Why Americans are obese, part 2


This was my second cruise, so it wasn’t quite as shocking as last time. But the frightening obesity problems everywhere has a good explanation. The fear of fat is as obvious as the enormous abundance of sugar and starch.

For starters, you are immediately offered unlimited refills of soda for six days for $6 (adults) or $4.50 (kids). And that is just the beginning…

Cake buffet

Once past the soda stations you can go for lunch. Beyond the obvious starchy fast food (fries, cheap hot dogs, ice cream and pizza) you can fortunately choose the buffet lunch with plenty of real food (meat, fish and vegetables).

But even the people choosing the buffet has a mountain of cakes and cookies to choose from. For lunch!


By the fast food

Overall the people choosing the buffet food where among the fittest on the boat. Outside, close to the pool, all the fast food, soda and ice cream you can eat were served for free. That is where the consequences of the American sugary and starchy food were most frightening.

The big mistake

Despite the abundance of pure sugar and starch, everywhere, that is not what Americans fear. Instead they are warned, for no good reason, to avoid natural fat.

For breakfast you can for example have loads of sugary cereals, even marschmallows (“Lucky Charms”). But natural whole milk you can forget. Instead you can choose from low fat, skim milk or low fat chocolate milk – with lots of added sugar!


And when you sit down at night for a nice dinner, when you actually can get GOOD and satisfying food, real food, then those who need it the most are suggested not to eat it.

Here is a menu with lots of excellent and tasty options, such as meat and fish dishes:


But check out the “healthy” options at the bottom, those that people with a weight problem may try to choose. Here we see the usual fear of fat and calories. The “healthy” options are low in fat, cholesterol and salt. But no one worries about the sugar and starch. It’s not even mentioned.

Left page, bottom:

Right page, bottom:

So what is the problem? These “healthy” options contain so few calories that the people choosing it are likely to wake up the next morning ravenously hungry, if they even make it that far. And then a ship full of free sugar and starch is waiting for them again. With the food that raises their blood sugar and the hormone insulin, our main fat storing hormone.

Americans fear fat and calories more than any other people. And during the decades that this has been going on they have became the fattest people on earth. How long will it take before everybody realize what a mistake it’s been?

Hopefully we can make it happen fairly soon.


Why Americans are obese: Nonfat yogurt

Why Americans are obese, part 1

Want to eat and lose weight instead? Try this:
LCHF for beginners


  1. Karen
    Thank you. And how sad!
  2. I am getting so tired of all this sugary, high starch non-food that they call food. I hardly see a skinny person when I go grocery shopping here in Texas. I see obese and very sick people. They few skinny persons that I see look sick with a poor muscle tone.
  3. I was very surprised at the amount of obese people on the cruise, compared to Miami where it was not that obvious. Scary thought: The future in US???
    That cereal was horrific!!!
  4. Milton
    Unfortunately, it is not much different if you check the isles in many of our grocery stores and supermarkets. Because low-fat is associated with health, even the shops that promote themselves as "healthy" have lots of starchy and sugar-rich foods among the many grain-based and fat-deprived items. Shopping for a healthy lifestyle is not easy, but it is worth the time and effort.
  5. @Milton,
    Tell me about it! Even many health food stores promote those products. They think it is healthier because it is organic or natural. It is definitely worth an effort to shop around.
  6. @Monique,
    My kids are considered strange because they don't eat those cereals, which to me is just like candy. They get some treats on a Saturdays instead. They think you come from out of space because you don't allow your kids to eat snacks or cereal that resemble candy. Or let them drink soda instead of water.
  7. Joe Strahl
    There is a third reason that leads to obesity in the United States and this is a non-food, non-diet matter but is important nonetheless: cars. Most Americans take their cars for short and long trips which means that they do not get as much everyday exercise as people in countries where there is a greater availability of alternative ways of getting around and where The Car Culture is not as prevalent. Walking and biking -- not as a recreational activity per se but as a means of everyday mobility "burns off" excess in a regular fashion much better than occassional very strenuous exercise. Even taking public transport/transit is a healthier alternative to solely using a car to get around since bus and train riders have to walk/cycle to a stop/station and walk around or up flights of stairs to get to platforms. However, since the US has been built around The Car as the sole solution to accessibility and mobility, this means that cyclists and others pursuing a healthier livestyle are viewed as "eccentric" "tree-huggers" and the like then this is a very long and uphill battle ahead. And American petrol/gas is still so cheap by international standards..... making it even harded.
  8. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Sure, exercise is good for you.

