Group items tagged

Dr. Monteiro and his colleagues developed a food classification system called Nova, named after the Portuguese and Latin words for “new.” It has since been adopted by researchers across the world.

Unprocessed or minimally processed foods, like fresh or frozen fruits and vegetables, beans, lentils, meat, poultry, fish, eggs, milk, plain yogurt, rice, pasta, corn meal, flour, coffee, tea and herbs and spices.

Processed culinary ingredients, such as cooking oils, butter, sugar, honey, vinegar and salt.

If you look at the ingredient list and you see things that you wouldn’t use in home cooking, then that’s probably an ultraprocessed food,”

his group includes freshly baked bread, most cheeses and canned vegetables, beans and fish. These foods may contain preservatives that extend shelf life.

Ultraprocessed foods made using industrial methods and ingredients you wouldn’t typically find in grocery stores — like high-fructose corn syrup, hydrogenated oils and concentrated proteins like soy isolate.

They often contain additives like flavorings, colorings or emulsifiers to make them appear more attractive and palatable.

Think sodas and energy drinks, chips, candies, flavored yogurts, margarine, chicken nuggets, hot dogs, sausages, lunch meats, boxed macaroni and cheese, infant formulas and most packaged breads, plant milks, meat substitutes and breakfast cereals.

Processed foods made by combining foods from Category 1 with the ingredients of Category 2 and preserving or modifying them with relatively simple methods like canning, bottling, fermentation and baking

That has led to debate among nutrition experts about whether it’s useful for describing the healthfulness of a food, partly since many UPFs — like whole grain breads, flavored yogurts and infant formulas — can provide valuable nutrients

Most research linking UPFs to poor health is based on observational studies, in which researchers ask people about their diets and then track their health over many years.

Why might UPFs be harmful?

In a large review of studies that was published in 2024, scientists reported that consuming UPFs was associated with 32 health problems, with the most convincing evidence for heart disease-related deaths, Type 2 diabetes and common mental health issues like anxiety and depression.

Such studies are valuable, because they can look at large groups of people — the 2024 review included results from nearly 10 million — over the many years it can take for chronic health conditions to develop

She added that the consistency of the link between UPFs and health issues increased her confidence that there was a real problem with the foods.

But the observational studies also have limitations,

It’s true that there is a correlation between these foods and chronic diseases, she said, but that doesn’t mean that UPFs directly cause poor health.

Dr. O’Connor questioned whether it’s helpful to group such “starkly different” foods — like Twinkies and breakfast cereals — into one category. Certain types of ultraprocessed foods, like sodas and processed meats, are more clearly harmful than others

UPFs like flavored yogurts and whole grain breads, on the other hand, have been associated with a reduced risk of developing Type 2 diabetes.

Clinical trials are needed to test if UPFs directly cause health problems, Dr. O’Connor said. Only one such study, which was small and had some limitations, has been done, s

In that study, published in 2019, 20 adults with a range of body sizes lived in a research hospital at the National Institutes of Health for four weeks. For two weeks, they ate mainly unprocessed or minimally processed foods, and for another two weeks, they ate mainly UPFs. The diets had similar amounts of calories and nutrients, and the participants could eat as much as they wanted at each meal.

During their two weeks on the ultraprocessed diet, participants gained an average of two pounds and consumed about 500 calories more per day than they did on the unprocessed diet

During their time on the unprocessed diet, they lost about two pounds.

That finding might help explain the link between UPFs, obesity and other metabolic conditions

The Nova system notably doesn’t classify foods based on nutrients like fat, fiber, vitamins or minerals. It’s “agnostic to nutrition,”

There are many “strong opinions” about why ultraprocessed foods are unhealthy, Dr. Hall said. “But there’s actually not a lot of rigorous science” on what those mechanisms are

Because UPFs are often cheap, convenient and accessible, they’re probably displacing healthier foods from our diets

the foods could be having more direct effects on health. They can be easy to overeat — maybe because they contain hard-to-resist combinations of carbohydrates, sugars, fats and salt, are high-calorie and easy to chew

It’s also possible that resulting blood sugar spikes may damage arteries or ramp up inflammation, or that certain food additives or chemicals may interfere with hormones, cause a “leaky” intestine or disrupt the gut microbiome.

Researchers, including Dr. Hall and Dr. Davy, are beginning to conduct small clinical trials that will test some of these theories.

most researchers think there are various ways the foods are causing harm. “Rarely in nutrition is there a single factor that fully explains the relationship between foods and some health outcome,”

In 2014, Dr. Monteiro helped write new dietary guidelines for Brazil that advised people to avoid ultraprocessed foods.

Other countries like Mexico, Israel and Canada have also explicitly recommended avoiding or limiting UPFs or “highly processed foods.”

The U.S. dietary guidelines contain no such advice, but an advisory committee is currently looking into the evidence on how UPFs may affect weight gain, which could influence the 2025 guidelines.

It’s difficult to know what to do about UPFs in the United States, where so much food is already ultraprocessed and people with lower incomes can be especially dependent on them,

“At the end of the day, they are an important source of food, and food is food,” Dr. Mattei added. “We really cannot vilify them,”

While research continues, expert opinions differ on how people should approach UPFs.

the safest course is to avoid them altogether

to swap flavored yogurt for plain yogurt with fruit, for example, or to buy a fresh loaf from a local bakery instead of packaged bread, if you can afford to do so

Dr. Vadiveloo suggested a more moderate strategy, focusing on limiting UPFs that don’t provide valuable nutrients, like soda and cookies

She also recommended eating more fruits, vegetables, whole grains (ultraprocessed or not), legumes, nuts and seeds.

Cook at home as much as you can, using minimally processed foods

The vast majority of waste — more than 80 percent — is generated by homes and consumer-facing businesses like grocery stores and restaurants.

The hype surrounding this movement is inflated by the public’s ignorance of the food supply chain.

Despite the dramatic anecdotes about truckloads of landfilled crops, little of farm waste is due to merely “cosmetic” blemishes. Much of it is bruised or weeping goods that can quickly break down and rot the entire crate. With many crops, misshapen produce knocks against its neighbors during transit, poking holes and jeopardizing entire bins. “Drops” (produce that’s fallen on the ground) are left behind because otherwise they tend to cause food-poisoning outbreaks. Farms till excessively damaged produce back into the soil along with the crop’s stems and leaves, recycling their nutrients.

North America’s packinghouses discard about 1 percent of the produce that enters their doors, according to the United Nations Food and Agriculture Organization — usually because it’s straight-up rotten.

For the most part, ugly-produce initiatives are simply gentrifying second-grade produce that was already being eaten — just not, perhaps, by upscale shoppers. It’s the food equivalent of Lyft “inventing” a bus.

The most effective ways to tackle that

boil down to the old mantra to reduce, reuse and recycle.

The single biggest source of U.S. food waste, accounting for 43 percent of the problem, is our own homes

Most of all, we should sync our shopping habits with our eating habits. Affluent shoppers waste the most produce because of how much of it they buy and then trash

The most important behavioral change consumers can make to address food waste isn’t to buy certain kinds of produce. It’s to actually eat what we bring home.

Homes, food service and grocery stores generate 7.8 million tons of food waste per year that can’t be salvaged, accounting for 12 percent of the problem. This waste needs to be recycled. The Environmental Protection Agency says that the United States composts only 5 percent of its food waste. (Compare that with 15 percent in the European Union.)

Biochar — made by heating inedible food and other organic waste until it becomes inert, odorless, nutrient-rich charcoal — could be a very effective way to recycle food waste, but it’s underutilized, because the equipment to do it at municipal scale is so new. Like composting, biochar can be used as a fertilizer, returning food waste’s nutrients back to the soil. Unlike composting, it can handle food waste that’s mixed with general nonhazardous trash — no need for costly separate collection and handling. Biochar also sequesters carbon for centuries.

But the infrastructure — donation matching software, cold storage and refrigerated trucks — to handle large donations of eggs, dairy, meat, bread and produce is still being built. Funding more food bank infrastructure, educating potential donors about liability laws, creating more donation tax incentives and standardizing food safety regulations would recover up to 996,000 tons of food, or 1.7 billion meals, per year, according to ReFED.

