The World Health Organization this month made combating obesity a priority, saying that and related health conditions are contributing factors in many deaths around the world. In the United States, the issue has spurred debate about whether the culture of fast food, which tends to be high in fat and calories, has contributed to rising obesity. A filmmaker set out to test that question by eating only food from McDonald's, three times a day for 30 days.
In the United States, McDonald's employees used to ask customers if they wanted to "super size" their order. That meant they could get a jumbo-sized soda and french fries for just a little more money. The practice was phased out in March, as the fast food restaurant chain responded to the trend toward healthier eating, adding salads and other alternatives to its menu of fast food staples, such as hamburgers and french fries.
Filmmaker Morgan Spurlock takes aim at the fast food culture in his documentary film, Super Size Me For 30 days, he ate exclusively at McDonald's and filmed his experience.
"I can only eat things that are for sale over the counter at McDonald's - water included," he said. "If McDonald's doesn't sell it, I can't eat it."
In the film, trips to McDonald's are interspersed with visits to health professionals and graphic representations of obesity-related statistics.
Before he started the film, Mr. Spurlock, who is 1.9 meters tall, was healthy, and weighed nearly 84 kilograms. Two weeks into the experiment, doctors said his liver was being seriously damaged and that he should stop. He did not, though, and by the end of the month, his blood pressure shot up, and he had gained more than 11 kilograms.
Mr. Spurlock has drawn criticism for his film from people who say he is unfairly attacking the food industry. But he says individuals need to take responsibility for their own diets and health.
"All people hear about is 'guy eats McDonald's for 30 days straight' and they think I'm just attacking this food industry, but I'm not," said Morgan Spurlock. "What I'm really attacking is the way we live our lives, the poor choices we make, this lifestyle that we, as Americans, now do every single day."
Dr. William Dietz, with the U.S. Centers for Disease Control and Prevention, says obesity in the United States has become an epidemic. He says about 30 percent of American adults are already obese, and the numbers have been growing.
"Among adults, obesity has increased two-fold since 1980, actually, between 1980 and 1999-2000," said Dr. Dietz. "Over that same time period, the prevalence of overweight children doubled, and the prevalence of overweight adolescents tripled."
Dr. Dietz says some of the causes of obesity are changes in the types of food people eat and a decrease in physical activity. He says data show that obesity is also increasing around the world. In late May, the World Health Organization adopted a global strategy on diet, physical activity and health to help raise awareness about the health consequences of obesity around the world.
Filmmaker Spurlock expressed concern that one contributor to the rise in global obesity is the export of American fast food culture. As an example, he points to McDonald's, which says it serves more than 46 million people each day, in more than 100 countries.
"You know, only half of the 46 million people they [McDonald's] feed are in the United States," he said. "So, 23 million are in the United States. The other 23 million are outside of our borders. So, what we're doing is, we're passing on our bad habits to the world."
In April, the McDonald's Corporation announced that it was adapting its menus around the world in light of growing health consciousness. Jim Skinner, vice chairman of McDonald's' global operations, unveiled details of the company's new global plan for what it calls a balanced lifestyle.
"New options include sliced fruit and low-fat, low-sugar fruit yogurt in the UK [Britain], toasted cheese and tomato sandwiches in Australia, fruit drinks and yogurt in Brazil, fruit cups in Italy, fish McDippers in Japan, white meat Chicken McNuggets in the United States and Canada, yogurt smoothies and flavored water in France, milk and orange juice in Mexico, and the list goes on," he said.
McDonald's officials said the company is simply responding to its customers' demands. It denies the changes are related to a number of lawsuits brought against McDonald's and other food companies in recent years by people who claimed the companies were responsible for causing their obesity. Many of the suits have been withdrawn or dismissed. Some have resulted in settlements.
Mr. Spurlock says, despite efforts by companies like McDonald's to provide healthier menu items, few customers are choosing them.
"Okay, they [McDonald's] sold 150 million salads [last year], but they feed 46 million people a day, almost 17 billion per year," said Morgan Spurlock. "So, that 150 million means not even one percent, less than one percent of everybody who goes there is buying a salad, because that's not why we go there."
Dr. Dietz says the challenge for society and health professionals is educating consumers and convincing them to change their lifestyles.
"Concerns about this problem are only now emerging. In the last three years, there has been a rapid increase in the awareness that obesity is a health problem," he said. "And I think, we're only beginning to come up with ways to solve it."
Mr. Spurlock says he hopes his film will contribute to the public debate about obesity.