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Is obesity simply about a lack of “balance”? Why Big Food wants you to be fit

Image Credit: Todd Hryckowian

This blog was commisioned from Yoni Freedhoff to coincide with the final week of the PLoS Medicine series on Big Food – eight articles published over 3 weeks that examine the activities and influence of the food and beverage industry in global health. The editors explain why they commissioned the series.  Join the debate on twitter #plosmedbigfood and comment on the articles.


Coca Cola calls it an “active balanced lifestyle,”  McDonald’s a “balanced active lifestyle,” General Mills a “balanced and healthy lifestyle,” Unilever a “balanced diet and lifestyle,” Mars a “well-balanced lifestyle,” while Nestle and PepsiCo refer to it as “a balanced lifestyle.”

What is “it”?

It” is what you need to do to maintain or establish a healthy weight.  Just “balance” your energy in with your own “energy out.”  Easy, no?

Yoni Freedhoff

It’s a brilliant strategy for the food industry as it not only shifts the blame away from the consumption of their calorific products, but it provides them with an incredibly robust and ethically unchallengeable marketing platform – fitness.

Cadbury, McDonald’s and Coca-Cola are currently using that platform in their roles as the 2012 London Olympic’s primary sponsors.   Cadbury launched its largest ever marketing campaign literally selling chocolate gold medals, Coca-Cola is running the Olympic Torch across Europe handing out “happiness” wherever they go, while McDonald’s built the world’s largest restaurant and created Olympic mascot branded Happy Meals.  Truly the emotions tied to the games are a marketer’s dream – joy, perseverance, celebration and health – and by the transpositional nature of marketing psychology, those emotions will be unconsciously tied to the sponsors’ brands.

Of course the food industry’s promotion of physical activity isn’t just about straight sales, it’s also about being part of “the solution” and affording the food industry with a bully pulpit from which to respond to criticism.  A few weeks ago I had a bit of a Twitter scuffle with two Directors of Coca-Cola Canada.  They were responding to criticisms of Coca-Cola’s partnership with ParticipACTION, a Canadian national non-profit organization designed to promote healthy living and physical fitness.  While it would be difficult to defend sugared soda as part of a healthy lifestyle, it wasn’t difficult for these Directors to point at their involvement in getting kids “moving” as proof they were the good guys in the story, though last time I checked the consumption of sugar water was just as bad for moving kids as unmoving ones.

Being part of the solution also provides the food industry with ammunition to draw upon in their fight against industry unfriendly legislative efforts.  For instance back in 2010 Coca-Cola’s President Sandy Douglas used their involvement in the promotion of fitness in his Atlanta Journal Constitution op-ed opposing soda taxes:

And we’re for active lifestyles, with more than 6 billion Diet Coke packages helping the National Heart, Lung and Blood Institute remind women about the importance of staying active and maintaining a healthy weight, and our support of physical activity initiatives like Exercise Is Medicine.

Obesity is a serious problem. But we can overcome it if we all work together. At Coca-Cola, we’re playing our part in helping develop and support workable solutions. Let’s stop pointing fingers and start working together productively. I think we’ll discover we burn more calories that way.

So is obesity about burnt calorie insufficiencies?  Doubly labeled water studies suggest that we’re burning as many today as we did back in the early 1980s (Westerterp, 2008); objective UK accelerometry data found that in 5-8 year old children even a tenfold difference in activity levels didn’t associate with weight or body fat percentage (Metcalf, 2007); while the CARDIA trial revealed that over the course of 20 years if you’re a man and you exercise 1hr/day, 6 days a week you’ll gain only 127 fewer grams a year than if you exercised less than 15mins/day and if you’re a woman and do the same you’ll gain 311 fewer grams (Hankinson, 2010).  But you’ll still gain.

Ultimately it seems quite clear, we’re eating too many calories, and while “moving” is crucial to good health and there’s no denying it does burn calories, if weights are the consideration, we’re going to have eat markedly less of them, and for the food industry, eating less is decidedly bad for business.

And business is what all of this is about.  Just ask Coca-Cola’s chief marketer Joe Tripodi who in 2011 provided these quotes to the Wall Street Journal:

If we can get 40 million-plus fans, or even some subset of them talking positively about the things we’re doing, ultimately that’s a good thing for us.

And by “good thing” Mr. Tripodi clarifies he means sales,

 I think it’s probably a leading indicator of potential sales.

And what kind of sales does Mr. Tripodi hope for?

We want to double our business in basically a decade.

And why wouldn’t they?  It’s the food industry’s fiduciary responsibility to increase profits where in these cases profits are being made on the intuitive, erroneous and commonly held belief that we can “balance” increased intake with increased output.

While I will readily agree there’s likely no behaviour more conducive to good health than exercise, regardless of how badly the food industry wants you to forget it, weight’s about food far more than it is about fitness and for the food industry being tied to fitness ultimately sells food.


