Durham, New Hampshire - leading nutritionist and anti-obesity expert Marion Nestle doesn't bother with the controversy surrounding low-carb diets. It's the heft of food-industry marketing budgets that has her worried. Chair of New York University's nutrition, food studies and public health department, Nestle used her years as an insider in the Washington food scene - she edited the 1988 surgeon general's landmark report on nutrition - to write the award-winning Food Politics: How The Food Industry Influences Nutrition And Health.
I'm watching her here at the University of New Hampshire at a conference called Eating As A Moral Act, as she dispenses smart rejoinders to the usual clichés about the fat crisis.
"I didn't want to see a public discussion about obesity without a discussion about marketing," says Nestle. Diet crazes don't interest her - her message is Just Eat Less.
The reason why so many North Americans have ballooned so badly over the last decade has to do with eating so many more calories, not a sudden shift in genetics or even a sudden decline in exercise levels. And they've eaten more because they were suckers for the marketing campaign behind Super-size It And They Will Come.
"You don't have to go any further than larger portions," she says. There's little use obsessing about the sociology of consumers - their education, age, income, foibles or culture. The answer lies in the economics of the food system, "the elephant under the living room rug that no one wants to talk about," she says.
The $1.3-trillion-a-year North American food industry spends $34 billion a year on advertising. The ad budget for Altoid mints alone is five times more than the U.S. government spends to promote vegetables and fruit, Nestle says. (The global food industry ad budget is $40 billion, greater than the GNP of 70 per cent of the world's nations, according to the report Broadcasting Bad Health.)
The North American food industry creates 10,000 new products a year to join the 320,000 already existing products on supermarket shelves (there are now 27 varieties of Oreo cookies instead of the mere six that existed in 1990), since surpluses drive compulsive innovation and spin-offs. This food juggernaut produces twice as much food as North American consumers need, so whatever isn't exported becomes Unidentifiable Food Objects, concocted edibles often aimed at kids.
Since the food industry needs to show continual growth to survive on the stock market - "That's the way capitalism works," says Nestle - it can't stomach any reference to eating limits or eating less.
Atkins, South Beach, low fat diets - the food industry can deal with all of them, adjusting products and marketing strategies, as long as it's the kind of calories, not the number of calories, that gets the attention.
"Eat less" are fighting words for the pop and food industry, as their current campaign against the World Health Organization report calling for limits to sugar consumption indicates. That campaign follows a successful 10-year effort to reframe U.S. government warnings on sugar. In 1980 and 85, the food guide urged people to "avoid too much sugar." By 2000 the advice was "Choose beverages and foods to moderate your intake of sugar."
But Nestle's focus on marketing drivers in the food industry may reflect her training in nutrition rather than the even more dismal science of economics. There's more involved in this weighty matter of obesity than the gross ethics of super-size marketing.
When I studied economics way back when, there was always a lecture on how the demand for food is "inelastic." No matter how much more money people make, there is only so much food they can jam down into their stomachs, so the demand is inelastic, the lecture went. That's why food couldn't be a growth industry, the conventional wisdom had it.
Economic theory about inelasticity of demand for food didn't reckon with the elasticity of skin and the ability of the human body to swell into obesity, or the ability of the food industry to market to people already full-to-busting. But super-sizing actually exposes a crisis in the food system more profound than marketing ethics or the mania for growth on the stock market.
It's another unintended outcome of subsidies designed to make food so cheap. When food out of the farm gate accounts for only 20 cents on the food dollar spent by consumers, and 80 cents goes to processors, packagers, advertisers and retailers, then super-sizing is almost inevitable. All those 80 cents' worth of overhead costs stay fixed, no matter what size portion the customer buys, so it only costs pennies to double the size and charge an extra quarter, quintupling the rate of profit.
The only way to control that trend would be to find a way to reward food producers or retailers for quality of food and health outcomes rather than quantity of food. This is something the designers of our food system or health system can't wrap their heads around, probably because, as eco theorist Wendell Berry puts it, the people who make food care nothing about health, while the people who do health care little about food, and never the twain shall meet.
That is the system problem behind obesity, and it is bigger than the super-sized elephant under the rug.