Why Americans are obese: Chocolate extravaganza


Here’s another scary scene from the recent cruise. Most Americans could probably handle one or two small pieces of dark (70%+) chocolate with their coffee. But they are habituated to heavier drugs than that.

This long line is headed for the free “chocolate extravaganza”. What do you think is found at the end of the line?


More chocolate

More chocolate

More chocolate

More chocolate


It was shocking to see the huge amounts of free extravaganza that ended up on the plates.

Obviously people are free to eat all the chocolate they want, whether on vacation or not. But is this really only a logical choice? Having this sugar feast among the often already obese Americans made me think of similar scenarios:

How about a smoking extravaganza at an emphysema conference? Or a luxurious free bar at an AA meeting?

What do you say?


The Archives: Why Americans are Obese

Sugar – A Sweet Addiction


Top comments

  1. Hugaldo
    Sugar addiction, not personal choice.
    Read more →
  2. Dr. Andreas Eenfeldt, MD Team Diet Doctor

    That is not to say that some of us can't really have very much but that is an individual problem (or taste).

    With the large majority of Americans becoming overweight or obese in a few decades it seems like more than individual problems.

    First, it is an "extravaganza," that is, etymologically, wandering outside of the norm. Nobody eats at an extravaganza every day.

    Are you sure? I fear a lot of people eat a high-carb extravaganza just about every day.

    Perhaps the problem is that our norms are outside of what they used to be.

    Read more →

All comments

  1. Chocolate would be fine if they didn't use sugar to sweeten it :P. And, in a lot of cases, it comes with a big ol' helping of additional extra carbs in the form of cake/rice/what-have-you.
  2. Shantel
    I see no guns pointed at the heads of those in line for free chocolate.
    They made a conscious choice to get up and get in line.
  3. Angie
  4. Hugaldo
    Sugar addiction, not personal choice.
  5. Peggy Holloway
    This may seem off-topic, but hear me out. Two weeks ago, we biked across the state of Nebraska as part of an organized ride. We were in rural communities where our eating options were either meals provided by local churches/clubs or the one "bar and grill" in town and the choices were pretty appalling. Not a green vegetable of salad to be found (baked beans and macaroni/pasta salads were plentiful), but every kind of cookie, cake, pie and ice cream, etc. were in abundance in addition to the packaged, sugary snacks and gatorade at every rest stop. Everyone on the trip chowed down heartily on those offerings. My ketogenic partner and I had a heck of time, but made do with hamburger patties, eggs, and steak. We still had plenty of energy and could ride for hours with no breakfast and no snacks.
    Two area bike shops sent along trucks and mechanics to help with bike problems. One of the bike mechanics was a well-known "character" in our local bike community who is around 50 years old (maybe a bit younger) who lives on his bicycle. He can be seen biking to work in the middle of snow storm, or a heat wave. He has the muscular body of a cyclist and always seems full of energy and good humour. Anyone who know him would guess that he is one of the healthiest people you could meet.
    We learned today that last week he had two stents put into blocked coronary arteries.
    Any coincidence that for years, he has followed the prescribed cyclist "carbo-loading" diet full of energy drinks and gels?
  6. Anders
    Difference compared with a participant at an AA meeting is that there is a desire to not drink and problem awareness.

    I believe that the majority of people are not aware of the danger of food and sweets if proportioned incorrectly.

  7. George I., M.D.
    Peggy, I bet if you did an MRI of that skinny cyclist you would find an overabundance of visceral fat. a lot of "thin" people who eat these carb fest diets are ticking time bombs.
  8. I could so much have enjoyed that buffet with a full plate before going LCHF! And I probably would have gone back for "seconds" of the items I most enjoyed.

    Now a single square of 72% chocolate gives me so much more pleasure than a plateful of those things (I can no longer call them "goodies" or "treats" because they are really "baddies" or "tricks"). I can really taste the chocolate and savor it. And when I have eaten my square I'm done, totally satisfied, not craving for more, not bloated and uncomfortable.

  9. Jennifer
    @George I

    One of the obesity specialists on the programme "The men who made us fat" (http://youtu.be/7cD4CLSmIRQ) called them 'TOFIs': Thin outside, fat inside.

    Kind of appropriate.

