No need to bring in a distracting discussion about private vs. public health system. In Europe the public health systems are doing terrible, too.

Things I've been told by doctors in USA and Europe: "Hospitals are full of obese and old people." "A significant chunk of the budget goes to a small fraction of extremely unhealthy people who keep coming back."

Boomers are getting really old and are starting to overload the system. Anything done to make them healthier counts.

I'm assuming you're a North American like myself. I find it shocking how attitudes towards health and food in Europe are so different from here. Flying back from France or Italy through the USA is a surreal experience -- obesity is a major problem in America and a pretty bad one in Canada as well.

I am convinced it's not a problem of willpower, but the food just being engineered to be addictive and overly flavourful at any cost.

> I am convinced it's not a problem of willpower, but the food just being engineered to be addictive and overly flavourful at any cost.

This is where I'm at with our processed food in the US, and I agree with this as an actual recovering addict (opioids). Massive lucrative businesses have been built on addiction and making things more addictive. We allowed this trend to continue in our culture by voting with our dollars, and I suppose wr could point fingers all day, but I also land back on the question of how do we, as a society, fix it and do better moving forward?

The world works on money. Socialized health care in Canada so if obesity and related health issues such as diabetes and so many other issues brought on by decreased mobility as seen with obese people costs the system too much money there will be an incentive to change it. We already are starting to see sugar taxes. Corporations and citizens can be taxed more just like cigarettes to help pay for healthcare costs and programs. Subsidies for gym memberships could be offered. Schools could include more health and fitness. Reduce taxes on qualified health foods. And ultimately an attitude shift. We have so many “influencers” promoting extremely obese body types as natural and okay. I would never body shame anyone but let’s get real about things and praise more healthy role models.

Unfortunately, obesity trends in Europe are catching up with the US (in many countries, at least): https://www.obesityevidencehub.org.au/collections/trends/adu...

Yeah it's difficult, bodyshaming is too much of a thing. Even something as simple as MSG makes you want to eat much more.

MSG occurs naturally in some foods but they tended to be really expensive (e.g. highly matured cheeses) so it was not such a big deal. But now it's added to everything.

It's true that MSG content in e.g. aged parmesan is high... but it's not so low in e.g. cheddar and people tend to use a lot more of that.

Also mushrooms, tomatoes, etc. especially dried.

Mainly staying away from too much processed foods helps, but MSG content isnt' the main problem with them, it's a combination of flavoring agents + very high calorie density.

I don't know, it feels like they are engineered.

Sometimes I'm not hungry at all but I take a small bowl of potato chips with a movie. Then after that I get a real craving for MORE. And I end up eating the whole bag. It's weird. I don't have it before I start.

Maybe other more natural snacks would be better yes but they are just so nice.

That "cheddar" isn't cheddar. It's probably not even cheese. It's a yellow melting slab. Not a lot of people actually eat real cheddar.

True, the cheddar I'd use to get in Ireland was very different than the yellow plastic-wrapped slices you get in the supermarket, or the gooey slabs at McDonald's.

It was more crumbly and a darker orange colour. Also much stronger taste.

They had it in the supermarket but it was not the wrapped-slice stuff but sold in bricks.

I'm surprised they're allowed call that stuff Cheddar actually.

If I recall correctly, the MSG content in both is not inconsiderable, so this isn't really a counterpoint.

Obesity is a major problem across Europe increasingly [0]. Britain is nearly as obese as the US now for example.

Australia and New Zealand have similar obesity problems as the US and Canada.

Europe is just catching up to the mistakes the US has made since the 1980s. Some nations are faring better due to their culture (strongly ingrained behaviors) holding back the mistakes, such as eg France.

[0] WHO report: Europe can reverse its obesity “epidemic” | https://www.who.int/europe/news/item/03-05-2022-new-who-repo...

"The report, launched at a press event on 3 May and presented at the European Congress on Obesity, reveals that in the European Region, 59% of adults and almost 1 in 3 children (29% of boys and 27% of girls) are overweight or living with obesity. Obesity prevalence for adults in the European Region is higher than in any other WHO region except for the Americas."

