Americans spend $40 billion a year on books, products, and programs designed to do one thing: help us lose weight. From Atkins to Ornish and Weight Watchers to South Beach, today's dieters have a dizzying array of weight loss programs from which to choose -- yet the underlying principles of these diets are often contradictory.
In "Diet Wars," FRONTLINE examines the great diet debate. Viewers follow FRONTLINE correspondent Steve Talbot, whose discovery that those "few extra pounds" have put him perilously close to the clinical definition of obesity prompts him to evaluate the myriad diets now available to overweight Americans.
"America has become the fattest nation on earth," Talbot says. "About two-thirds of the American population is overweight, and of those, half are already obese. The diet industry is the visible sign of a looming public health problem."
How did America get so fat in recent years? "Diet Wars" explores the social, cultural, and dietary factors that have led to the fattening of America, while also examining how the medical and diet industries have responded to consumers' desire to lose weight. The documentary examines how concerns in the early 1960s that Americans were eating too much animal fat and cholesterol prompted doctors to begin recommending that patients reduce the amount of fat in their diets. The problem, some observers say, is that the low-fat recommendations failed to distinguish between the so-called "good fats" -- unsaturated vegetable and fish oils -- and the "bad fats" -- saturated animal fats -- associated with clogged arteries, heart disease, and other health problems.
"Somehow, we got this notion that, 'Aha! If we take the fat out of foods we will be able to reduce the total caloric intake and people will be able to control their weight,'" says Tufts University Nutrition Professor Dr. Jeanne Goldberg. "And so industry got very busy making low-fat, reduced-fat, fat-free products… ."
Soon, low-fat and fat-free products flooded the marketplace, as did high-profile low-fat diets like Pritikin and Ornish. In "Diet Wars," Talbot's search for the perfect diet takes him from a Weight Watchers pep rally -- where spokeswoman Sarah "Fergie" Ferguson revs up the audience of faithful followers -- to several low-fat diet centers, where proponents extol the virtues of their respective plans.
"The Pritikin Diet is basically a healthy diet. Pritikin didn't start as a weight loss program -- it started as a way to reverse heart disease, high blood pressure, diabetes," says Dr. James Kenney, chief nutritionist of the Pritikin Longevity Center. "What makes eating healthy in America difficult is that most restaurant foods -- particularly fast restaurant food -- is designed to make people fat and sick."
So popular did the low-fat craze become that in 1992 the U.S. Department of Agriculture introduced its much-vaunted food pyramid guidelines that recommended Americans lay off the fat and load up on grains and cereals, which are carbohydrates.
But there was a problem. During the 1990s, despite the new guidelines and the glut of low-fat and fat-free products available, Americans got even fatter. While most experts agree that Americans' increasingly sedentary lifestyle and fondness for fast food contributed to the nation's growing girth, others postulate that the low-fat label misled consumers into believing that such products contained fewer calories, causing them to eat even more.
"The low-fat message was interpreted as if you had a product that was lower in fat it was good for you without thinking of calories," says Professor Marion Nestle of New York University's Department of Nutrition, Food Studies & Public Health. "The best example is the Snackwell phenomenon: Snackwell cookies were advertised as low-fat cookies but they had almost the same number of calories."
Nutritionists also note that in order to make products low-fat, companies had to replace the fat with something else -- usually carbohydrates.
Enter Dr. Atkins and the low-carb diet craze currently sweeping the nation. Whereas low-fat diets like Pritikin and Ornish warned followers against eating high-fat foods like steak and eggs, Atkins followers avoided the carbohydrates that are the mainstay of a low-fat lifestyle.
Not surprisingly, low-carb diets have come under attack by everyone from low-fat diet proponents to scientists and the media. In "Diet Wars," Talbot speaks with science journalist Gary Taubes, who wrote a controversial article for The New York Times Magazine that questioned whether the food pyramid was wrong and limiting carbohydrates was the way to go.
"I got crucified in a variety of publications," Taubes tells FRONTLINE. "A Washington Post reporter went after me, the Center for Science in the Public Interest went after me … because suddenly I turned around and said, 'Maybe low-fat diets don't work and maybe low-carbohydrate diets are the answer.'"
Taubes admits to being surprised by the ferocity with which his article was attacked. "People are more polarized on this than they are in politics," he says. "I'm stunned."
What most nutritionists and industry experts do agree on is the fact that America is facing an obesity problem of epidemic proportions.
"This is the public health issue of our generation," says Dr. James Hill, director of the University of Colorado's Center for Human Nutrition. "[When] you see 65 percent of Americans are overweight or obese, what amazes me is that anyone maintains a healthy weight in this environment."