  10. This is so strangely moralistic. First, it is an "extravaganza," that is, etymologically, wandering outside of the norm. Nobody eats at an extravaganza every day. there are many extravaganzas in the world. If there is not food left over at a Chinese banquet, the host is probably in disgrace. One of the effects of the low-fat foolishness is that suddenly after centuries of civilization, we were supposed to think Hollandaise sauce was a poison. We don't want to do the same thing to chocolate mousse. That is not to say that some of us can't really have very much but that is an individual problem (or taste). Chill out, dietdoctor.
  11. C. Buck
    I would have been in that line, eaten (no, gorged myself on)most of what was pictured, not all, been happy, then gone back to low carb the next day.
    Yeah, I'm a chocolate addict, and not ashamed.
    just too much cake like stuff there.
  12. moreporkplease
    "Obviously people are free to eat all the chocolate they want, whether on vacation or not. But is this really only a logical choice?"

    Sugar addiction - it's real. You've posted on it yourself, Andreas. These people aren't "choosing," just as Dr. Lustig says.

    They can't control their eating - their insulin and sugar drives are truly in charge.

  13. Dr. Andreas Eenfeldt, MD Team Diet Doctor

    That is not to say that some of us can't really have very much but that is an individual problem (or taste).

    With the large majority of Americans becoming overweight or obese in a few decades it seems like more than individual problems.

    First, it is an "extravaganza," that is, etymologically, wandering outside of the norm. Nobody eats at an extravaganza every day.

    Are you sure? I fear a lot of people eat a high-carb extravaganza just about every day.

    Perhaps the problem is that our norms are outside of what they used to be.

  14. The cruise chefs and owners will provide the foods which people are asking for and consuming. When on holiday, people like to treat themselves and eat differently to how they might eat when they are at home. I realise that you are not suggesting that people eat like this all the time, but the expectation is that when you are paying for something expensive like a cruise, you should get something special in terms of the food.

    I am hopeful that a day will come when our expectation change, but until then you cannot blame the cruise management or the people in the queue. Everyone is simply reacting to ingrained notions of what they should expect and want when on holiday.

  15. mezzo
    Why? I think one of the reasons is that Americans and others tend to think that the more there is of one thing, the better. Bigger, better, more - that has been the message for the last xxx years. Look at supermarkets. In the sixties there were maybe three kinds of yoghurts to be bought from one brand. Today you get a whole aisle full of stuff that nobody needs. But it LOOKS like choice and it is very difficult be use discernment in view of these mountains of food.
  16. Perhaps the question that should be asked is why are people able to pile their plates with 2000 calories of chocolate flavored sugar and eat it? We've created a society here in the US that seems to be constantly hungry and has almost no mechanism to sense that they've eaten enough.

    Try this analogy; A large fuel truck is carrying 5,000 gallons of gasoline in the large tanker at the back. It's an expanding tank and can carry as much fuel as we can put into it.This truck is run on diesel fuel and those tanks are only say, 30 gallons. The engine needs 9 gallons an hour to run. It can run on either diesel or gas. However the fuel pump delivers12 gallons an hour to the engine. The three extra gallons per hour can't go back to the small tanks so they convert the diesel to gas and send it to the large tank in the back. We've busted the connection from the large tank in the back and blocked the engine's ability to use the large amount of gas it's carrying around. Every 2 hours the small tanks are starting to run dry and need to be filled. The large tank at the back is getting fuller all the time but the small tanks constantly need to be fed.

    Ok, that's a little obtuse and a crude attempt at an analogy of our metabolic systems. The fact remains that it's absurd that we can eat so many carbs when we are more than fully fueled. If one simply didn't offer such an "extravaganza" we'd find a way to stuff ourselves anyway because our bodies are driving us to it.

  17. Laura
    Cate absolutely I agree! I was jsut about to launch myself into a very similar diatribe!
    The same basic question (The bright pink elephant in the room) should be asked in the BBC TV program The Men who Made us fat!
    WHY do we overeat in teh first place.....the message that is being given is that it is portion size rather than food type!!!! What is it IN/ABOUT the food that we overeat that seems to suppress all signals of fullness!! That is abnormal it itself and this should be the question!!.
    If you blame it all on the food, the abundance, the external stimulus I think you are also removing a possibility of control. Because this abundance is all around us. Prof Kessler's (the end of over eating) disappointing advice at the end of his book was avoid all fast food places and when in teh supermarket stick to the outside isles...how is that going to solve the problem?
    The problem is not in the size but in the food type. You cannot overeat on meat/fat because you soon feel FULL! Carbohydrate seem to completely OVERRIDE these normal internal control systems. The body goes into overdrive.
    So we have to take control by not viewing those food displays as food in teh first place!