While Europe is not immune (and obesity is rising), I suspect the EU will have a much more pro-active attitude towards stemming the rise.

It's hard to find data, but America had an early, meteoric rise in obesity starting in the 90s (after a slow rise in the 80s) that I believe is far worse than what Europe saw. Europe is catching up, however, and I imagine there's at least some "americanization" of food to be blamed here.

One little data point. Until like 10 years ago you never got sauces with your food (except fast food), and especially not in your salads here.

Now there's a full sauce menu everywhere and I suspect coleslaw defeats the point of having a salad completely.

Particularly the way coleslaw is presented in the US. You can make a perfectly delicious and healthful coleslaw without mayonnaise or cream (or sugar!)

I just looked at the ingredients of a premade coleslaw (Safeway). The second and third ingredients are mayonnaise and sugar respectively.

Mayo in the US is poison, you couldn't pay me to eat it.

I think it's the rise of transported from afar cheap vegetables. Since they are more sturdy, they are cheaper, it's more lucrative (and budget friendly when cooking at home) to get bland supermarket tomatoes and make a salad with them, by adding sauce.

Locally sourced vegetables can be much more flavourful, reducing the need for additional sauces. I always enjoy making a "tomato, cucumber, olive oil" salad and watch foreigners coming to Bulgaria ask "oh wow what sauce did you use" and I go - none, that's how those veggies are supposed to taste.

But you only get those kind of supplies by going to a bazaar/market and pick them out individually yourself.

ahhhh Doritos!

Not even once.

(too late)

I think it is willpower and the food itself. The food taxes willpower, which is a finite resource, and the food industry is winning.

I know the debate between big and small government is endless, but there are some cases of choice removal that are good.

The recent headlines that "CA are banning Skittles"[1] are emblematic of the power of the food lobby. They are in no way banning Skittles. They are banning 3 chemicals, 1 of which is banned for putting on your skin but not in your stomach. All are banned in the EU (I believe).

Google results for the quoted string above are littered with results that don't say one thing about the truth.

[1] https://www.today.com/food/news/california-bill-ab418-skittl...

I don't think you can or should blame willpower here. If the carrying capacity of an environment is finite and you overwhelm it, you blame the stressor, not the capacity.

I agree that the industry is too good at setting the narrative and "flooding the zone" in the US, however.

I agree with your point about stress, but I have a more charitable read of GP's post.

As someone who has had these kinds of issues in the past, I think it's important to acknowledge the effect food has on "willpower". I wanted to eat less, but some foods made it nigh impossible to stop once I'd started. And I've noticed that they also make you not want to eat anything else, so when you run out, you'll buy the same crap again.

This compounds in other areas of life, too: I was a lazy slob because I had no energy to do anything, even though I was consuming massive amounts of calories.

So in that light, I think GP very much blames the stressors: the companies overwhelming the willpower.

You did a better job of explaining what I meant. Thanks.

I have struggled with a sugar addiction my whole life. I've read that sugar is in nearly every packaged food. It's just too hard to avoid, unless you make all your own food from scratch.

Also, sugar is everywhere. Trying to avoid it is nearly impossible. People bringing sweets to work, going to the store, bakery (obvious, but sometimes you go to pick up bread), coffee shop, etc. It's literally everywhere.

Companies definitely intentionally overwhelm our willpower.

That's what I've also noticed. What helped me a lot, was that during university I wasn't particularly social, so I was able to stop eating sweets (by not buying them, and not being in a place where they were offered freely – think parties and such).

This worked to the point that I stopped identifying those as food, and would actually not want to eat any when encountering them, although two years prior I'd buy Snickers bars by the truckload.

Of course, later I more or less relapsed, by trying just this piece of cake when eating out. Which became more and more regular. Of course, eating out is terrible for this, as I'm pretty sure they put tonnes of sugar in their sauces. Otherwise, I can't explain why eating a steak in a restaurant will make me hungry two hours later, whereas eating the same-sized steak at home, but without the sauce, will have me satiated until evening.

