I was recently driving along with a friend in rural Australia and we passed a McDonalds location and the topic of nutrition came up. Fast food isn't something I think about that much because for the most part I try my best to avoid it. But upon reflection it's everywhere these days, including in some surprisingly remote locations. I couldn't help but think about how there is such good access to low quality food these days. I've just been spending some time in rural Australia and one of my friends was saying that there was a massive obesity problem in the town now. After observing people a bit I noticed he was entirely correct, for example I saw one family in a supermarket buying hundreds of cans of cola along with other junk food and only a tiny portion of their purchases were anything remotely healthy. That family was all obese. The kids were too young to have a say in these purchasing decisions and the parents were setting their kids up for a lifetime of health problems which I found very depressing. Many small towns now have exceedingly good access to junk food, even if other infrastructure is lacking. For example in one such town I was in a supermarket and the ice cream section was a freezer section 25 meters long, this section was completely full as well. It is worth noting that none of the ice cream in that supermarket would have been made locally in that small town, all of it would have been freighted in using Just in time logistics in refrigerated trucking. The ice cream economy is fascinating, a lot of resources and planning have to go into having such a wide selection of ice cream being constantly in stock in a geographically remote location such as this. It's not at all straightforward to move that amount of ice cream around in a nation and as such it provides a very good example of economic revealed preferences. For example if you asked people if they preferred critical infrastructure or a wider ice cream selection, many people would say critical infrastructure. But the economy reveals a preference towards junk food being highly available, people simply spend their money on junk food, follow the money and not the words and you'll see how many things really work. Or in other words in the current economy there's enough money being spent on junk food that there's clearly a lucrative industry in providing it, even when providing it isn't cheap.

There's a worldwide chain called Burger King, that in Australia is called Hungry Jacks because of an old trademark dispute with a burger place in Australia called Burger King. When I was younger one of the first cases of American cultural exports that I distinctly remember was when "super sized" portions became available at Hungry Jacks. This was in the early 2000s. At the time I remember this being a cheap way to get a whole lot of fries and you could share one of these monstrous portions with a friend or two and get some cheap, but empty, calories. As a broke student at the time I remember this somewhat fondly. Some time later this particular type of serving size disappeared, with justifications at the time being that it was not "healthy" or "responsible" for these venues to offer these sizes. For context it is important to remember back then people cared about obesity a lot more and there was zero institutionally funded gaslighting trying to claim that obesity was not a health issue back then. Put simply in the early 2000s obesity was still seen as a moral failing, not just a health problem.

The movie Super Size Me was released in 2004 and was extremely influential on the culture. This movie follows independent film maker Morgan Sherlock as he goes on a McDonald's only diet and documents his health during the process. After eating only fast food for a while his health fell apart. His story was very influential because it provided a compelling narrative. His story was also popular because it tapped into some cultural trends at the time, people were starting to notice a rapid rise in obesity levels and subconsciously many people were wondering why. McDonalds phased out super sized portions in 2004, no doubt in response to a variety of pressures to be seen to be healthier. It's wild thinking about how 20 years ago people cared more about health, but it was a different era for sure. Spurlock recently passed away at age 53 and this is what inspired me to take another looks at fast food, including the influential movie he made 20 years ago.

One of the claims in the movie is that these fast foods were causing him liver damage. In retrospect his liver was already probably extremely damaged before any filming began. It turns out that Spurlock was drinking very heavily during the making of the file but wasn't telling doctors this in the movie. Doctors were seeing the medical impacts of alcoholism destroying his health but in the movie the narrative was that all of these health impacts were coming only from the fast food consumption. Many of the viewers of the documentary probably ran with this idea, it seemed compelling but people who knew more about health probably could have deduced that something didn't add up. Yes, eating only fast food isn't good for your health, but how that is not good for your health is very specific. Likewise alcohol is not good for your health, but how that is not good for your health is also very specific. Confusing the two deliberately to push a narrative is not only disingenuous it's also dangerous. If someone is drinking heavily and has liver issues, having that person quit fast food but not the alcohol is not going to help them as much as having them quit alcohol.

To be clear these fast food places aren't providing highly nutritious foods and they most certainly aren't something you'd want to entirely base your diet around but do they cause liver failure? Probably not in the way that was shown in this documentary. What worries me is that people might be taking some of the wrong messages from these sorts of documentaries. And part of this is that if the authors aren't being honest with the audience it always makes me highly suspicious. There's evidence to show that this was the case, at least as far as the alcohol consumption bit went.

Perhaps the biggest thing about obesity is that obesity can only be caused by an extreme intake of calories. It is impossible to get obese without a significant calory surplus. This is another thing from the movie that benefits from a second look, Spurlock decided to eat 5000 calories a day. This is a lot, 2000-3000 calories a day is generally a reasonable range for a healthy adult male. So he was effectively eating double the amount of calories needed. Even when eating healthier foods if you eat double the amount of calories that you need you'll put on weight, and probably a lot of it. The hard part with healthier food is actually consuming double the amount of calories you need, healthy food makes you feel full much faster than empty calories. There's a whole lot of biological feedback mechanisms with food that get activated when you eat healthy food that signals to your brain that you are full. Its not all that easy to consume a lot of calories from healthy food for a variety of reasons. Various "challenges" like eating a lot of eggs are hard because your body starts to tell you that you are full and that's very hard to overcome.

There's a Mark Twain quote that I think is very relevant here "Its easier to fool a man than to convince him that has has been fooled". Many people were fooled by the movie "super size me" with the bit about liver damage coming on so fast from fast food consumption. You don't get a lifetimes worth of alcohol damage to a liver with just a few weeks of eating junk food. The broad assertion that fast foods aren't good for you is a pretty simple one and one that's generally true, but we have to be very careful with half-truths obscuring our view of deeper truths. These sorts of documentaries can prematurely stop people's thinking on complex topics by giving people a simple narrative to run with. Partial truths embedded in compelling narratives can easily stop people thinking more deeply on topics and with complex topics this is often disastrous. Getting healthy is a complex endeavour and getting these your health sorted is most certainly worth it. But to get your health right requires nuanced thinking that's personalized to you. It's crucial that you get good nutrition, good exercise and good sleep if you want to be healthy. What this means for you is going to be personal because we all have different bodies and different lifestyles, not to mention different health goals. But health is a holistic thing and can't just be broken down to one simple thing. Good nutrition is just part of getting healthy.