    The food industry has found our consumers' jugular...whether they stumbled on it for political/economical reasons or it was a calculated (CREEPY) move they now know that if you put sugar/carbs/fat/salt all together in a meal the normal body signals of fullness shut down. We eat more, we want more we BUY more!!
    So it is both environmental stimulus (hyperpalatable unnatural combinations of high sugar/highfat/highcarbs/highsalt) with our innate machinery whereby insulin takes over and puts us in hunger/fat storage mode.
    This is the crucial thing to know and then the battle with yourself begins. All this so called processed food is not going to go away we need to start seeing it as NON-FOOD and wean ourselves of it and then we will not be fat arsed in a queue for a chocolate feast!

    One day...dream on!

  18. A year ago I might have eaten at that chocolate bar. It would have taken an extreme act of willpower to avoid it. 7 months ago I stumbled onto this wonderful site and understood what was happening to me right away. (Well done Doc for your clear presentation of the problem and solution.) After having gone LCHF for 7 months, not only do I have no desire to overeat at an extravaganza like this or anywhere else, I simple have no craving nor desire to do so. Regardless of how much 'tempting' food is shoved under my nose.
    You're so right Laura, for most people it's an ongoing battle with themselves that most are losing. If we can wean ourselves away from the need for carbs there's no longer a battle with ourselves and no company is going to lay out a food extravaganza that will simply go uneaten and to waste.
  19. JAUS
    #1 I agree, there nothing wrong with chocolate as long as there's no sugar in it.

    Unsweetened chocolate is actually quite delicious if you choose one thats made of high quality cocoa beans. I have made a french chocolate cake that was very LCHF-friendly made of unsweetened chocolate, butter, eggs and erythriol.

  20. shums
    Doctor I can't help but point the arrow back at you in a manner of speaking. Yes it is true that in America and in western civilization we have a serious issue with eating too much sugar. I will grant you that. I will also grant you that America is probably a cultural leader of "The West" so to speak. Perhaps the cold war did a lot to make that so. That is for someone else to determine I suppose. I also know that in Europe alcohol consumption is a large part of your culture. Even more so than here in America actually. I also know that varies by country over there. Is drunkenness, alcoholism, drunk/drink driving and the like not an issue over there too? Again it depends on country but I would say it is maybe an even larger issue over there than here. Potentially much larger. Yet the attitude in Europe about alcohol would never be one that it should be outlawed or banned. Would it? If I took a picture of a bar full of people in Sweden and then posted "Why Swedes are Alcoholics" you might take a bit of an exception to that. What if I started a campaign to make alcohol harder to get or much more expensive in Sweden. Something tells me you would speak out against it. Lastly I would like to just point out that America isn't the only country with a serious obesity problem. The video you posted recently actually highlighted Britain as having a huge problem too. Was everyone in that photo American? Did you ask them? The logic of this post is just flawed on so many levels. Your logic of eating low carb to attain health is right on though Doctor and I hope you will post more of that stuff. That is why I started reading your blog. Not to get into debates on freedom of choice regarding soda and to see random pictures making wild assumptions. Give us information and give us more of those amazing videos you do with the experts. That is helpful. This post is not.
  21. FrankG
    I agree with many of the sentiments expressed here but if nothing else, posts like this from Dr Andreas spark off some lively debate ;-)

    Yes (as I see it) chocolate per se is not an issue but rather the confections (rich in sugar and refined starches) in which it is often used WHEN eaten on a frequent basis rather than "on occasion" as our Grandparents and previous generations did. Cake for your birthday is probably just fine.. every day for breakfast probably not so much

    Of course this is not just an issue for the USA but I also don't think it is simply a case of personal choice... I do think that societal attitudes need to change before we can all be healthier. How many of us eating an LCHF diet notice that there are fewer options available to us in most social eating occasions like downtown for lunch, or at a party? In my experience it is sometimes easier to eat what is available rather than searching out what one might really want or need to eat.

    In this example posted by Dr Andreas, I wonder how much imagination and inventiveness it would have taken for the chef to come up with optional alternatives using dark chocolate, whipping cream and wild berries, for example?