For certain crops like berries, tomatoes, leafy greens and cucumbers, farms can take advantage of state and federal funds that would help them switch from open-field to hoophouse or greenhouse methods. Already common in East Asia and Europe, these methods boost yields and dramatically reduce how much of the crop is too damaged to leave the farm

As long as we eat fresh food instead of shelf-stable nutrient bars, perishability is part of the bargain. The only way to completely eliminate food waste is to abolish fresh food. Beyond that, all we can do is manage the waste.

the mouth feel of soda and many other food items, especially those high in fat, is second only to the bliss point in its ability to predict how much craving a product will induce.

He organized focus-group sessions with the people most responsible for buying bologna — mothers — and as they talked, he realized the most pressing issue for them was time. Working moms strove to provide healthful food, of course, but they spoke with real passion and at length about the morning crush, that nightmarish dash to get breakfast on the table and lunch packed and kids out the door.

as the focus swung toward kids, Saturday-morning cartoons started carrying an ad that offered a different message: “All day, you gotta do what they say,” the ads said. “But lunchtime is all yours.”

When it came to Lunchables, they did try to add more healthful ingredients. Back at the start, Drane experimented with fresh carrots but quickly gave up on that, since fresh components didn’t work within the constraints of the processed-food system, which typically required weeks or months of transport and storage before the food arrived at the grocery store. Later, a low-fat version of the trays was developed, using meats and cheese and crackers that were formulated with less fat, but it tasted inferior, sold poorly and was quickly scrapped.

One of the company’s responses to criticism is that kids don’t eat the Lunchables every day — on top of which, when it came to trying to feed them more healthful foods, kids themselves were unreliable. When their parents packed fresh carrots, apples and water, they couldn’t be trusted to eat them. Once in school, they often trashed the healthful stuff in their brown bags to get right to the sweets.

This idea — that kids are in control — would become a key concept in the evolving marketing campaigns for the trays. In what would prove to be their greatest achievement of all, the Lunchables team would delve into adolescent psychology to discover that it wasn’t the food in the trays that excited the kids; it was the feeling of power it brought to their lives.

The prevailing attitude among the company’s food managers — through the 1990s, at least, before obesity became a more pressing concern — was one of supply and demand. “People could point to these things and say, ‘They’ve got too much sugar, they’ve got too much salt,’ ” Bible said. “Well, that’s what the consumer wants, and we’re not putting a gun to their head to eat it. That’s what they want. If we give them less, they’ll buy less, and the competitor will get our market. So you’re sort of trapped.”

at last count, including sales in Britain, they were approaching the $1 billion mark. Lunchables was more than a hit; it was now its own category

he holds the entire industry accountable. “What do University of Wisconsin M.B.A.’s learn about how to succeed in marketing?” his presentation to the med students asks. “Discover what consumers want to buy and give it to them with both barrels. Sell more, keep your job! How do marketers often translate these ‘rules’ into action on food? Our limbic brains love sugar, fat, salt. . . . So formulate products to deliver these. Perhaps add low-cost ingredients to boost profit margins. Then ‘supersize’ to sell more. . . . And advertise/promote to lock in ‘heavy users.’ Plenty of guilt to go around here!”

men in the eastern part of Finland had the highest rate of fatal cardiovascular disease in the world. Research showed that this plague was not just a quirk of genetics or a result of a sedentary lifestyle — it was also owing to processed foods. So when Finnish authorities moved to address the problem, they went right after the manufacturers. (The Finnish response worked. Every grocery item that was heavy in salt would come to be marked prominently with the warning “High Salt Content.” By 2007, Finland’s per capita consumption of salt had dropped by a third, and this shift — along with improved medical care — was accompanied by a 75 percent to 80 percent decline in the number of deaths from strokes and heart disease.)

I tracked Lin down in Irvine, Calif., where we spent several days going through the internal company memos, strategy papers and handwritten notes he had kept. The documents were evidence of the concern that Lin had for consumers and of the company’s intent on using science not to address the health concerns but to thwart them. While at Frito-Lay, Lin and other company scientists spoke openly about the country’s excessive consumption of sodium and the fact that, as Lin said to me on more than one occasion, “people get addicted to salt

the marketing team was joined by Dwight Riskey, an expert on cravings who had been a fellow at the Monell Chemical Senses Center in Philadelphia, where he was part of a team of scientists that found that people could beat their salt habits simply by refraining from salty foods long enough for their taste buds to return to a normal level of sensitivity. He had also done work on the bliss point, showing how a product’s allure is contextual, shaped partly by the other foods a person is eating, and that it changes as people age. This seemed to help explain why Frito-Lay was having so much trouble selling new snacks. The largest single block of customers, the baby boomers, had begun hitting middle age. According to the research, this suggested that their liking for salty snacks — both in the concentration of salt and how much they ate — would be tapering off.

Riskey realized that he and his colleagues had been misreading things all along. They had been measuring the snacking habits of different age groups and were seeing what they expected to see, that older consumers ate less than those in their 20s. But what they weren’t measuring, Riskey realized, is how those snacking habits of the boomers compared to themselves when they were in their 20s. When he called up a new set of sales data and performed what’s called a cohort study, following a single group over time, a far more encouraging picture — for Frito-Lay, anyway — emerged. The baby boomers were not eating fewer salty snacks as they aged. “In fact, as those people aged, their consumption of all those segments — the cookies, the crackers, the candy, the chips — was going up,” Riskey said. “They were not only eating what they ate when they were younger, they were eating more of it.” In fact, everyone in the country, on average, was eating more salty snacks than they used to. The rate of consumption was edging up about one-third of a pound every year, with the average intake of snacks like chips and cheese crackers pushing past 12 pounds a year

Riskey had a theory about what caused this surge: Eating real meals had become a thing of the past.

“We looked at this behavior, and said, ‘Oh, my gosh, people were skipping meals right and left,’ ” Riskey told me. “It was amazing.” This led to the next realization, that baby boomers did not represent “a category that is mature, with no growth. This is a category that has huge growth potential.”

The food technicians stopped worrying about inventing new products and instead embraced the industry’s most reliable method for getting consumers to buy more: the line extension.

He zeroed right in on the Cheetos. “This,” Witherly said, “is one of the most marvelously constructed foods on the planet, in terms of pure pleasure.” He ticked off a dozen attributes of the Cheetos that make the brain say more. But the one he focused on most was the puff’s uncanny ability to melt in the mouth. “It’s called vanishing caloric density,” Witherly said. “If something melts down quickly, your brain thinks that there’s no calories in it . . . you can just keep eating it forever.”

Frito-Lay acquired Stacy’s Pita Chip Company, which was started by a Massachusetts couple who made food-cart sandwiches and started serving pita chips to their customers in the mid-1990s. In Frito-Lay’s hands, the pita chips averaged 270 milligrams of sodium — nearly one-fifth a whole day’s recommended maximum for most American adults — and were a huge hit among boomers.

There’s a paradox at work here. On the one hand, reduction of sodium in snack foods is commendable. On the other, these changes may well result in consumers eating more. “The big thing that will happen here is removing the barriers for boomers and giving them permission to snack,” Carey said. The prospects for lower-salt snacks were so amazing, he added, that the company had set its sights on using the designer salt to conquer the toughest market of all for snacks: schools

The company’s chips, he wrote, were not selling as well as they could for one simple reason: “While people like and enjoy potato chips, they feel guilty about liking them. . . . Unconsciously, people expect to be punished for ‘letting themselves go’ and enjoying them.” Dichter listed seven “fears and resistances” to the chips: “You can’t stop eating them; they’re fattening; they’re not good for you; they’re greasy and messy to eat; they’re too expensive; it’s hard to store the leftovers; and they’re bad for children.” He spent the rest of his memo laying out his prescriptions, which in time would become widely used not just by Frito-Lay but also by the entire industry.

Dichter advised Frito-Lay to move its chips out of the realm of between-meals snacking and turn them into an ever-present item in the American diet. “The increased use of potato chips and other Lay’s products as a part of the regular fare served by restaurants and sandwich bars should be encouraged in a concentrated way,”

the largest weight-inducing food was the potato chip. The coating of salt, the fat content that rewards the brain with instant feelings of pleasure, the sugar that exists not as an additive but in the starch of the potato itself — all of this combines to make it the perfect addictive food. “The starch is readily absorbed,” Eric Rimm, an associate professor of epidemiology and nutrition at the Harvard School of Public Health and one of the study’s authors, told me. “More quickly even than a similar amount of sugar. The starch, in turn, causes the glucose levels in the blood to spike” — which can result in a craving for more.