> I am convinced it's not a problem of willpower

This is an interesting thought. I agree, but I also agree, in a sense, when people say we need to have more willpower in order to overcome the problem. Yet, I agree with it in the same way I agree I need to have stronger muscles if I want to beat a grizzly bear in a wrestling match. Of course I do. But is it practical or even humanly possible? Not really and almost certainly not. I'm worried that the engineering we're doing to food is essentially that grizzly bear, and we're at a point where it's becoming borderline inhuman to tackle that problem.

Humans are not islands, and as individuals, we depend immensely upon the decisions others make around us in order to thrive. At the moment, our food industry expressly undermines our ability to thrive in order to ensure it thrives instead. In terms of health outcomes, it appears to me that some of the best things that can happen to you as a child are a) not being exposed to much sugar, thus not developing much of a taste for it, b) not having access to convenience foods such as fast food, instant meals, to-go items, etc, and c) being introduced and accustomed to whole foods early in life such that they're appealing and gratifying later in life. In North America, we seem to actively work against this happening.

I know people have a lot of willpower. We've survived this far because of it. Today we still have as much as our ancestors did, but our attention and energy is so broadly divided and absorbed so intensively. The project of not eating unhealthy food is—bizarrely—an intensive and demanding one for those of us who have been pulled into its grip. To say no to the craving, or to delve into the science of what's harming us and how, or why such delicious food is unhealthy even though so many people insist otherwise, is a serious job in and of itself. Frankly I don't fault anyone for struggling in that battle.

So, sure, willpower would help. But most of us are tapped out. We need to reduce the need for willpower at a systemic level. Suggesting otherwise often ignores one's good fortune of not needing that willpower in the first place, or having the opportunity to focus one's willpower for one reason or another. This good fortune is rare for many, many people.

its because to make everything 'low-fat' they reduced flavor, so everything now has sugar added to it.

Low-fat also means no satisfaction. You can eat a ton of rice cakes to no avail. Try a salad with no oil or cheese. Ugh.

> the food just being engineered to be addictive and overly flavourful at any cost.

Not only. Highly palatable foods are also designed to bypass and confuse our satiety response so that we consume vastly more of it than we would if we were eating "regular" food.

While I agree with the truth of your first statement, your view seems rather black and white. Companies don’t only see patients as profit centers, most investors probably do. Anthropomorphizing corporations is of little value, arguably a dangerous abstraction.

Ever been to a medical provider (MD, NP, PA) and have them breeze in, mumble some questions to you, type some things on their computer while barely looking at you, and then breeze back out, all within 15 minutes?

That's because they are required to see as many patients as possible. One company my wife worked for required her to see 21 a day. She had bonuses tied to increased volume. Not their improved health outcomes. How many patients she saw.

Having bonuses tied to the number of patients she saw was something she experienced at every company she has worked for as an NP except one.

Now, tell me again how companies don't see patients as profit centers.

I agree with you that investors surely do. However, all but one of those companies she worked for were private companies--one was a family-owned practice.

Wait until you find out about the US cosmetics industry

> The Federal Food, Drug, and Cosmetic Act does not require cosmetic products and ingredients to be approved by FDA before they go on the market, except for color additives that are not intended for use as coal tar hair dyes

https://www.fda.gov/cosmetics/cosmetic-products-ingredients/...

And that includes additives strongly suspected of being carcinogenic like specific estrogen-agonistic parabens

Why did you cherry-pick the sentence that confirms your thesis? For the record, here is the full paragraph that adds way more context:

> The Federal Food, Drug, and Cosmetic Act does not require cosmetic products and ingredients to be approved by FDA before they go on the market, except for color additives that are not intended for use as coal tar hair dyes. However, they must be safe for consumers under labeled or customary conditions of use. Companies and individuals who market cosmetics have a legal responsibility for the safety of their products and ingredients.