  22. Bernardo
    I don't understand why everyone gets political with these posts. I think the doctor just wanted to make a fun post about how much sugar is praised and overused. The existence of the Extravaganza is both a cause and a consequence of the obesity problem, and he's not suggesting banning it, but he thinks its quite ironic to have that in a health conference. Chill out :P
  23. I'm cool and I certainly don't want to argue with dietdoctor. It got political because the headline is Why Americans are obese. In any case, I assume that this was not the part of the cruise that was the health conference. I certainly am sensitive to such ironies. I posted on FB, the refreshments at Jeffrey Friedman's obesity talk at Downstate. Dietdoctor has one of the most compelling presentations on how to help people who have a weight or metabolic problem but that is different than knowing that everybody needs to eat that way. (Knowing, that is, the data, not what you think). Remember the USDA panel has (on paper) even better credentials than Andreas and they are sure that they know what everybody should eat but we don't like them. Also, there is a strong tendency in America to ban, regulate substances that are abused by a small fraction of the population with disregard for those people who need or like the thing. Sometimes this is a good thing but it is the condemnation of fat that got us where we are. (I only know about pseudo ephedrine from what I hear on TV but this may be an appropriate case). We still have to be careful about our Puritan traditions.
  24. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    shums #20,
    I do agree with most of what you write. However when writing a blog some amount of generalization and provocation may occasionally be necessary. Being too careful can result in the bigger sin of being boring.
  25. Margaretrc
    I don't blame extravaganzas like that for America's (and other countries') problems with obesity. I blame the villification of fat. If we had left well enough alone back when and hadn't villified fat, extravaganzas like this would not have had the effect it did. I'd bet in France, you could put up an extravaganza like that and very few would fill their plates or over consume the goodies. I consider myself lucky. I did not fall under the "low fat is great" umbrella long enough to seriously mess up my metabolism. So I could go to an extravaganza like that and I would eat a little piece of this a little piece of that (only the most delicious) and leave it at that. I know because I have been to extravaganzas like that on cruises. I can only eat so much before I reach a point where another bite would probably make me sick. But our villification of fat has seriously messed up many people's ability to recognize when they've had enough, in part because industry was only too happy to supply us with "fat free" and "low fat"processed junk loaded with sugar that doesn't satisfy our need for fat and that drive us to eat and eat and eat. I like Cate's analogy. It makes a lot of sense. And, as Dr. Feinman said, it's trying to avoid fat that has put us in the position of that truck. I applaud what Dr. Eenfeldt (and Dr. Feinman, too) is(are) doing to try to fix our trucks. That's where we need to focus our energy. But I agree that banning/forbidding is not the answer. There's too much of that already. Education is the answer and this blog, Dr. Feinman's blog, and others are doing a great job of that. That's what we need.
  26. I approve this message.
  27. Peggy Holloway
    I don't understand the concept that one celebrates being on vacation by eating garbage - I don't even get the idea of foods as "treats." When I am on vacation, the last thing I want to do is eat sugary, carby stuff that will make me feel like crap. That is "no vacation."
    I am vigilant about not eating anything that will give me blood sugar/insulin swings. In some ways, maybe I am lucky because my symptoms are so extreme. I become really angry when, despite my best efforts, I fall victim to "hidden carbs." The last bad experience was when I was at a rare family gathering at my mother's and we went to eat at a barbecue restaurant. I carefully ordered a steak (afraid of the sugar in the barbecue sauces/seasonings), grilled vegetables and a salad with blue cheese dressing -usually a safe option. The salads came first and I nibbled slowly ate it. The entrees took a long time to arrive, and about 15 minutes after my first bites of salad, I started getting the tingling and shaking that indicate a blood sugar/insulin spike. I didn't finish the salad and supposed that the dressing had added sugar, or even worse, corn syrup (it was probably "reduced fat" - I didn't ask) , and ate just the steak and veggies. By midafternoon, I was sleepy and lacking any motivation or energy to do anything. It was truly a "ruined" a day. I have no intention of deliberately destroying a vacation. No "treat" is worth that.
    If more people would go really low-carb, ketogenic and experience how wonderful they can really feel, then the "chocolate extravaganza" would become a thing of the past.
  28. Dana
    From my experience, people tend to eat as much as they can at a 'buffet' of this sort that does not cost any additional money. I have seen this at work parties where people bring in all kinds of food to eat and then load their plates up like they haven't eaten in a week. Not everyone behaves this way....but many do.
  29. moreporkplease
    So I see today that our friends the Danes have created a small soda tax - about US$0.17 a liter. Sugar-free or diet sodas are exempt from this new tax and stay at the usual sales tax (VAT) rate.

    They also applied a sugar tax to chocolate and ice cream of about US$0.09, while reducing the sales tax (VAT) on sugar-free versions.

    Are the Danes now the first to create a soda tax? They kind of snuck it in to a larger tax bill that became law yesterday.

  30. finn
    There are chocolate and "chocolate" which is actually 60-90% sugar. I believe real chocolates are good for my health and I eat once a week. :)

    PS. funny video how advertisements' before/after pics are made. Guy shows how it's done in 5 hours http://www.youtube.com/watch?v=M957dACQyfU

  31. Here's my take on the Danes and this strange taxation thing: http://wp.me/p16vK0-8t

    Also, nobody has ever answered my original questions despite the fact that my credentials in finance are at the same level as Hizzona's expertise at biochemistry: if they raise the price of sugared drinks and you are a bottler of water or diet soda, isn't there supply and demand? Won't you raise your price? So the net effect is a establishment of a higher price and since people liked the sugared drinks originally we will have same consumption. Isn't this a possibility?

