by Rob Saint Laurent, M.Ed
There’s another health crisis in the US, and it’s been hiding in plain sight.
In September 2021, word broke of new data by the CDC showing America’s adult obesity rate in 2020 was at an all-time high of at least 35 percent in 16 states—versus 12 states just a year earlier. In an already upward trend, this was a significant rise, thanks to pandemic-fueled stress. Keeping with current trends, the increase was mostly seen in the US South and Midwest regions, and minority populations in particular.1
In 2018, 42.4 percent of US adults were considered obese (defined as a body mass index/BMI of 30 or greater). Comparatively, 30.5 percent of us were obese in 2000. At the same time, the rate of severe obesity (a BMI of 40 or higher) jumped from 4.7 percent to 9.2 percent. Though obesity in adults and children has been the norm in US culture for some time, it is still considered a serious and underappreciated chronic disease that can lead to cardiovascular and metabolic problems, cancer, and now increased risk of severe COVID-19 illness.2
In 2008, obese people averaged more than $1,400 greater medical costs than people with a healthy weight.2
Besides psychological stress, obesity is linked to socioeconomic factors. For example, there is the reality of “food deserts” in many low-income urban areas and the added expense of eating healthier (about $1.50 per day per person in 2013, according to a Harvard study).
But there’s yet another reason for rising obesity that’s often tied to convenience and feeling stressed.
In 2013, the media was abuzz with the New York Times #1 bestseller Salt Sugar Fat: How the Food Giants Hooked Us by Pulitzer Prize-winning investigative journalist Michael Moss. Moss describes in the book how the US became the world’s most obese nation. At the time, 300 corporations reigned over America’s food supply with some 60,000 supermarket items lurking throughout the middle aisles. These processed products are based on three ingredients: salt, sugar, and fat, carefully crafted to overtake the brain’s self-control mechanism and promote overeating.3
We know that over time, eating too many sugary carbohydrates can lead to insulin resistance, where the body’s cells cannot properly metabolize blood sugar. It includes brain cells where, under normal circumstances, we experience a post-eating rise in dopamine (a principal feel-good chemical) from insulin that helps signal a feeling of satiety or fullness. Science has revealed that insulin resistance impairs this process, as high sugar intake has been linked to low dopamine release in the brains of insulin-resistant people, causing them to overeat.4
Functional MRI research has shown that formulating foods with sugar and fat activates the brain’s pleasure centers like cocaine. Manufacturers add enough sugar to reach a “bliss point” of maximum taste. It short-circuits the brain’s reward system and causes the consumer to crave more sugar, which readily converts to body fat and can ultimately lead to diabetes.3
The saturated fat in processed foods also has a specific purpose in providing “mouthfeel,” or a sensation of dryness and gumminess with moisture release. It can be freely added to foods for better allure. And while salt isn’t something we’re born liking, we’re coaxed into liking it from about the age of six months and then develop a craving for it.3
It’s been eight years since Moss’ first book was published, and the issue remains as pressing as ever, with consumption of ultra-processed foods rising in the US for the past 20 years among all population segments. According to researchers at NYU School of Public Health, “The overall composition of the average US diet has shifted towards a more processed diet. It is concerning, as eating more ultra-processed foods is associated with poor diet quality and a higher risk of several chronic diseases. The high and increasing consumption of ultra-processed foods in the 21st century may be a key driver of the obesity epidemic.”5
Perhaps the biggest indictment against these corporations is that, as Moss points out, many of the top processed food executives avoid their own products like the plague.3
The 2014 movie Fed Up also documents how Big Food bears much of the blame for why American society doesn’t seem to get healthier with time.
Experts generally agree that a more lifestyle-based approach to weight loss is more effective in the long term since healthy new habits are formed in the process.
There is solid evidence that a Mediterranean style of eating (Table 1) is an effective approach to “cardiodiabesity,” or the syndrome of obesity, cardiovascular disease, and Type 2 diabetes.6, 7
The Mediterranean Diet is grounded on eating whole (real) foods with grocery lists available online. It’s critical to avoid or minimize processed foods and added sugars, especially sugary drinks (soda, fruit juice, sugary energy drinks, etc.), and high fructose corn syrup. Americans consume, on average, about 92 grams of added sugar each day, yet the recommended upper limit is 21 grams per day for women and 38 grams for men. Even if a packaged food is advertised as low in salt, sugar, or fat, it’s usually higher in the other two ingredients when examining the label.3
That said, not all carbohydrates are created equal; whole grains like oats, barley, and brown rice are healthy, and since they’re high in fiber and digest slowly, you feel satiated longer and avoid a spike in blood sugar and insulin hormone that promote obesity, insulin resistance, and diabetes.
Other evidence-based lifestyle tips for aiding weight loss and overall health include drinking more water, especially before meals; eating eggs (or lean protein) for breakfast to feel full throughout the day; reducing overall carbohydrate intake; drinking black coffee and green tea; using a restricted feeding window, such as eating all of your meals within a six to 12-hour period; and replacing some of your calories with whey protein powder. Also, supplementing with magnesium and chromium may help steady blood sugar and reduce sweet cravings to transition to healthier eating.
Eating purer foods tastes better than those processed after detoxing from excessive salt and sugar. For many, the excess weight comes off effortlessly with these changes, it stays off, and they feel no pressure.
Forming Healthy Habits
It takes most people at least three months to form a new habit. Often, the most challenging part of eating healthier is modifying unhealthy behavior patterns, particularly after subsisting for years on processed foods. For long-term success, it’s essential to be sure you’re ready to start changing your eating habits (Table 2).
The motivation to make successful dietary and physical activity changes has to come from deep within—what will drive you to initiate and maintain these changes over the long term? Experts suggest making a list of things that will encourage you to stay on track, especially in the face of temptation. Logging meals and using digital tools can also help keep focused.8
Having the support of someone else is another good idea when modifying behavior. Someone who will lift your spirits and reinvigorate you to keep going, rather than put you down, embarrass, or sabotage you, should you succumb to temptation. Mayo Clinic suggests someone or a network of people with similar goals who will listen to you and join in creating healthy menus.8
If you can’t seem to curb your cravings and impulse to overeat, you may be one of the roughly 20 percent of Americans living with food addiction. A professional treatment program may be in order, such as a 12-step program or cognitive-behavioral (talk) therapy with a licensed clinician or counselor.
1. Centers for Disease Control and Prevention. (n.d.). Adult Obesity Prevalence Maps.
2. Centers for Disease Control and Prevention. (n.d.). Adult Obesity Facts.
3. Pogue, J.M. (2014 July). Salt Sugar Fat: How the Food Giants Hooked Us. Baylor University Medical Center Proceedings, 27(3), 283-84.
4. Brookhaven National Laboratory. (2013, June 10). High Sugar Intake Linked to Low Dopamine Release in Insulin Resistant Patients [Press release].
5. New York University. (2021, October 14). Americans Are Eating More Ultra-Processed Foods [Press release].
6. Franquesa, M. Pujol-Busquets, G., Garcia-Fernandez, E., et al. (2019, March). Mediterranean Diet and Cardiodiabesity: A Systematic Review through Evidence-Based Answers to Key Clinical Questions. Nutrients, 11(3), 655.
7. D’Innocenzo, S., Biagi, C., & Lanari, M. (2019, June). Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet. Nutrients, 11(6), 1306.
8. Mayo Clinic Staff. (2021, December 7). Weight loss: 6 strategies for success. Mayo Clinic.