If Americans snacked only occasionally, and in small amounts, this would not present the enormous problem that it does. But because so much money and effort has been invested over decades in engineering and then relentlessly selling these products, the effects are seemingly impossible to unwind.

Todd Putman, who worked at Coca-Cola from 1997 to 2001, said the goal became much larger than merely beating the rival brands; Coca-Cola strove to outsell every other thing people drank, including milk and water. The marketing division’s efforts boiled down to one question, Putman said: “How can we drive more ounces into more bodies more often?”

Landfills of rotting food emit methane, a gas that is roughly 25 times more harmful than carbon dioxide. And to harvest and transport all that wasted food requires billions of acres of arable land, trillions of gallons of water and vast amounts of fossil fuels.

For consumers, cutting back on food waste is one of the few personal habits that can help the planet. But for some reason, a lot of people who fret about their carbon footprint aren’t sweating the vegetables and rump steak they toss into the garbage.

“There’s been a lot of focus on energy,” said Paul Behrens, a professor in energy and environmental change at the University of Leiden in the Netherlands. “But climate change is as much a land issue and a food issue as anything else.”

Reducing waste is a challenge because selling as much food as possible is a tried, tested and ingrained part of all-you-can-eat cultures. Persuading merchants to promote and profit from “food rescue,” as it is known, is not so obvious.

“Consumers are paying for the food, and who wants to reduce that?

A growing number of supermarkets, restaurants and start-ups — many based in Europe — are trying to answer that question. The United States is another matter.

“Food waste might be a uniquely American challenge because many people in this country equate quantity with a bargain,

Nine of the 10 United States supermarket chains that were assessed by the nonprofit Center for Biological Diversity last year were given a C grade or lower on food-waste issues

Some of the most promising food waste efforts are apps that connect food sellers to food buyers

Among the most popular is Too Good to Go, a company based in Copenhagen, with 13 million users and contracts with 25,000 restaurants and bakeries in 11 countries. Consumers pay about one-third of the sticker price for items, most of which goes to the retailer, with a small percentage paid to the app

“I was on a business trip to Scotland and I read about Selina in a newspaper,” Mr. Jensen recalls. “Around that time, we learned that every Dane was throwing out 63 kilos of food per year” — about 139 pounds — “and I was sitting in this airport thinking, she’s right.”

After the two met in a Copenhagen cafe, REMA 1000 eliminated in-store bulk discounts. As of 2008, there would be no more three hams for the price of two, or any variations on that theme

Executives at S-market in Finland make no such claims about their happy hour. Mika Lyytikainen, an S-market vice president, explained that the program simply reduces its losses.“When we sell at 60 percent off, we don’t earn any money, but we earn more than if the food was given to charity,” he said. “On the other hand, it’s now possible for every Finn to buy very cheap food in our stores.”

With such a huge food supply, food marketing got better and restaurants got cheaper. The low cost of food fueled the growth of the fast-food industry. If food were expensive, you couldn’t have fast food.

The epidemic was caused by the overproduction of food in the United States. Beginning in the 1970s, there was a change in national agricultural policy. Instead of the government paying farmers not to engage in full production, as was the practice, they were encouraged to grow as much food as they could. At the same time, technological changes and the “green revolution” made our farms much more productive. The price of food plummeted, while the number of calories available to the average American grew by about 1,000 a day.

Well, what do people do when there is extra food around? They eat it! This, of course, is a tremendously controversial idea. However, the model shows that increase in food more than explains the increase in weight.

There’s no magic bullet on this. You simply have to cut calories and be vigilant for the rest of your life.

Americans are wasting food at a progressively increasing rate. If Americans were to eat all the food that’s available, we’d be even more obese.

What new information did your equation render? That the conventional wisdom of 3,500 calories less is what it takes to lose a pound of weight is wrong. The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight onto an obese person than on a thinner one. Also, there’s a time constant that’s an important factor in weight loss. That’s because if you reduce your caloric intake, after a while, your body reaches equilibrium. It actually takes about three years for a dieter to reach their new “steady state.” Our model predicts that if you eat 100 calories fewer a day, in three years you will, on average, lose 10 pounds — if you don’t cheat. Another finding: Huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake.

People don’t wait long enough to see what they are going to stabilize at. So if you drop weight and return to your old eating habits, the time it takes to crawl back to your old weight is something like three years. To help people understand this better, we’ve posted an interactive version of our model at bwsimulator.niddk.nih.gov.

we should stop marketing food to children.

weight change, up or down, takes a very, very long time. All diets work. But the reaction time is really slow: on the order of a year.

I could see the facts on the epidemic were quite astounding. Between 1975 and 2005, the average weight of Americans had increased by about 20 pounds

People think that the epidemic has to be caused by genetics or that physical activity has gone down. Yet levels of physical activity have not really changed in the past 30 years. As for the genetic argument, yes, there are people who are genetically disposed to obesity, but if they live in societies where there isn’t a lot of food, they don’t get obese. For them, and for us, it’s supply that’s the issue.

I think childhood obesity is a major problem. And when you’re obese, it’s not like we can suddenly cut your food off and you’ll go back to not being obese. You’ve been programmed to eat more. It’s a hardship to eat less. Michelle Obama’s initiative is helpful. And childhood obesity rates seem to be stabilizing in the developed world, at least. The obesity epidemic may have peaked because of the recession. It’s made food more expensive.

I think the food industry doesn’t want to know it. And ordinary people don’t particularly want to hear this, either. It’s so easy for someone to go out and eat 6,000 calories a day.

“Their reaction is, ‘Let me enjoy what I want to eat, and stop telling me what to do.’ And it’s one of the few things that less well-off people have: they don’t have to cook.”

The ubiquity, convenience and habit-forming appeal of hyperprocessed foods have largely drowned out the alternatives: there are five fast-food restaurants for every supermarket in the United States; in recent decades the adjusted for inflation price of fresh produce has increased by 40 percent while the price of soda and processed food has decreased by as much as 30 percent; and nearly inconceivable resources go into encouraging consumption in restaurants: fast-food companies spent $4.2 billion on marketing in 2009.

overconsumption of fast food “triggers addiction-like neuroaddictive responses” in the brain, making it harder to trigger the release of dopamine. In other words the more fast food we eat, the more we need to give us pleasure; thus the report suggests that the same mechanisms underlie drug addiction and obesity.

This addiction to processed food is the result of decades of vision and hard work by the industry. For 50 years, says David A. Kessler, former commissioner of the Food and Drug Administration and author of “The End of Overeating,” companies strove to create food that was “energy-dense, highly stimulating, and went down easy. They put it on every street corner and made it mobile, and they made it socially acceptable to eat anytime and anyplace. They created a food carnival, and that’s where we live. And if you’re used to self-stimulation every 15 minutes, well, you can’t ru

Real cultural changes are needed to turn this around. Somehow, no-nonsense cooking and eating — roasting a chicken, making a grilled cheese sandwich, scrambling an egg, tossing a salad — must become popular again

HOW do you change a culture? The answers, not surprisingly, are complex. “Once I look at what I’m eating,” says Dr. Kessler, “and realize it’s not food, and I ask ‘what am I doing here?’ that’s the start. It’s not about whether I think it’s good for me, it’s about changing how I feel. And

we change how people feel by changing the environment.”

Obviously, in an atmosphere where any regulation is immediately labeled “nanny statism,” changing “the environment” is difficult. But we’ve done this before, with tobacco.

Political action would mean agitating to limit the marketing of junk; forcing its makers to pay the true costs of production; recognizing that advertising for fast food is not the exercise of free speech but behavior manipulation of addictive substances; and making certain that real food is affordable and available to everyone.

bruise, brown, wilt, oxidize, ding, or discolor and that is apparently something American shoppers will not abide. For an American family of four, the average value of discarded produce is nearly $1,600 annually

(Globally, the United Nations Food and Agriculture Organization estimates that one-third of all food grown is lost or wasted, an amount valued at nearly $3 trillion. )

“Grocery stores routinely trash produce for being the wrong shape or containing minor blemishes,

“Vast quantities of fresh produce grown in the U.S. are left in the field to rot, fed to livestock or hauled directly from the field to landfill, because of unrealistic and unyielding cosmetic standards.”