    On the other hand, the rates of obesity has tripled i the US since the end of the 80s. As far as I know Americans already used cars twenty years ago. So that can hardly be the main explanation for the massive obesity epidemic in the last couple of decades.

  9. Joe, if it makes you feel any better cities are seeing increases of 30-85% in commuting by bike over the past few years. Though they probably are accompanying their ride with a big bottle of Gatorade or PowelGel for their 2-3 mile ride...
  10. Margaretrc
    I agree that the car culture is not a good thing and that exercise is. However, I agree with the Doc that it doesn't explain the sharp rise in obesity in the past 30 + years. The fear of fat and the resulting consumption of enormous amounts of sugar and starches does.
  11. Congratulations, Doc!

    If I may predict the future, you started something in the U.S the same time you entered your first cruise... The American Food Revolution started... with a low carb cruise! Make sure the media is engaged the next time. If not otherwise, someone ought to be interested in making a documentery to keep in the archives until the low carb movement is large enough in the U.S to show how it really began.

  12. Ailsa Washington
    Yes I was one of the obese people on the cruise and like many people who are like me I am carrying a lot of emotional baggage that makes me eat when I am down. It isn't that I need to learn what to eat that is the problem I know what I shouldn't eat but I have a big emotional problem that I am trying to conquer that makes like extremely difficult. I have had lots of therapy through my life that I have realized it is me that has to help myself there are no quick fixes if there was i would have bottled it up and made a million by now.
    I have lost over 60 pound so far and I am heading in the right direction I love my low carb American friends(I am English) and have made some life long friends who love and respect me for the person I am. We respect not criticize each other as we all live the same struggle. I admire and envy those people who can just give up the 'bad' foods but it is not always that easy and it takes more than just that. Try think of an alcoholic trying to give up alcohol giving up food isn't always that straight forward. Yes call me weak willed as possibly I am. And to quote another poster 'sad' well I definitely am!
  13. Funderaren
    Ailsa, Im a carbaddict myself, its not easy avoiding carbs when you are surrounded by them all the time. But since you know how to eat you have solved at least 50% of the problem. Its a big problem if you think your food is healthy, when its the opposite.

    Your emotional problem is of course another issue, but im sure none of them is because you are weak or a sad person. :)

  14. To Funderaren: that was a lovely and considerate response you gave to Alisa. I'm glad the discussion tone here is so respectful and supportive.

    And to Alisa: I've also spent most of my 40 years being a carb addict. I was lucky enough not to get a serious weight problem because of enormous amounts of exercise, but that's not too healthy either. For the past 4 months I've been on LCHF and never felt better. I've also felt better emotionally, which hopefully you'll discover too. When you give your body proper nutrition, it will also effect your mind positively and help you to heal - in so many ways. All the best to you and good luck on your journey!

  15. Ailsa Washington
    I know I'm not a weak and sad person but I was just responding to this report with sarcasm, a lot of people are hurting because of this right now and quite frankly I feel let down right now as both myself and a lot of my friends were very respectful and welcoming on the cruise.
  16. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    It certainly is not easy to avoid bad carbs in America. That is exactly the problem! So I mean absolutely no disrespect to all the people who are struggling as best they can with their weight.

    The point I wanted to make is that it's important to try to make that easier for people, by not promoting low fat products while the alternative is lots of sugar and starch.

  17. Ailsa Washington
    The big battle is our government and food agencies both in america and the UK are insisting low fat is the way to go so we have a up hill battle. It was only last year the diabetic nurses were agreeing with me about low carb diets which I found refreshing but I was offered gastric surgery as a cure which does not change my attitude towards food and it is proven gastric surgery doesn't work if you don't work at it.

    I wish you luck with changing attitudes but it maybe need to be more directed higher up, low carb is hard to convince people because of the bad press.

  18. Funderaren
    Ailsa the best way is that we change one person at the time. Once we change enough people the goverment cant ignore the issue.
  19. I agree with Funderaren here. When there are enough people telling their success stories - even government officials have to listen. That's what's happening right now in Sweden. Finally! And I'm sure the rest of the world will follow. Even if it might take some time.
  20. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    I don't think change is going to come from "higher up" for a long time, if ever. Those people are benefiting from the way things are, they would lose money and/or prestige if it changed.

    Change can only come from the bottom up, like a revolution usually does.