Westerterp K, Speakman J  Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals International Journal of Obesity, 2008;32 (8):1256-1263

Metcalf BS, Voss LD, Hosking J, Alison JN, Wilkin TJ Physical activity at the government recommended level and obesity related health outcomes: a longitudinal study. Arch Dis Child 2008;93:772-777

Hankinson A, Daviglus M, Bouchard C, Carnethon M, Lewis C, Schreiner P, Liu K, Sidney S. Maintaining a High Physical Activity Level Over 20 Years and Weight Gain JAMA 2010;304 (23):2603-2610


Yoni Freedhoff is an Assistant Professor of Family Medicine at the University of Ottawa where he’s the founder and medical director of the Bariatric Medical Institute dedicated to inter-disciplinary, non-surgical weight management since 2004.  Dr. Freedhoff sounds off daily on his award winning blog Weighty Matters and is also easily reachable on Twitter (  Look for Dr. Freedhoff’s book on the fallacies and future of modern day dieting to be published by Simon & Schuster’s Free Press in Spring 2013.

  1. Excellent article Yoni.

    The food industry would love to have people believe it’s just a matter of “balance” and personal responsibility, but it’s hard for people to be responsible when they’re inundated with billions of dollars worth of advertising.

    I still believe, slowly, people will wake up. You are what you eat.

  2. Some interesting stats in there. You are, of course right in every respect regarding the hypocrisy of Big Food. It’s an absolute disgrace that they be allowed to hijack something like the Olympics and use that platform to trade their HFCS laden, sugary, fat making poisons to us as healthy (you just have to find the right balance). Newsflash….. that “right balance” is somewhere around 1 can of soda per month, but Big Food aren’t going to tell you that are they? Because that would be bad for business.

  3. I ran in the Bluegrass 10K yesterday and was sad to see the race water came in a Pepsi cup. I’ve been training for the Tri for Sight and was disappointed it’s now become part of the McDonald’s Central Kentucky Triathlon Race Series. It’s getting harder and harder to find athletic events to participate in that aren’t a vehicle for fast food and soda marketing. It’s really terrible to see so many kids athletic events with these sponsors when Kentucky has the third highest rate of childhood obesity.

  4. A number of recent studies, such as the one just published in JAMA and reported by Lustig and Taubes, debunk the “calories in calories out” theory. Obesity is not about how many calories you eat and how much you exercise, obesity is about the types of food you eat. We get fat by eating carbs and sugar. Soda, loaded with sugar and high fructose corn syrup, is proven to lead directly to obesity. The soda companies today are engaged in the same misdirection that the tobacco companies were when reports of tobacco consumption causing cancer first appeared. The tobacco companies knew, but they wanted to delay as long as possible. Similarly, the soda companies know their products make us fat, and sick. But they will run advertising charades as long as they can, to sell us more fat juice. I bet that sometime in the next 5-10 years soda companies will be paying billions in fines for the knowing damage they’ve done. It can’t come soon enough…

  5. Thank you! When will real food beat out food-like products in marketing? When will the public be as outraged by this kind of marketing hypocrisy as they have become with cigarettes? I remember when cigarette companies sponsored sport (do they still do this?). No one today would think that his is acceptable. Yet another example of how the Olympics have been taken over by big business. I can barely watch the games now that they have become such corporate spectacles.

  6. I don’t understand: If “balance” is the key concept here, what is it about healthy produce, whole grains, and lean protein that needs to be “offset” by sugar and HFCs?

  7. As someone who always hated carbs and has a sweet tooth or 32; I like to think it’s the carbs. Everything gets digested differently from person to person. Metabolism is more complicated then people take into account. It’s kind of hard to blame one company and get them to change their products or marketing which is probably why the article series focuses on the whole industry. Individuals still need to figure out what works best for them.

  8. ‘@Hilary, it may be true that there is some metabolic variation between individuals. But we human beings share the same basic metabolism. When we eat sugar and refined carbs (which quickly break down into sugars), our body’s insulin cycle kicks in. Blood sugar rises (increasing risk of diabetes II) and the insulin converts these sugars into fatty acids, some of which is stored in fat cells (contributing to obesity) and some of which is released into the blood stream (raising heart disease risks). Recent studies have shown that the high amounts of carbs and sugar in our western diet are making us sick. Check out this 60 Minutes story for a very good overview of the science – JR

  9. Having spent 32 years in food R&D and worked on nearly every food type from frozen entrees (ala Healthy Choice) to sugary beverages (Pepsi) I am strongly in the “balance” camp. I’m tired of listening to articles like this that vilify the food companies. You mention Coke and McDonald’s as two bad actors. They both offer food choices in the “healthy” category – e.g. salads, yogurt, energy drinks, even water. So when Coke talks about doubling sales, it’s not all about sugary beverages. Of course, you fail to mention that. As a society we have lost personal accountability. Any issue, like obesity, must be someone else’s fault. Even too much water can kill you!!

  10. Exercise tends to increase appetite. It makes sense to me that the food industry would promote their unhealthy, addictive products while also promoting exercise as “healthy” at the same time. Anything that makes you want to eat (including typical calorie restriction “dieting”) is the industry’s friend.