“In my mind, the desire for perfect produce came about in the 1940s as housewives adapted to widespread refrigeration and new CPG [consumer packaged goods] products,”

Perfection and manicured foods came to represent safety and new technology.

this obsession might become amplified in an era of high foodie-ism and Instagram where a sort of heirloom airbrushing has taken hold. Writing in The Times in 2014, Pete Wells christened the extension of this phenomenon in restaurants as “camera cuisine,”

in the last year, ‘foodies’ and chefs have catapulted the issue of food waste into popular conversations,” she adds, naming initiatives by chefs and public intellectuals such as Dan Barber and Roy Choi as well as the pu pu platter of coverage of the issue in elite food magazines.

start-ups like the Bay Area’s Imperfect Produce are starting to deliver ugly but otherwise consumable goods at a discount

France has banned supermarkets from throwing away food by directing them to compost or donate all expiring or unsold food.

Germany is focusing on the issue in part by reforming expiration dates, which many argue are arbitrary and problematic.

“My hope is that as food education proliferates, so will an appreciation for ugly fruits and veggies, biodiversity, local crops, and so much more, all of which can help mitigate food waste,”

“Wouldn't it be neat if the power of Instagram was used to share recipes for carrot top pesto and food scrap stock? Or if we had easy-to-use apps for sharing extra produce with neighbors or food pantries? Both ideas I've already seen foodies fiddling with.”

Climate change will make those threats even worse, as floods, drought, storms and other types of extreme weather threaten to disrupt, and over time shrink, the global food supply

food shortages could lead to an increase in cross-border migration.

A particular danger is that food crises could develop on several continents at once

“The potential risk of multi-breadbasket failure is increasing,” she said. “All of these things are happening at the same time.”

The report also offered a measure of hope, laying out pathways to addressing the looming food crisis, though they would require a major re-evaluation of land use and agriculture worldwide as well as consumer behavior

Proposals include increasing the productivity of land, wasting less food and persuading more people to shift their diets away from cattle and other types of meat.

“People’s lives will be affected by a massive pressure for migration,” said Pete Smith, a professor of plant and soil science at the University of Aberdeen and one of the report’s lead authors. “People don’t stay and die where they are. People migrate.”

activities such as draining wetlands — as has happened in Indonesia and Malaysia to create palm oil plantations, for example — is particularly damaging. When drained, peatlands, which store between 530 and 694 billion tons of carbon dioxide globally, release that carbon dioxide back into the atmosphere.

Between 2010 and 2015 the number of migrants from El Salvador, Guatemala and Honduras showing up at the United States’ border with Mexico increased fivefold, coinciding with a dry period that left many with not enough food and was so unusual that scientists suggested it bears the signal of climate change

As a warming atmosphere intensifies the world’s droughts, flooding, heat waves, wildfires and other weather patterns, it is speeding up the rate of soil loss and land degradation, the report concludes.

Higher concentrations of carbon dioxide in the atmosphere

will also reduce food’s nutritional quality, even as rising temperatures cut crop yields and harm livestock

In some cases, the report says, a changing climate is boosting food production because, for example, warmer temperatures will mean greater yields of some crops at higher latitudes. But on the whole, the report finds that climate change is already hurting the availability of food because of decreased yields and lost land from erosion, desertification and rising seas

Overall if emissions of greenhouse gases continue to rise, so will food costs, according to the report, affecting people around the world.

“You’re sort of reaching a breaking point with land itself and its ability to grow food and sustain us,”

agriculture itself is also exacerbating climate change.

the window to address the threat is closing rapidly

Every 2.5 acres of peatlands release the carbon dioxide equivalent of burning 6,000 gallons of gasoline

And the emissions of carbon dioxide continues long after the peatlands are drained. Of the five gigatons of greenhouse gas emissions that are released each year from deforestation and other land-use changes, “One gigaton comes from the ongoing degradation of peatlands that are already drained,”

(By comparison, the fossil fuel industry emitted about 37 gigatons of carbon dioxide last year, according to the institute.)

cattle are significant producers of methane, another powerful greenhouse gas, and an increase in global demand for beef and other meats has fueled their numbers and increased deforestation in critical forest systems like the Amazon

each year, the amount of forested land that is cleared — much of that propelled by demand for pasture land for cattle — releases the emissions equivalent of driving 600 million cars

The authors urge changes in how food is produced and distributed, including better soil management, crop diversification and fewer restrictions on trade

They also call for shifts in consumer behavior, noting that at least one-quarter of all food worldwide is wasted

But protecting the food supply and cutting greenhouse emissions can also come into conflict with each other, forcing hard choices. For instance, the widespread use of strategies such as bioenergy — like growing corn to produce ethanol — could lead to the creation of new deserts or other land degradation

The report also calls for institutional changes, including better access to credit for farmers in developing countries and stronger property rights

Planting as many trees as possible would reduce the amount of greenhouse gases in the atmosphere by about nine gigatons each year

But it would also increase food prices as much as 80 percent by 2050.

“We cannot plant trees to get ourselves out of the problem that we’re in,

“The trade-offs that would keep us below 1.5 degrees, we’re not talking about them. We’re not ready to confront them yet.”

Preventing global temperatures from rising more than 1.5 degrees Celsius is likely to require both the widespread planting of trees as well as “substantial” bioenergy to help reduce the use of fossil fuels

“Above 2 degrees of global warming there could be an increase of 100 million or more of the population at risk of hunger,” Edouard Davin, a researcher at ETH Zurich and an author of the report, said by email. “We need to act quickly

The same is true for planting large numbers of trees (something often cited as a powerful strategy to pull carbon dioxide out of the atmosphere), which can push crops and livestock onto less productive land

“Agricultural practices that include indigenous and local knowledge can contribute to overcoming the combined challenges of climate change, food security, biodiversity conservation, and combating desertification and land degradation,”

an average of three people were killed per week defending their land in 2018, with more than half of them killed in Latin America.

the longer policymakers wait, the harder it will be to prevent a global crisis. “Acting now may avert or reduce risks and losses, and generate benefits to society,” the authors wrote. Waiting to cut emissions, on the other hand, risks “irreversible loss in land ecosystem functions and services required for food, health, habitable settlements and production.”

The answer to both lies in one word: satiety. It’s a concept that we don’t use much in everyday life but that we’ve all experienced at some point. It describes the sensation of having had enough and not wanting any more.

The primary reason we have gained weight at a pace unprecedented in human history is that our diets have radically changed in ways that have deeply undermined our ability to feel sated

The evidence is clear that the kind of food my father grew up eating quickly makes you feel full. But the kind of food I grew up eating, much of which is made in factories, often with artificial chemicals, left me feeling empty and as if I had a hole in my stomach

In a recent study of what American children eat, ultraprocessed food was found to make up 67 percent of their daily diet. This kind of food makes you want to eat more and more. Satiety comes late, if at all.

After he moved in 2000 to the United States in his 20s, he gained 30 pounds in two years. He began to wonder if the American diet has some kind of strange effect on our brains and our cravings, so he designed an experiment to test it.

He and his colleague Paul Johnson raised a group of rats in a cage and gave them an abundant supply of healthy, balanced rat chow made out of the kind of food rats had been eating for a very long time. The rats would eat it when they were hungry, and then they seemed to feel sated and stopped. They did not become fat.

then Dr. Kenny and his colleague exposed the rats to an American diet: fried bacon, Snickers bars, cheesecake and other treats. They went crazy for it. The rats would hurl themselves into the cheesecake, gorge themselves and emerge with their faces and whiskers totally slicked with it. They quickly lost almost all interest in the healthy food, and the restraint they used to show around healthy food disappeared. Within six weeks, their obesity rates soared.