  21. Ailsa Washington
    Yes I agree the government get money from the diabetic meds and encourage low fat hi carb diets which exacerbate diabetes so they need more meds! I was one of these I was on insulin which piled my weight on. The problem is when you are told u need something like insulin it takes a big leap of faith to trust something everyone is saying is wrong. I did it and got off all my meds but the struggle is still there even with normal range hba1c and physical proof my consultant was still saying what I was doing was wrong!
  22. Dana
    Alisa: Believe it or not, your emotional problems may be strongly connected to your nutritional status. I am not over my longstanding problem with depression but it is a LOT better than it was. I do not always stay on the wagon with low-carb eating, though my carb intake is still a lot lower than it used to be on average, but one thing I *have* permanently changed is that I will now eat beef fat and butter and coconut oil whereas, before, a lot of my fats came from industrial seed oils (aside from coconut, obviously). Your brain is made up primarily of fat and cholesterol. If it's not getting enough of either of those, it's not going to work right. At the end of the day you're a physical body and your brain is part of that body and needs nourishment just like your heart and kidneys do.

    It astounds me how many doctors put their diabetic patients on insulin without so much as testing them to see if they're still making any. There's a test called the C-peptide that checks for native insulin, and all doctors ought to be using it.

  23. Dana
    Oh, and Joe, I've found myself in situations where I *had* to walk a mile or more each day just to get to and from work because I was too poor to afford a car, so I had to take the bus, whose nearest stop to my workplace was far enough away that had I been disabled I could not have worked. I lost some weight that way, but I never got back down to a normal weight range for me--I was still in the overweight category. And I wasn't getting as much to eat during that time so I suspect part of what I lost was lean mass. It's not as simple as just moving more to burn it off. You have to be eating right also; in fact, that's about 80 percent or more of the problem with overweight, is what you're eating.
  24. Jane
    Weight has more to do with diet than exercise, so stop blaming cars. Cars are essential to the U.S. It's a big country with a large rural population. It would be unfeasible to bike, let alone walk, to work and back every day for most people in this country.

    It's the snobbery and the "I'm better than thou, therefor you should all be like me" attitude that gets the tree hugging label more so than what you choose to do in your personal life.

    And to put it bluntly, it is governments that got us into this mess to begin with.

    Governments have their function, but that function should be severely limited. It should not include butting their noses in and micro-managing people's lives.

    Also, people put too much stock in said governments and it's embarrassing how much people look to them to take care of them. "But the government said..." We're all grown adults now and should not have to look to government to be the new parent.

    Seriously, people, government is just a small handful of people that don't know their butt from a hole in the ground about most of the stuff they talk about. And like most people, they do things that benefit them (money, influence, power). The problem is, when people in government do these things, the ramifications are felt by millions rather than just one (and usually it's not beneficial).

    So stop looking to the government to solve this for you. Take a little responsibility, a little effort, and you can make things happen in your own life. You want LCHF, then do it. Meat can be found, coconut, veggies, butter. It's not as difficult as people make it out to be. Might be a little expensive, but not difficult.

    If you want to change the views, like the Doc said, you have to do it one individual at a time. Lead from the front...be an example. People will see the results and there's a good chance someone will ask you how you did it. That opens a line of dialogue that allows you to share what you have learned without shoving it down someone's throat unasked for. It also makes them more receptive to what you have to say.

    They will either take it to heart or not. And if not, don't worry about it. You can't change the world, but you can create ripples in the pond.

  25. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Very true... although all those ripples might become a tsunami (for good) in the end.
  26. Nina
    Ailsa, changes come from the outside and from the buttom, not from the inside and the top. (I'm not a native english speaker but i hope you get what i mean)
    Continue eating LCHF (or low carb or what you call it) and work with your sugar addiction, then it will get better.
    And if you lose weight you can tell everybody you know! ;)
  27. Ails a Washington
    Right did my blog tonight which hopefully will explain why I reacted the way I'd did if you want to read it! My blog can be found here http://ailsauk.blogspot.com/
  28. CMCM
    While so many people eat due to emotional factors (in the past, when I was upset over something, I'd run right to the sugar treats....I'd drive to the store, I'd make something, I knew exactly how to medicate myself...with sugar). Going LCHF got me off that insulin driven roller coaster long enough to change that behavior. Now emotions no longer drive me to eat the sugar. Occasionally I really want it purely for the taste, and that can lead to problems, but at least I got rid of the emotional fix long enough to drop most of my excess weight.