  11. With all due respect, “whole grains” does not belong in that sentence. Wheat is a toxic substance, now being found in far too many foods, in addition to bread, rolls, bagels and pizza. Plz read “Wheat Belly” by Dr. William Davis. We would all be healthier if we ate wheat free diets.

  12. I am no fan of big food, but they supply what is demanded. If people decided to consume diet (non-sugar) beverages, and truely healthy foods, not high sugar, high carb and high pufa concoctions, then that is what the companies will supply. While I do not consider the big food companies paragons of virtous corporate citizenship, I find it pathetic that they be given all the blame. Do we have to abdicate critical thought and diciplined behaviour to accept impotent victimhood and the comfort of a scapegoat?

  13. Yes, Coke and McDonalds offer a few “healthy” choices. But the vast majority of their revenues and profits come from the unhealthy junk food they sell. Research shows that junk food is addictive, pure and simple, and fast food R&D folks know that. That’s why they “super size” it!

    Sugary and carb laden junk food has been proven to be as unhealthy for us as cigarettes. And we should treat it the same way. It’s true that some people could smoke cigarettes and avoid cancer, just as it’s true that some people can drink lots of soda and eat lots of junk food and not develop diabetes, obesity and heart disease. But it’s also true that smoking cigarettes vastly increased your chances for developing cancer. Eating junk food and drinking soda vastly increases the likelihood that you will become fat and sick. We should treat junk food and soda the way we treated tobacco. Tax it prohibitively, makemitmillegal for chldren to buy it, and make it illegal to advertise it. McDonalds and Coca Cola are just like Joe Camel, selling addictive, unhealthy products to unwitting consumers.

  14. There is a paradox here. Coke claiming that their diet drinks are a health option is not only a tacit acknowledgement that their non-diet (HFCS laden) drinks are unhealthy, but replacing the High Fructose Corn Syrup with sweetener, a known brain toxin isn’t healthy either. Neither one is a healthy choice. One makes you fat and the other fries your brain. Same goes for McDonald’s. I don’t think that initially anyone blamed them, they were only doing what companies do which is grow and make more profit, they didn’t know that what they were doing would have this effect, but they do now. They know it, just like the cigarette manufacturers came to know it. And now, just like the cigarette manufacturers did, they deny it. They are killing us and denying it, what else can they do? They won’t stop, they can’t, we have to stop them.

  15. Very good post.

    BBC has just produced a brilliant documentary on the role of food industry in obesity epidemic (“Men who made us fat”). It’s very well done and most of facts are line with recent literature reviews on the role of sugary soda in obesity. The programme seems to be available at BBC .com and You Tube.

    Food industry, like any other idustry, is about profits. If profits need to be doubbled in a decade (within a such mature market), no quick and dramatic losses are accetable. This translates into defensive communication tactics in sugar soda business. Thus, we will experience a continued “as a part of balanced diet” message roll and aggressive lobbying during the next decade.

    Soda industry prepares for the feature without sugar, but it has no way of escaping reality of economics and requirements of share holders.

  16. An important first step is getting the junk food vending machines out of schools and colleges. I recently made a brief re-entry into teaching (my previous stint being in the 1980s) and was shocked to find that in just over 20 years it has become ‘normal’ for children not to be able to concentrate at all after they’ve eaten lunch, which for most is not real food but diet drinks, chocolate bars and packet chips. That’s why the school day has got shorter, from ending at 4–4.30 pm to now ending at 3 pm; the teachers feel it’s not worth trying. And yes, they are mostly obese as well as having inadequate brain functioning. Plus, around half were on inhalers for asthma–virtually unheard of 2 decades ago.

  17. It is a fallacy that you can burn everything-the good & the not so good by merely balancing it off by doing movement. Even physical exercises which most can actually afford in their routine, it is doubtful, can nullify the huge intake from high sugar foods.

  18. Don’t demand more taxes; demand an end to corn and grain subsidies. Government is using our tax dollars to pay farmers to grow corn to keep the price artificially low… Hence we get cheap and plentiful HFCS. If we end the subsidies, prices will go up without the need for yet another tax. Taxes create far more problems than they solve… Once the government gets hooked on the extra cash, they have a vested interest in keeping that money coming in.

  19. Well said DJ. And whilst they are at it, they can also stop subsidising cultivation of tobacco, the 3rd largest subsidised crop, whilst spending our tax dollars on anti smoking campaigns. Just saying. Your logic extends to other such harmful hypocrisies. I would go so far as to say stop subsidising the things that are bad for us and move those subsidies to green vegetables, make those cheaper and the corn proportionally even more expensive.

  20. It’s a shame that we’ve come to a point that eg young women go to the gm and think drinking ‘diet coke’ ia a healthy drink. Parents shouldn’t take their kids to mcdonald’s parties. Also, they shouldn’t give sweets/chocolates/potato chips as ‘treats’. If anything, soda and candies should be used as punishment.

    Mcdonalds, coke and cadbury’s sponsoring the olympics gave out a terrible message.
    Look how bad sugar is…askbet a friend to give up sugar for a week. Even 3 days. see how hard it is.


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