They took all the processed food away and gave the rats their old healthy diet. Dr. Kenny was confident that they would eat more of it, proving that processed food had expanded their appetites. But something stranger happened. It was as though the rats no longer recognized healthy food as food at all, and they barely ate it. Only when they were starving did they reluctantly start to consume it again.

Drugs like Ozempic work precisely by making us feel full.

processed and ultraprocessed food create a raging hole of hunger, and these treatments can repair that hole

the drugs are “an artificial solution to an artificial problem.”

Yet we have reacted to this crisis largely caused by the food industry as if it were caused only by individual moral dereliction

Why do we turn our anger inward and not outward at the main cause of the crisis? And by extension, why do we seek to shame people taking Ozempic but not those who, say, take drugs to lower their blood pressure?

The first is the belief that obesity is a sin.

The second idea is that we are all in a competition when it comes to weight. Ours is a society full of people fighting against the forces in our food that are making us fatter.

Looked at in this way, people on Ozempic can resemble cyclists like Lance Armstrong who used performance-enhancing drugs.

We can’t find our way to a sane, nontoxic conversation about obesity or Ozempic until we bring these rarely spoken thoughts into the open and reckon with them

remember the competition isn’t between you and your neighbor who’s on weight-loss drugs. It’s between you and a food industry constantly designing new ways to undermine your satiety.

Reducing or reversing obesity hugely boosts health, on average: We know from years of studying bariatric surgery that it slashes the risks of cancer, heart disease and diabetes-related death. Early indications are that the new anti-obesity drugs are moving people in a similar radically healthier direction,

But these drugs may increase the risk for thyroid cancer.

Do we want these weight loss drugs to be another opportunity to tear one another down? Or do we want to realize that the food industry has profoundly altered the appetites of us all — leaving us trapped in the same cage, scrambling to find a way out?

"There's a vast amount of scientific evidence suggesting certain phthalates can contribute to several adverse health effects,

A 2012 study found a strong association between the presence of DEHP and diabetes. A 2013 study found that exposure to the industrial chemical can increase the risk of various allergic diseases in children. And a 2016 study concluded that it can also negatively affect child behavior.

A study undertaken last year, for instance, found that exposure to the phthalate was associated with higher blood pressure.

The reason people who eat fast food seem to have much higher levels of potentially harmful industrial chemicals is unclear. But it's easy enough to guess: the sheer amount of processing that goes into food served at quick-service restaurants

The more machinery, plastic, conveyor belts, and various forms of processing equipment that food touches, the more likely the food is to contain higher levels of phthalates. And fast food tends to touch a good deal more of these things than, say, the food one purchases at a local farmers market

Considering the prevalence of packaged food — and widespread exposure to phthalates (they can be detected in more than 98 percent of the population, per the CDC) — however,  the takeaway isn't necessarily that fast food is toxic. Fast food, after all, isn't the only culprit here.

Anything that's gone through some form of processing or industrial packaging is vulnerable.

Tim Lang, professor of food policy at City University, London, and a former government adviser, said ministers have worked on the assumption that feeding Britain can be left to the market and big retailers. While ministers have been in discussion with supermarket chief executives during the pandemic, Lang argues they are failing to grasp the structural weaknesses in the food system and the scale of food poverty.

Lang added: “Borders are closing, lorries are being slowed down and checked. We only produce 53% of our own food in the UK. It’s a failure of government to plan.”

“Some £1bn extra food and groceries were bought by households in the last two to three weeks. That’s like Christmas but worse because it’s gone on for three times as long,” said Andrew Opie, director of food at the British Retail Consortium, the supermarket trade association.

Supermarkets have built supply chains of immense complexity and sophistication over the last four decades, affording customers a choice of more than 40,000 lines from around the world – from dozens of different kinds of pasta to a permanent global summertime of fresh fruits and vegetables.

The consequences of a disrupted supply chain will be most acute for the millions in households whose incomes are so low that they have depended on food banks or free meals at school or in daycare centres, which have now closed.

She added: “We may need the army to oversee biosecurity as caterers, for example in school kitchens, supply hubs and to enforce social distancing as people collect food from them.”

The government has also been working on a scheme for parents of the 1.6 million children who had been on free school meals, with vouchers which can be redeemed in supermarkets. Campaigners, however, argue the vouchers should be usable for nutritionally-balanced meals from school kitchens, which could be kept open.

The industry can see other threats on the near horizon. The British food system is largely built on a cheap and highly flexible labour force, which can be turned on and off like a tap. Now that is drying up as Brexit, travel restrictions and fear of illness are keeping away the migrants who have typically done that work.

It is creating around eight new hubs from which children in low-income families and isolated adults can have food delivered to their doors. “We have the data to identify people who are likely to be struggling and have mobilised staff,” said its director of public health, Jason Strelitz, but the council was still waiting for government to commit money.

That food waste in landfills generates carbon dioxide and methane, a greenhouse gas 28 to 36 times more effective at trapping heat in the atmosphere than carbon dioxide

you are not just wasting calories and money. You are wasting all the resources that went into growing, packaging and transporting that food.

The FDA, researchers and the grocery manufacturing industry largely agree on an initial solution to this particular part of the food waste problem: clearer package-date labels.

In 2017, the grocery industry, led by the Grocery Manufacturers Association and the Food Marketing Institute, announced a voluntary standard on food-date labeling. They narrowed the plethora of date-label terms down to two: “best if used by” and “use by.” “Best if used by” describes product quality, meaning the product might not taste as good past the date but is safe to eat. “Use by” is for products that are highly perishable and should be used or tossed by that date

while the FDA is encouraging manufacturers to use “best if used by” as a best practice, it is still not required by law. There is no federal law that requires dates on food, except for infant formula.

to have an effect, these changes need to be federally mandated.

“They’re trying to bring clarity to the descriptor of the date. Okay that’s great, that’s better than what we have now,” he said. “But I think some things just shouldn’t be dated."

Now we have a body of research that makes the connection between stress and addiction definitive. More surprising, it shows that we can change the path to addiction by changing our environment.

Neuroscientists have found that food and recreational drugs have a common target in the “reward circuit” of the brain, and that the brains of humans and other animals who are stressed undergo biological changes that can make them more susceptible to addiction.

In a 2010 study, Diana Martinez and colleagues at Columbia scanned the brains of a group of healthy controls and found that lower social status and a lower degree of perceived social support — both presumed to be proxies for stress — were correlated with fewer dopamine receptors, called D2s, in the brain’s reward circuit

The reward circuit evolved to help us survive by driving us to locate food or sex in our environment

Today, the more D2 receptors you have, the higher your natural level of stimulation and pleasure — and the less likely you are to seek out recreational drugs or comfort food to compensate

people addicted to cocaine, heroin, alcohol and methamphetamines experience a significant reduction in their D2 receptor levels that persists long after drug use has stopped. These people are far less sensitive to rewards, are less motivated and may find the world dull, once again making them prone to seek a chemical means to enhance their everyday life.

Drug exposure also contributes to a loss of self-control. Dr. Volkow found that low D2 was linked with lower activity in the prefrontal cortex, which would impair one’s ability to think critically and exercise restraint

Food, like drugs, stimulates the brain’s reward circuit. Chronic exposure to high-fat and sugary foods is similarly linked with lower D2 levels, and people with lower D2 levels are also more likely to crave such foods. It’s a vicious cycle in which more exposure begets more craving.

At this point you may be wondering: What controls the reward circuit in the first place? Some of it is genetic. We know that certain gene variations elevate the risk of addiction to various drugs. But studies of monkeys suggest that our environment can trump genetics and rewire the brain.

simply by changing the environment, you can increase or decrease the likelihood of an animal becoming a drug addict.

The same appears true for humans. Even people who are not hard-wired for addiction can be made dependent on drugs if they are stressed

Is it any wonder, then, that the economically frightening situation that so many Americans experience could make them into addicts? You will literally have a different brain depending on your ZIP code, social circumstances and stress level.

In 1990, no state in our country had an adult obesity rate above 15 percent; by 2015, 44 states had obesity rates of 25 percent or higher. What changed?

What happened is that cheap, calorie-dense foods that are highly rewarding to your brain are now ubiquitous.

Nothing in our evolution has prepared us for the double whammy of caloric modern food and potent recreational drugs. Their power to activate our reward circuit, rewire our brain and nudge us in the direction of compulsive consumption is unprecedented.

