now there's a lot of speculation of

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 like

inulin allow those cells

to thrive. Inulin is found in things

like Jerusalem artichoke, chicory,

etc. Also another group of fibers

called beta fructans, which are found in whole grains

and bananas. 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. You're seeking almost

compulsive craving for ultra 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

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 play 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

enabled 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

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 in

our bodies and brains that drive food

intake. For many,

GLP1s are creating a, uh, window of

opportunity. People who once felt powerless

against their cravings are finding it easier to make

healthier choices, not m 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

against a problem that's decades in the

making.

Imagine realizing that you need

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

Redesigning your relationship 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, 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.

We want you to realize that grains are not the enemy.

Whole grains actually reduce obesity, et cetera. Refined

grains are, ah, 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

seed oils. You gained the weight because all of these

things were processed together in uh, 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.

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 reminder

that solutions aren't, uh, 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@ah, yourdoctorsorders.com and

forku.com so if you like

today's discussion about obesity, ultra processed food

and 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 a

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. 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 someplace like Accomplish Health, who, by

the way, has not paid for that endorsement.

Today's podcast was distributed by our

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.