    What's unfortunate is all the bad science and LIES out there which convince people to eat in all the crazy ways you see, really self defeating ways such as low fat and high carb. People are also led to believe that losing a lot of weight can be easy and quick, and it simply cannot. It takes times and consistency, which is why you have to find a sane way of eating. That way is LCHF, no way around it. While I believe that exercise (moderate) has its health benefits, I have personally seen that it is NOT required for weight loss. When I first did Atkins for about 6 or 8 weeks in 2003, I had a sprained shoulder/broken rib from a ski fall, and I did the program with zero exercise. The weight dropped off effortlessly because I was totally consistent with the LC diet.

  29. terrence
    Re: exercise and weight loss: in WWGF, Gary Taubes quotes someone from 1942, and says, "A 250 pound man will burn three extra calories from climbing one flight of stairs. ... He will have to climb twenty flights of stairs to rid himself of the energy contained in one slice of bread!"

    The old saying "work up an appetite" is true - people who work hard eat more than those you do not work as hard. Depending upon what they eat, they may well gain more weight.

  30. Funderaren
    If we were obese because we doesnt move so much these days, I do wonder why we can see slim IT nerds, and construction workers that are fat.

    Yes I do think you can compensate bad food habits by exercise. But why excersise and keep the bad food habits? Its seems like one step forward and one step back.

  31. MaryB
    According to The World Health Organization here are the 10 fattest nations in the world. Please note how close many of them are in percentages. There is not a lot of difference between American and Germany, for example.

    By the way, America is NOT the fattest nation in the world, it is the fattest DEVELOPED nation in the world.


    "Since obesity rates can be an indicator of a nation’s nutritional trends, health and culture, we thought it might be useful information for the expat to know. Here are the 10 fattest countries of the last decade:

    (of the population that is overweight)

    (1) American Samoa, 93.5%
    (2) Kiribati, 81.5%
    (3) U.S.A., 66.7%
    (4) Germany, 66.5%
    (5) Egypt, 66%
    (6) Bosnia-Herzegovina, 62.9%
    (7) New Zealand, 62.7%
    (8) Israel, 61.9%
    (9) Croatia, 61.4%
    (10) United Kingdom, 61%

    So my point is that this is not simply an American problem, it is a world wide problem. By the way, poverty is one of the leading causes of obesity in America.

  32. Funderaren
    Mary of course its not only an american problem. But I dont agree that poverty is the reason. Its not expensive to eat real food.

    But when you eat a diet consisting of high amount white flour, sugar and very little fat. Chances are big that you overeat.

  33. Alma
    Why do people assume that Americans eat a low fat diet? The powers that be may SUGGEST that they should eat a low fat diet but this is certainly not the case by any stretch of the imagination. The truth, weather you choose to see it or not, is that Americans ARE in fact eating a great deal of fat natural or otherwise(consumption of meat and vegetable oils has gone up) in addition to way too much sugar and starch. That is the true cause of obesity. Starch on it's own is not fattening in spite of the silliness put forward by the low carb crowd. Nobody ever got fat eating brown rice and plain potatoes but mix the starch with lots of fat and sugar and there lies the obesity bomb. It's so obvious! I cant understand why we have half the health blogs online fighting the low fat corner and the other half fighting the low carb corner when in truth they both have merit but not for the reasons they think! lol
  34. Kathy
    I can tell they are American not bc they are overweight but bc they dress horribly. That is how i always spot an american tourist in europe.
  35. Jodie
    It is really difficult these days to find regular, full-fat yogurt. I don't eat dairy, but my husband and son would if I let them. We lived in Germany for 3 years and my boys were totally spoiled with the selections of full-fat yogurts we were able to find! Now, all that's around is this nasty, sugar-overload crap that the big food companies continue to market as "natural" and even "organic!" Who cares if that little cup of sugar and starches is organic or not? It truly is difficult to go out to eat AT ALL in the U.S. any more. Nothing is safe to eat if you aren't preparing it yourself. I see the same thing you see when you took those pics on the cruise and I see it everywhere I look. I feel like I need to lose some weight, but I'm NOTHING compared to all those folks in your pics. And I'm trying to raise my little son to respect food and where it comes from, teaching him to eat real foods and stay away from all the over-processed crap that's out there. But it's hard when there are sooooo many around him that are eating it. It's hard. But I believe it's definitely a fight worth fighting.

    Unfortunately, I don't see this trend changing any time soon. The reason it is so slanted in the wrong direction is because of corporate greed. These companies that produce all the crap they call food that fills the grocery store aisles is making money hand over fist. They can produce it on the cheap and sell it for a maximum profit. They buy off politicians to keep the regulation in their favor. So, it will take a lot to turn this trend around...probably a lot of grass-roots efforts on all of us who know the truth and can afford to sway the country with the power of our purchasing dollars.