The processed food industry has transformed our food into a quasi-drug, while the drug industry has synthesized ever more powerful drugs that have been diverted for recreational use.

Fortunately, our brains are remarkably plastic and sensitive to experience. Although it’s far easier said than done, just limiting exposure to high-calorie foods and recreational drugs would naturally reset our brains to find pleasure in healthier foods and life without drugs.

as with climate change, the powers that be in this country are doing very little to head off the potentially disastrous results of expanding obesity, obesity specialists say.

Well-intentioned efforts like limiting access to huge portions of sugar-sweetened soda, the scientists note, are effectively thwarted by well-heeled industrie

With rare exceptions, the sugar and beverage industries have blocked nearly every attempt to add an excise tax to sugar-sweetened beverages.

Claims that such a tax is regressive and unfairly targets low-income people is shortsighted

“What people would save in health care costs would dwarf the extra money paid as taxes on sugar-sweetened beverages,” he said in an interview.

in a city like Philadelphia, where a soda tax of 1.5 cents an ounce took effect three years ago, total purchases declined by 38 percent even after accounting for beverages people bought outside the city

piecemeal changes like this are not enough to make a significant difference in the obesity forecast for the country

nationwide changes are needed in the ubiquitous food environment that has fostered a steady climb toward a weight-and-health disaster.

Americans weren’t always this fat; since 1990, the prevalence of obesity in this country has doubled.

Our genetics haven’t changed in the last 30 years. Rather, what has changed is the environment in which our genes now function.

“Food is very cheap in the United States, and super easy to access,”

We eat out more, consuming more foods that are high in fat, sugar and salt, and our portion sizes are bigger.

“You don’t even have to leave home to eat restaurant-prepared food — just call and it will be delivered.

As a society, we also snack more, a habit that starts as soon as toddlers can feed themselves.

“People are snacking throughout the day,” Mr. Ward said. “Snacking is the normal thing to do in the United States. In France, you never see anyone eating on a bus.”

We also eat more highly processed foods, which have been shown to foster weight gain, thanks to their usually high levels of calories, sugar and fat.

even when controlling for weight, consuming lots of processed foods raises the risk of developing Type 2 diabetes.

“Through marketing, we’re constantly being sold on foods we didn’t even know we wanted. We’re all about immediate rewards. We’re not thinking about the future, which is why we’re going to see more than half the population obese in 10 years.”

Unless something is done to reverse this trend, Mr. Ward said, “Obesity will be the new normal in this country. We’re living in an obesogenic environment.”

“if I could wave a magic wand, I’d make a tax on beverages a federal mandate because they’re the largest source of added sugar in the diet and are strongly linked to weight gain and health problems.

the link between beverage consumption and greater intake of calories may also apply to drinks flavored with no-calorie or low-calorie sweeteners.

prompting restaurants to gradually, surreptitiously reduce the amount of fat, sugar and calories in the meals they serve could help put the brakes on societal weight gain. “Menus could make healthier, lower-calorie meals the default option,

Controlling portion sizes is another critically important step. “Big portions are especially motivating for low-income people who reasonably want to get more calories for their dollar,”

Another policy-based approach that could reverse rising obesity projections might be to partner with climate control advocates, Dr. Bleich suggested. “If we pull more meat out of the American diet, it would help both the environment and weight loss,

“prevention is the way to go. Children aren’t born obese, but we can already see excessive weight gain as early as age 2. Changes in the food environment are needed at every level — local, state and federal. It’s hard for individuals to voluntarily change their behavior.”

health-promoting changes in the food packages provided to low-income women, infants and children since 2009 have helped to reverse or stabilize obesity in the preschool children who receive them.

“The prevailing story is that this is the best of all possible worlds — cheap food, widely available. If you don’t think about it too hard, it makes sense,”

A closer look, however, reveals a much different story, he said. “To put it in stark terms: The diet is killing us.”

Part of the problem, he added, is a natural tendency for people to overeat as they can afford more food.

The prevalence of obesity has doubled in 73 countries since 1980, contributing to four million premature deaths, the study found.

The story is as much about economics as it is nutrition. As multinational companies push deeper into the developing world, they are transforming local agriculture, spurring farmers to abandon subsistence crops in favor of cash commodities like sugar cane, corn and soybeans — the building blocks for many industrial food products.

the rising clout of big food companies also translates into political influence, stymieing public health officials seeking soda taxes or legislation aimed at curbing the health impacts of processed food.

For a growing number of nutritionists, the obesity epidemic is inextricably linked to the sales of packaged foods, which grew 25 percent worldwide from 2011 to 2016, compared with 10 percent in the United States,

The same trends are mirrored with fast food, which grew 30 percent worldwide from 2011 to 2016, compared with 21 percent in the United States

For some companies, that can mean specifically focusing on young people, as Ahmet Bozer, president of Coca-Cola International, described to investors in 2014. “Half the world’s population has not had a Coke in the last 30 days,” he said. “There’s 600 million teenagers who have not had a Coke in the last week. So the opportunity for that is huge.”

, Brazil is a microcosm of how growing incomes and government policies have led to longer, better lives and largely eradicated hunger.

now the country faces a stark new nutrition challenge: over the last decade, the country’s obesity rate has nearly doubled to 20 percent, and the portion of people who are overweight has nearly tripled to 58 percent. Each year, 300,000 people are diagnosed with Type II diabetes, a condition with strong links to obesity.

In a country where famines have destabilized dynasties throughout history, the ruling Communist Party is also aware that fulfilling basic needs is a prerequisite for political stability.

Already, farmland in China is shrinking, as rapid urbanization has polluted large swaths of the country’s soil and governments have sold rural land to developers. The distribution of water between northern and southern China is uneven, leaving some crop-growing regions vulnerable to droughts and others to flooding.

The war in Ukraine has threatened China’s access to wheat and fertilizers. And a trade war with the United States that began in 2018 made it more expensive for China to buy soybeans and other foods from America.

The Chinese government frequently points out that it has to feed one-fifth of the world’s population with less than 10 percent of the world’s arable land.

To create a more stable food supply, China has stockpiled crops and purchased more farmland overseas. It has been developing heat-resistant rice strains, genetically modified soybeans and new seed technologies, an effort that has triggered accusations of intellectual property theft from the United States.

The rains hit just as farmers were preparing to begin this year’s harvest, causing some of the wheat to sprout. This lower-quality wheat is unsuitable to process into flour and is typically sold at a lower price as animal feed.

the most recent fears about food security stemmed from the flooding in Henan Province and the surrounding regions in central China, which produce more than three-quarters of the country’s wheat.

“But when extreme weather conditions happen, it not only creates damage, but it’s also very expensive to fix.”

The extent of the damage to this year’s crop is still unclear. A lower wheat yield could force China to import more wheat this year and raise global grain prices

China is the world’s largest producer and consumer of wheat. Demand has risen along with incomes as people in cities buy more Western-style breads and desserts. Soaring meat consumption in China has also necessitated more wheat, which is used for animal feed.

China’s fixation on food security has global implications, in large part because it maintains huge stockpiles of food, including what the U.S. Department of Agriculture estimates is about half of the world’s wheat reserves.

Gauging the stability of China’s food supply is difficult because information about the exact quantity and quality of its crop stockpiles is treated like a state secret. Although the country’s official data regularly shows record high wheat output, for instance, analysts have questioned the reliability of the data.

In response to the accusations by Western countries that China was hoarding food, a commentary published in The Economic Daily, a state-controlled newspaper, revealed that China had enough wheat and rice reserves to feed its people for at least 18 months, which the article suggested was a reasonable amount of stockpiling.

The ordinary fixes—the kind that draw on people’s will, and require eating less and moving more—rarely have a large or lasting effect. Indeed, America itself has suffered through a long, maddening history of failed attempts to change its habits on a national scale: a yo-yo diet of well-intentioned treatments, policies, and other social interventions that only ever lead us back to where we started

Through it all, obesity rates keep going up; the diabetes epidemic keeps worsening.

The most recent miracle, for Barb as well as for the nation, has come in the form of injectable drugs. In early 2021, the Danish pharmaceutical company Novo Nordisk published a clinical trial showing remarkable results for semaglutide, now sold under the trade names Wegovy and Ozempic.