You clearly missed "however" that could undermine your thesis.

For example, here is what FDA says on parabens (something people often freak about needlessly): https://www.fda.gov/cosmetics/cosmetic-ingredients/parabens-...

> Are parabens safe as they’re used in cosmetics? Are they linked to breast cancer or other health problems?

> FDA scientists continue to review published studies on the safety of parabens. At this time, we do not have information showing that parabens as they are used in cosmetics have an effect on human health. Here are some of the questions we are considering: (...)

Everything is carcinogenic. It's the dose that is a poison not the substance. That's what scientific evidence over long years of research shows.

> Everything is carcinogenic. It's the dose that is a poison not the substance. That's what scientific evidence over long years of research shows.

Definitely not my area of expertise, but I think this statement of yours is plain wrong. There are indeed certain substances (mutagenics) that are known to be carcinogenic where are others that are not. I think it doesn't depend on the quantity but on the substance itself.

> For example, here is what FDA says on parabens (something people often freak about needlessly)

1. Parabens aren't homogenous

2. There is very concrete evidence now that SPECIFIC parabens induce an identical or near-identical effect as an excessively high estrogen level, which includes breast cancer and cervical cancer.

3. There is also mounting evidence that SPECIFIC parabens accumulate in vitro and hence circumvent the metabolism.

4. There is recent evidence that it's a lot easier to cross the daily threshhold of topical paraben application than expected because consumers apply larger amounts of products.

> Everything is carcinogenic. It's the dose that is a poison not the substance

Of course, life itsself is carcinogenic but that doesn't mean all substances are equally dangerous, which is the whole point here.

> The food industry in the US is making us sick

Food industry everywhere is making everyone sick. The difference is culturally, we don’t care in the US. How many people in the US make food at home? And by make food, I don’t mean heat frozen meals or throw ready made pasta on pasta? That makes a huge difference on how sick we get.

Mandatory for profit economy results in inhumane outcomes. Full stop.

> Mandatory for profit economy results in inhumane outcomes. Full stop.

How have the non-"Mandatory for profit economy" in communist states worked out?

Sorry but I don't find many differences between large capitalist corporate hierarchical structure and the SSSR one. Do you?

Just stop subsidizing large businesses, revert regulatory capture and give incentives to start new businesses as coops for instance. I get that most people have been brought up in the "greedy by default" mode, but that's no excuse to give up and just transact ourselves to oblivion.

You're misrepresenting the parent comment's viewpoint as a binary choice. There is a massive spectrum between shareholder-value-above-all and the "communism boogeyman".

What communist states? They all stopped at the bloody "revolution" and became dictatorships.

The world is incomparably better than pre-capitalism. Yes, the healthcare system in the USA sucks. Doesn’t invalidate the rest of the thing.

Sure, it has been better since the economy switched away from serfs and slaves to wage labor.

It does, though. Same shit can be seen everywhere. Food for profit? Addictive poison. Health for profit? Ineffective care with prolonged suffering and excluded populace. Cars for profit? Emission cheating, subscriptions. Farm equipment for profit? War on independent repair.

Profit motive worked when the market was regulated, there were not many monopolies, excessive profits were progressively taxed, research has been sufficiently well funded, worst jobs were outsourced to colonies and most importantly markets were not saturated and there was an organic demand for new and better products.

I think there are markets where competition creates wealth and markets where supply and demand is inherently dysfunctional. I recommend reading about "market failures" where a free market does not leave participants better off. (There are four broad categories of market failures). So the free market works where it does and doesn't in other cases.

Decent description below: https://www.investopedia.com/terms/m/marketfailure.asp

Replying to my own comment. If you are wondering why healthcare is specifically a market failure related to

1) Information asymmetry. Patients do not generally know how to select and shop for their treatment without medical expertise.