    In terms of outcomes, though, the strategy is clear. If it fails to reduce obesity, the conclusion will be that we didn't try hard enough and therefore we will raise the tax further. If it succeeds, it will demonstrate the value of the tax and we will raise the tax further. Of course, since even these taxes are a drop in the bucket for Bloomberg, is he likely to get fat?

  32. moreporkplease
    Hi Dr. Feinman:

    "the strategy is clear"

    I read your piece, it was amusing. Let me say that we have learned all this from the public health campaign against tobacco. At a low level, the tax is a mere annoyance; people grumble, but keep buying and so consumption stays the same.

    Set the tax higher and people begin to engage in arbitrage actions such as crossing the state line, smuggling, etc. But arbitrage actions have a friction cost (which is a fancy way of saying they're a pain in butt). Then add strong enforcement and with the innate friction the arbitrage diversion drops to a fairly low level, not really enough to seriously distort the policy outcome. But this middle-level tax only cuts consumption a certain amount because people really are addicted, and they will give up other things to continue their addiction.

    Various studies have shown that you basically have to tax at 200-250% (that is, raising the cost of the object 3 times over the starting price) before you will see overwhelming social avoidance. The tobacco experience has given social scientists & economists a lot of data in this regard.

    If we use our current science to conclude that sugar should follow the tobacco model - and I think many of us here do because we are evidence-based - my comment on the Danish action is that the new soda tax isn't remotely high enough. It's just at the "annoyance factor" level.

    If a 20-oz soda here in the USA normally costs US$1.25 a bottle at the 7-11, then to make a difference we need to increase that to US$3.75, minimum if we are to seriously impact/halt consumption. I laid all this out in a comment here previously a couple of months ago, I believe, with all the links & cites there.

    If we truly have knowledge from our current science, and are actually people who understand that policy must be evidence-based, then I think we have to look at the Danish soda tax as an interesting foray, altho' one that doesn't go far enough to achieve its goal.

    The new differential between diet and sugar soda in the tax law is also interesting - I hope they collect data to see if the consumption of diet soda rises. But again, the tax is so small I doubt the effect will be significant from a public health perspective. The data will tell us, just as the recent data on their sat fat tax proved it was likewise a bust.

  33. "Evidence-based" is somewhat self-serving. I have made analogy with a court of law where a judge decides evidence (e.g. http://wp.me/p16vK0-4A ) or, more generally, there is cross-examination and other avenues for examining evidence. Now, in tobacco, one question is whether taxing has been more effective than education (possibly because it is easier to think of cigarette smoke as an actual toxin than it is to think of Coca-cola as a toxin). So, how could we decide. It is always seemed that one could look at level of education vs. cigarette reduction per unit cost or something. I will leave to the people whose area this evidence bears on but I believe the data exists. If it turns out that education is as important or more important, we should investigate the kind of evidence in tobacco vs. the kind of evidence in soft drinks. But I don't think it is really about evidence. It is about the mind-set of physicians and politicians that "we must do something" (even if we don't know the answer), hence margarine and trans-fat, etc.
  34. Diane
    I didn't find most of the stuff in the pictures all that terribly appealing, but I'm sure that I would have found something good at a chocolate extravaganza and that I would have filled a plate with it. Even though maybe it's not the best thing for me. I know that it won't kill me. It's good to lighten up sometimes.
  35. Julz
    Until I developed Fibromyalgia 11 years ago, I was a fit and Healthy 40 year old woman. But as the Fibro developed, so did my cravings for all things sweet - particularly chocolate.
    However, after several false starts in trying to curb my sugar addiction - for that is surely how it feels - I have read throughout this website, in depth and have learned exactly what I now need to do, and intend to do it.....to rid myself of the extra pounds I am now carrying.
    I have cleared all my cupboards of carbohydrates, been shopping for the foods I need to focus on, and am looking forward to eating because I am hungry and will therefore enjoy the food I prepare, rather than eating without thinking, because something in my head is yelling CHOCOLATE at me as a desire that has to be sated.

    As a newcomer I'd like to say Hello to everyone here, and to thank you for the inspiration you have all given me through your positive posts.
    Here goes the first day of my new life that will take me to where I WANT to be.

  36. I have been all over the world and have never seen more fat people than in USA.
  37. if the sign had said "low carb chocolate extravaganza" i would happily have joined !!! :D

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