Patients in the study who’d had injections of the drug lost, on average, close to 15 percent of their body weight—more than had ever been achieved with any other drug in a study of that size. Wadden knew immediately that this would be “an incredible revolution in the treatment of obesity.”

Many more drugs are now racing through development: survodutide, pemvidutide, retatrutide. (Among specialists, that last one has produced the most excitement: An early trial found an average weight loss of 24 percent in one group of participants.

In the United States, an estimated 189 million adults are classified as having obesity or being overweight

The drugs don’t work for everyone. Their major side effects—nausea, vomiting, and diarrhea—can be too intense for many patients. Others don’t end up losing any weight

For the time being, just 25 percent of private insurers offer the relevant coverage, and the cost of treatment—about $1,000 a month—has been prohibitive for many Americans.

The drugs have already been approved not just for people with diabetes or obesity, but for anyone who has a BMI of more than 27 and an associated health condition, such as high blood pressure or cholesterol. By those criteria, more than 140 million American adults already qualify

if this story goes the way it’s gone for other “risk factor” drugs such as statins and antihypertensives, then the threshold for prescriptions will be lowered over time, inching further toward the weight range we now describe as “normal.”

How you view that prospect will depend on your attitudes about obesity, and your tolerance for risk

The first GLP-1 drug to receive FDA approval, exenatide, has been used as a diabetes treatment for more than 20 years. No long-term harms have been identified—but then again, that drug’s long-term effects have been studied carefully only across a span of seven years

the data so far look very good. “These are now being used, literally, in hundreds of thousands of people across the world,” she told me, and although some studies have suggested that GLP-1 drugs may cause inflammation of the pancreas, or even tumor growth, these concerns have not borne out.

adolescents are injecting newer versions of these drugs, and may continue to do so every week for 50 years or more. What might happen over all that time?

“All of us, in the back of our minds, always wonder, Will something show up?  ” Although no serious problems have yet emerged, she said, “you wonder, and you worry.”

in light of what we’ve been through, it’s hard to see what other choices still remain. For 40 years, we’ve tried to curb the spread of obesity and its related ailments, and for 40 years, we’ve failed. We don’t know how to fix the problem. We don’t even understand what’s really causing it. Now, again, we have a new approach. This time around, the fix had better work.

The fen-phen revolution arrived at a crucial turning point for Wadden’s field, and indeed for his career. By then he’d spent almost 15 years at the leading edge of research into dietary interventions, seeing how much weight a person might lose through careful cutting of their calories.

But that sort of diet science—and the diet culture that it helped support—had lately come into a state of ruin. Americans were fatter than they’d ever been, and they were giving up on losing weight. According to one industry group, the total number of dieters in the country declined by more than 25 percent from 1986 to 1991.

Rejecting diet culture became something of a feminist cause. “A growing number of women are joining in an anti-diet movement,” The New York Times reported in 1992. “They are forming support groups and ceasing to diet with a resolve similar to that of secretaries who 20 years ago stopped getting coffee for their bosses.

Now Wadden and other obesity researchers were reaching a consensus that behavioral interventions might produce in the very best scenario an average lasting weight loss of just 5 to 10 percent

National surveys completed in 1994 showed that the adult obesity rate had surged by more than half since 1980, while the proportion of children classified as overweight had doubled. The need for weight control in America had never seemed so great, even as the chances of achieving it were never perceived to be so small.

Wadden wasn’t terribly concerned, because no one in his study had reported any heart symptoms. But ultrasounds revealed that nearly one-third of them had some degree of leakage in their heart valves. His “cure for obesity” was in fact a source of harm.

In December 1994, the Times ran an editorial on what was understood to be a pivotal discovery: A genetic basis for obesity had finally been found. Researchers at Rockefeller University were investigating a molecule, later named leptin, that gets secreted from fat cells and travels to the brain, and that causes feelings of satiety. Lab mice with mutations in the leptin gene—importantly, a gene also found in humans—overeat until they’re three times the size of other mice. “The finding holds out the dazzling hope,”

In April 1996, the doctors recommended yes: Dexfenfluramine was approved—and became an instant blockbuster. Patients received prescriptions by the hundreds of thousands every month. Sketchy wellness clinics—call toll-free, 1-888-4FEN-FEN—helped meet demand. Then, as now, experts voiced concerns about access. Then, as now, they worried that people who didn’t really need the drugs were lining up to take them. By the end of the year, sales of “fen” alone had surpassed $300 million.

It was nothing less than an awakening, for doctors and their patients alike. Now a patient could be treated for excess weight in the same way they might be treated for diabetes or hypertension—with a drug they’d have to take for the rest of their life.

the article heralded a “new understanding of obesity as a chronic disease rather than a failure of willpower.”

News had just come out that, at the Mayo Clinic in Minnesota, two dozen women taking fen-phen—including six who were, like Barb, in their 30s—had developed cardiac conditions. A few had needed surgery, and on the operating table, doctors discovered that their heart valves were covered with a waxy plaque.

Americans had been prescribed regular fenfluramine since 1973, and the newer drug, dexfenfluramine, had been available in France since 1985. Experts took comfort in this history. Using language that is familiar from today’s assurances regarding semaglutide and other GLP-1 drugs, they pointed out that millions were already on the medication. “It is highly unlikely that there is anything significant in toxicity to the drug that hasn’t been picked up with this kind of experience,” an FDA official named James Bilstad would later say in a Time cover story headlined “The Hot New Diet Pill.

“I know I can’t get any more,” she told Williams. “I have to use up what I have. And then I don’t know what I’m going to do after that. That’s the problem—and that is what scares me to death.” Telling people to lose weight the “natural way,” she told another guest, who was suggesting that people with obesity need only go on low-carb diets, is like “asking a person with a thyroid condition to just stop their medication.”

She’d gone off the fen-phen and had rapidly regained weight. “The voices returned and came back in a furor I’d never heard before,” Barb later wrote on her blog. “It was as if they were so angry at being silenced for so long, they were going to tell me 19 months’ worth of what they wanted me to hear. I was forced to listen. And I ate. And I ate. And ate.”

For Barb, rapid weight loss has brought on a different metaphysical confusion. When she looks in the mirror, she sometimes sees her shape as it was two years ago. In certain corners of the internet, this is known as “phantom fat syndrome,” but Barb dislikes that term. She thinks it should be called “body integration syndrome,” stemming from a disconnect between your “larger-body memory” and “smaller-body reality.

In 2003, the U.S. surgeon general declared obesity “the terror within, a threat that is every bit as real to America as the weapons of mass destruction”; a few months later, Eric Finkelstein, an economist who studies the social costs of obesity, put out an influential paper finding that excess weight was associated with up to $79 billion in health-care spending in 1998, of which roughly half was paid by Medicare and Medicaid. (Later he’d conclude that the number had nearly doubled in a decade.

In 2004, Finkelstein attended an Action on Obesity summit hosted by the Mayo Clinic, at which numerous social interventions were proposed, including calorie labeling in workplace cafeterias and mandatory gym class for children of all grades.

he message at their core, that soda was a form of poison like tobacco, spread. In San Francisco and New York, public-service campaigns showed images of soda bottles pouring out a stream of glistening, blood-streaked fat. Michelle Obama led an effort to depict water—plain old water—as something “cool” to drink.

Soon, the federal government took up many of the ideas that Brownell had helped popularize. Barack Obama had promised while campaigning for president that if America’s obesity trends could be reversed, the Medicare system alone would save “a trillion dollars.” By fighting fat, he implied, his ambitious plan for health-care reform would pay for itself. Once he was in office, his administration pulled every policy lever it could.

Michelle Obama helped guide these efforts, working with marketing experts to develop ways of nudging kids toward better diets and pledging to eliminate “food deserts,” or neighborhoods that lacked convenient access to healthy, affordable food. She was relentless in her public messaging; she planted an organic garden at the White House and promoted her signature “Let’s Move!” campaign around the country.