2) Adverse selection. Unhealthy people want good healthcare, which drives up the risk pool of "good plans". While insurance companies in general want healthier patients, which often leads to insurance firms to compete to offer plans that only appeal to the healthiest people. (I.e who can offer the most restrictive, and cheapest plans) see insurance death spiral. https://en.m.wikipedia.org/wiki/Death_spiral_(insurance)

3) Perverse incentives. Profitable treatment does not always align with best treatment decisions. This both comes from providers and insurers. See information asymmetry.

4) Monopolistic characteristics: A Monopoly is generally defined by a firms ability to restrict output to reach the profit maximizing production (absent of meaningful competition). Try seeing a specialist on an HMO and you can figure the relation to healthcare. Significant regulatory and market capture makes avoiding with health insurance impossible (including your providers insurance), leading to spiraling costs.

Also, "the world" is literally burning.

Healthcare isn't the only market where under-regulated capitalism has essentially corrupted it. Politics and finance are two others.

The issue at stake isn't healthy profit-seeking that happens in a regulated market - but the rent-seeking that occurs when markets break down (logical endgame of capitalism).

This doesn’t have anything to do with capitalism.

This is so true, and so wrong. We will look back and see it as outright barbarism.

I think we're headed towards a major Constitution revision (or a sequel to the Declaration of Independence) within a couple of generations, and the "rights" we will enshrine will include things like "health care whose PKI is health outcomes and not profit" and "money cannot be a factor in elections".

Of course, voter education has to go right along with that.

If there were one food & safety item the Biden Administration should put its focus on, it's destroying the US addiction to sugar generally and high fructose corn syrup specifically. It would be an immense contribution to roll that backwards. And fix the mistake of proclaiming fat in general to be the problem decades past, by pushing national education on healthy / unhealthy fats. The US Government has a budget to put ads everywhere just focused on this matter.

And regarding the healthcare industrial complex. For the US scenario, there is only one approach that will work at this point: California needs to build its own universal healthcare system from the ground-up, and that includes utilizing the UC university system to train / educate its labor just to build that up. It's already understood how to model it, there are numerous good example nations to choose from (there are obviously multiple variations of a universal system that will work, and far better than what the US is doing now). California has scale and can control many aspects of a healthcare system that a smaller, weaker state can't (including manufacturing its own generic drugs if necessary).

Many prominent politicians keep trying to force universal healthcare as an idea, as though we can just slap it on top of our existing cost structure. It doesn't work right now due to the extreme cost of US healthcare (unless we want to instantly go broke nationally). You have to be able to start over from first steps and contain the cost correctly from day one. California is one of the few places that can do that, and it has the best shot at it overall (some money, majority favors universal healthcare politically, UC system, etc).

Sugar is really tough because a lot of popular items have much more sugar than most people realize. Consider this label of Kroger milk[0]. That's 12g of sugar in one cup. If you stick two cups in your breakfast, that's nearly 2/3 of the way to a can of coke and that's before you even consider how much sugar is in the cereal itself.

[0]https://www.kroger.com/product/images/large/left/00011110416...

Agreed. There are over 50 different names for sugar that the FDA will accept on the ingredients list and you can bet your ass the food manufacturers will take advantage of that.

I saw a popular granola bar once that listed four different kinds of sugar as the first four ingredients. Of course, the rest of the packaging touted the bar as being "healthy"

Wow just checked my brand of milk and it is the same. I never paid attention or realized that before.

Have a look at your peanut butter. That's right. The major food manufacturers add sugar to peanut butter.

One of the best peanut butters I've ever tasted was Crazy Richard's. Here's the ingredients list verbatim:

Peanuts. (No, seriously. That’s all.)

If you like milk, ultrafiltered milk (Fairlife is the big national brand, though I think there are some smaller brands) may be a good option here; its more expensive, but has less sugar (and not with any substitution).

Many products have a great deal of added sugar, but the sugar in milk is naturally occurring lactose. It would be better to remove the breakfast cereal from your diet than the milk.

Naturally occurring sugar is still sugar.

And wait until you find out what's in fruit juice.

It's a distraction. America isn't obese because milk has naturally occurring sugars.