  36. Paula
    I found the Diet Doctor when I was researching WLS in America. While getting scheduled for surgery, I read Wheat Belly and then hired a nutritionist recommended in his book. This put me on the LCHF eating plan. I had previously felt I couldn't give up diet soda or treats only to find that by eating real foods (like BACON! and butter and avocado) I felt full and satisfied and my desire for all things sugar started to disappear. As I adjusted I tried eliminating and adding things in/out of our diet. If I eat things high in carbs or have a beer, I am so hungry the next day it's unreal.

    I cancelled my surgery and in 8 months have dropped 55lbs eating LCHF. I never have an issue finding something to eat when out and about...unless the only options are fast food. Yuck...never cared much for it to begin with...can't even handle the smell anymore. Weight keeps coming off at a rate of 1-3lbs every week. This summer it has slowed b/c I was eating more fruit. When I cut that out the weight flies off again.

    My kids and I are much healthier and happier with a LCHF diet. Now to convince hubby!

  37. Jennifer A
    I have to say first that I am a cruise addict. I have been on 8 cruises in the last few years. I have been on 2 since I started LCHF on doctors orders. The last 2 cruises are the ones that I felt the best, had energy and enjoyed so much more. I had lots of wonderful protein choices, a salad bar and yummy cheese. I even created my own dessert after the dining room meal. I had a small bowl of berries with cream, a small cheese plate and a cup of hot tea with cream. It was satisfying and decadent without the carb bloat and coma. I lost weight on both cruises! I feel that I had more choices and was more satisfied than when I am home so it was so much easier.

    I do agree that cruises can be a floating carb fest and many people are terribly obese and that is a sad sight. I am one of the obese, but if you see me on a cruise, I am making LC choices and getting better.

  38. Kat
    I definitely understand how hard it is to try to lose weight. As an obese American who has had a weight problems since she was a child there is so much judgement that you have to face every day. I am starting a low carb diet but i am so nervous i won't do it right as i am not as educated person in this matter. If anyone has advice for me i would love to listen. You can email me at katlynnpayton2013@email.com. i just want to make sure i am here for my daughter as long as possible. Thank you.
    Reply: #39
  39. Zepp
    Then you should read on.. its no strange thing about it.. only real food.. less carbs and some more fat.




    The low carb thing is about lower glucose levels and insulin levels.. less fat storing and longer satiety.

    And for losing fat one have to be a fatburner.. then one have to eat fat, and it takes some adaptions.

    Fysical adaptions is the easy part, one get side effects in the begining, but the mental change is more difficult.

  40. Reiki Nurse
    Greetings, Doc!

    Obviously, we have a major struggle in America to re-educate our patients, and the public in general. We need to get the news out about hearth-healthy fats! We have to 'undo' 30 plus years of 'fat phobia', after all. It's going to be a long time, but worth every effort. Thank you for all the splendid information! More LCHF recipes would be greatly appreciated! Good recipes are difficult to find on the web.
    Brilliant website! I am constantly coming back for more education ;)

  41. JerryMe
    I find it interesting, and maybe telling, that all of the avatars of the Diet Doctor shows him with vegetables. Shouldn't he be carrying or holding butter, steaks, and chicken?
  42. Kaiah
    One thing people seem to leave out is that income hasn't increased the way the expense of food has. High carb is cheap. I know there are people that will say "Oh I get all organic vegetables for every meal for $20 a month" blah blah If it is true then great for you but where I live it is high and I go to the farmer's market. I bought a spaghetti squash and it was $8. I bought 2 red peppers and they were $4. Even the cheap crap bread is $2 a loaf now. Lettuce $2 a head. Forget watermelon, cherries. grapes...I had a small bag of cherries and it was $11. I told her to put that back. Outrageous. A box of mac and cheese is a dollar. I can go to McDonalds and get fries, drink, and burger for $3.50. Can't make it for that. This isn't even organic. I just don't even look at that stuff it is so high.
  43. GutHealth
    Hello, my colleague has had success switching to low-carb with your help. I'm interested for my husband and I to change our eating habits for the better as well. Any concerns with incorporating lots of plain yogurt along with low carb? Any recommendations for types? As a patient with Crohn's disease, I eat plain yogurt because of the probiotics which help me control inflammation ect.

    We will be starting the challenge Sunday - very excited to see how I feel after the 2-week challenge! Thank you for making this possible.

  44. Barb Trawon

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