An all-out war on soda would come to stand in for these broad efforts. Nutrition studies found that half of all Americans were drinking sugar-sweetened beverages every day, and that consumption of these accounted for one-third of the added sugar in adults’ diets. Studies turned up links between people’s soft-drink consumption and their risks for type 2 diabetes and obesity. A new strand of research hinted that “liquid calories” in particular were dangerous to health.

when their field lost faith in low-calorie diets as a source of lasting weight loss, the two friends went in opposite directions. Wadden looked for ways to fix a person’s chemistry, so he turned to pharmaceuticals. Brownell had come to see obesity as a product of our toxic food environment: He meant to fix the world to which a person’s chemistry responded, so he started getting into policy.

The social engineering worked. Slowly but surely, Americans’ lamented lifestyle began to shift. From 2001 to 2018, added-sugar intake dropped by about one-fifth among children, teens, and young adults. From the late 1970s through the early 2000s, the obesity rate among American children had roughly tripled; then, suddenly, it flattened out.

although the obesity rate among adults was still increasing, its climb seemed slower than before. Americans’ long-standing tendency to eat ever-bigger portions also seemed to be abating.

sugary drinks—liquid candy, pretty much—were always going to be a soft target for the nanny state. Fixing the food environment in deeper ways proved much harder. “The tobacco playbook pretty much only works for soda, because that’s the closest analogy we have as a food item,

that tobacco playbook doesn’t work to increase consumption of fruits and vegetables, he said. It doesn’t work to increase consumption of beans. It doesn’t work to make people eat more nuts or seeds or extra-virgin olive oil.

Careful research in the past decade has shown that many of the Obama-era social fixes did little to alter behavior or improve our health. Putting calorie labels on menus seemed to prompt at most a small decline in the amount of food people ate. Employer-based wellness programs (which are still offered by 80 percent of large companies) were shown to have zero tangible effects. Health-care spending, in general, kept going up.

From the mid-1990s to the mid-2000s, the proportion of adults who said they’d experienced discrimination on account of their height or weight increased by two-thirds, going up to 12 percent. Puhl and others started citing evidence that this form of discrimination wasn’t merely a source of psychic harm, but also of obesity itself. Studies found that the experience of weight discrimination is associated with overeating, and with the risk of weight gain over time.

obesity rates resumed their ascent. Today, 20 percent of American children have obesity. For all the policy nudges and the sensible revisions to nutrition standards, food companies remain as unfettered as they were in the 1990s, Kelly Brownell told me. “Is there anything the industry can’t do now that it was doing then?” he asked. “The answer really is no. And so we have a very predictable set of outcomes.”

she started to rebound. The openings into her gastric pouch—the section of her stomach that wasn’t bypassed—stretched back to something like their former size. And Barb found ways to “eat around” the surgery, as doctors say, by taking food throughout the day in smaller portions

Bariatric surgeries can be highly effective for some people and nearly useless for others. Long-term studies have found that 30 percent of those who receive the same procedure Barb did regain at least one-quarter of what they lost within two years of reaching their weight nadir; more than half regain that much within five years.

if the effects of Barb’s surgery were quickly wearing off, its side effects were not: She now had iron, calcium, and B12 deficiencies resulting from the changes to her gut. She looked into getting a revision of the surgery—a redo, more or less—but insurance wouldn’t cover it

She found that every health concern she brought to doctors might be taken as a referendum, in some way, on her body size. “If I stubbed my toe or whatever, they’d just say ‘Lose weight.’ ” She began to notice all the times she’d be in a waiting room and find that every chair had arms. She realized that if she was having a surgical procedure, she’d need to buy herself a plus-size gown—or else submit to being covered with a bedsheet when the nurses realized that nothing else would fit.

Barb grew angrier and more direct about her needs—You’ll have to find me a different chair, she started saying to receptionists. Many others shared her rage. Activists had long decried the cruel treatment of people with obesity: The National Association to Advance Fat Acceptance had existed, for example, in one form or another, since 1969; the Council on Size & Weight Discrimination had been incorporated in 1991. But in the early 2000s, the ideas behind this movement began to wend their way deeper into academia, and they soon gained some purchase with the public.

“Our public-health efforts to address obesity have failed,” Eric Finkelstein, the economist, told me.

Others attacked the very premise of a “healthy weight”: People do not have any fundamental need, they argued, morally or medically, to strive for smaller bodies as an end in itself. They called for resistance to the ideology of anti-fatness, with its profit-making arms in health care and consumer goods. The Association for Size Diversity and Health formed in 2003; a year later, dozens of scholars working on weight-related topics joined together to create the academic field of fat studies.

As the size-diversity movement grew, its values were taken up—or co-opted—by Big Business. Dove had recently launched its “Campaign for Real Beauty,” which included plus-size women. (Ad Age later named it the best ad campaign of the 21st century.) People started talking about “fat shaming” as something to avoid

By 2001, Bacon, who uses they/them pronouns, had received their Ph.D. and finished a rough draft of a book, Health at Every Size, which drew inspiration from a broader movement by that name among health-care practitioners

But something shifted in the ensuing years. In 2007, Bacon got a different response, and the book was published. Health at Every Size became a point of entry for a generation of young activists and, for a time, helped shape Americans’ understanding of obesity.

Some experts were rethinking their advice on food and diet. At UC Davis, a physiologist named Lindo Bacon who had struggled to overcome an eating disorder had been studying the effects of “intuitive eating,” which aims to promote healthy, sustainable behavior without fixating on what you weigh or how you look

The heightened sensitivity started showing up in survey data, too. In 2010, fewer than half of U.S. adults expressed support for giving people with obesity the same legal protections from discrimination offered to people with disabilities. In 2015, that rate had risen to three-quarters.

In Bacon’s view, the 2000s and 2010s were glory years. “People came together and they realized that they’re not alone, and they can start to be critical of the ideas that they’ve been taught,” Bacon told me. “We were on this marvelous path of gaining more credibility for the whole Health at Every Size movement, and more awareness.”

that sense of unity proved short-lived; the movement soon began to splinter. Black women have the highest rates of obesity, and disproportionately high rates of associated health conditions. Yet according to Fatima Cody Stanford, an obesity-medicine physician at Harvard Medical School, Black patients with obesity get lower-quality care than white patients with obesity.

That system was exactly what Bacon and the Health at Every Size movement had set out to reform. The problem, as they saw it, was not so much that Black people lacked access to obesity medicine, but that, as Bacon and the Black sociologist Sabrina Strings argued in a 2020 article, Black women have been “specifically targeted” for weight loss, which Bacon and Strings saw as a form of racism

But members of the fat-acceptance movement pointed out that their own most visible leaders, including Bacon, were overwhelmingly white. “White female dietitians have helped steal and monetize the body positive movement,” Marquisele Mercedes, a Black activist and public-health Ph.D. student, wrote in September 2020. “And I’m sick of it.”

Tensions over who had the standing to speak, and on which topics, boiled over. In 2022, following allegations that Bacon had been exploitative and condescending toward Black colleagues, the Association for Size Diversity and Health expelled them from its ranks and barred them from attending its events.

As the movement succumbed to in-fighting, its momentum with the public stalled. If attitudes about fatness among the general public had changed during the 2000s and 2010s, it was only to a point. The idea that some people can indeed be “fit but fat,” though backed up by research, has always been a tough sell.

Although Americans had become less inclined to say they valued thinness, measures of their implicit attitudes seemed fairly stable. Outside of a few cities such as San Francisco and Madison, Wisconsin, new body-size-discrimination laws were never passed.

In the meantime, thinness was coming back into fashion

In the spring of 2022, Kim Kardashian—whose “curvy” physique has been a media and popular obsession—boasted about crash-dieting in advance of the Met Gala. A year later, the model and influencer Felicity Hayward warned Vogue Business that “plus-size representation has gone backwards.” In March of this year, the singer Lizzo, whose body pride has long been central to her public persona, told The New York Times that she’s been trying to lose weight. “I’m not going to lie and say I love my body every day,” she said.

Among the many other dramatic effects of the GLP-1 drugs, they may well have released a store of pent-up social pressure to lose weight.

If ever there was a time to debate that impulse, and to question its origins and effects, it would be now. But Puhl told me that no one can even agree on which words are inoffensive. The medical field still uses obesity, as a description of a diagnosable disease. But many activists despise that phrase—some spell it with an asterisk in place of the e—and propose instead to reclaim fat.