We are how we eat, and the problem of fast-food culture

Dr. Valerie Taylor doesn't believe that most people with a weight problem would say, "This is not my fault," or, "This is because of McDonald's."

"Absolutely, they take responsibility," says Taylor, an assistant professor in psychiatry and behavioural neuroscience at McMaster University in Hamilton, and director of the Canadian Obesity Network mental health program. Many people feel guilty about their weight, she says, "and they struggle to accept treatments like surgery because they really feel they should be able to control this problem themselves."

The truth, she says, is that certain people are vulnerable to overeating, "and we have created an environment in which high-fat food is abundant."

But is the solution more self-control? More regulation of the food industry? More social pressure?

Some say what is required is nothing less than a fundamental shift in social norms and the way we view food.

Like smoking in the 1970s, Dr. David Kessler says, there are no social boundaries when it comes to eating. It has become culturally acceptable to eat almost anywhere, and anytime - in a business meeting, in a classroom. "We have children who are eating almost constantly throughout the day."

Even three meals a day are no longer enough. "Some restaurants have been as audacious as to advertise the fourth meal," says Kessler, a former U.S. Food and Drug Administration commissioner who led the crusade for tougher tobacco laws in the '90s. Taco Bell markets a late-night menu called the Fourthmeal, "the meal between dinner and breakfast."

"What the food industry did was to take fat, sugar and salt, put it on every corner, make it available 24/7, make it socially acceptable to eat any time," Kessler says. "We've added the emotional gloss of advertisement, we've made the food into entertainment, and we're living the consequences.

"What did we think was going to happen?"

Today in Canada, 61% of adults - 13.2 million Canadians - and 26% of children aged six to 19 (1.4 million) are overweight or obese. "Kids are probably not going to live as long as their parents do, because of weight," Taylor says. Doctors are reporting a rise in the "super-obese," people with a body mass index in the 50s and 60s, something that was unheard of a generation ago. A BMI - a measure of body fat based on weight and height - of 30 or more is considered obese.

In the fight against obesity, some are pushing for public policies, such as higher taxes on soft drinks. Studies suggest sugar-sweetened beverages - the single greatest source of added sugar in our diets - may also be the single biggest driver of the obesity epidemic, especially among children.

"There seems to be something special about calories when they get delivered in liquids," says Kelly Brownell, co-founder and director of the Rudd Center for Food Policy and Obesity at Yale University. "The body doesn't recognize them well, and there's less compensation when people consume too much. Third is, they're so heavily promoted, it's ridiculous. And fourth, you've got this possibility of the sugar, especially coupled with caffeine, being addictive enough to be a problem."