Film Review - “Super Size Me”

Few movies can change the way America eats, thinks, and lives. Even fewer can cause global corporate superpowers like McDonald’s to quake in their boots. “Super Size Me” accomplishes both. In his highly acclaimed 98-minute documentary, Morgan Spurlock sheds light on the obesity epidemic, the health issues it has raised, and the culprits who have made our great nation into the Home of the Free, the Brave, and the 100 million overweight or obese Americans (60% of adults and 37% of children). The film is both sensationalistic and earnest in its portrayal of an American public health tragedy. At the same time, it is continuously buoyed by Spurlock’s irrepressible sense of humor, gratuitous if not entertaining commentary on his McDiet-induced sexual dysfunction, and a catchy, well-chosen soundtrack.

In all its muck-raking glory, Super Size Me is a film that combines harrowing statistics, interviews with a star-studded lineup of health experts, e.g., head of US Health and Human Services Tommy Thomson, NYU Professor in the Department of Nutrition, Food Studies, and Public Health Marion Nestle, Yale Professor of Epidemiology and Public Health Kelly Brownell, and former U.S. Surgeon General David Satcher, to name a few, and Spurlock’s self-devised extreme challenge: ingesting only McDonald’s food for thirty straight days, Super-sizing his meals, restricting his physical activity, and enlisting a bevy of doctors to track his rapid health decline. Ultimately, Spurlock suffers a smorgasbord of problems including near liver failure from fat deposits, a jump in cholesterol from 168 to 230 mg/dl, a 25 lb weight gain, a doubled increase in risk of heart disease, as well as self-reported chest pains, depression, exhaustion, mood swings, and “worthless” sex drive.

“Super Size Me” is Spurlock’s vigilante version of an FDA drug trial: only here, McDonald’s, not Big Pharma, is under scrutiny. Spurlock, participant n=1, a man of “above average health” at the trial’s start, undergoes a rapid decline within the first two weeks. Despite his doctors’ warnings and stern recommendations that he end the trial early, Spurlock persists in his challenge to the bitter end, downing a 5000-calorie/day diet that is twice the caloric needs of a man of his stature. The results of the trial are dramatic . . . but what of the trial’s controls? Would a 5000-calorie/day diet of any kind of food prove disastrous to his body? Would a 2500-calorie McDiet combined with regular physical activity mitigate his health decline? Would consciously opting for healthier menu options, while bypassing some of the 610-cal fries and 410-cal Cokes in those Super Size Meals, allow for a sustainable, even healthy, diet at McDonald’s?

Spurlock avidly asserts that his experience is not an “extreme” example, because in reality, many Americans actively consume fast food products several times a week. Yet, clearly something was a bit “extreme” when Spurlock vomited out of a car window—on film—while downing his first Super Size Meal on Day 1. In some ways, the undeniably extreme nature of Spurlock’s McDiet somewhat trivializes his eating experiment, since viewers will recognize that in reality people do not willingly undertake such gastronomic absurdity. Indeed, we believe the most valuable part of Spurlock’s documentary lies in his grounded coverage of America’s current obesity epidemic, its causes, and its insidious effects on our nation’s health. Various items of interest gleaned from the documentary included the following:

THE OBESITY EPIDEMIC

• Obesity is second only to smoking as a leading cause of preventable death with 400,000 deaths per year directly or indirectly linked to obesity. • Former U.S. Surgeon General David Satcher points out that in the last twenty to twenty- five years, the U.S. has seen a doubling in the number of obese and overweight children and adolescents. Twenty percent of obese children have abnormal liver function, and biopsies of these livers reveal that half show fibrosis or scarring of the liver (early stages of cirrhosis). • U.S. Secretary for Health and Human Services Tommy Thomson discusses diabetes, a disease strongly linked with obesity. Thomson states that direct medical costs associated with diabetes have doubled within five years from $44 billion in 1997 to $92 billion in 2002 ($132 billion including non-direct costs1). • Statistics suggest that one in three children born today will have diabetes in his or her lifetime2.

CAUSES OF THE EPIDEMIC/OTHER OBESITY ‘FOOD FOR THOUGHT’

In addition to the fast food industry, Spurlock attributes America’s obesity epidemic to food companies’ crafty marketing and lobbying strategies. He particularly rails at what he sees as manipulative targeting of children.

• Author Kelley Brownell (Food Fight) characterizes today’s fast food world a “toxic environment” that guarantees illness. He emphasizes that “toxic” is not an overstatement in light of the sixty percent of America that is overweight or obese. • There’s that number again! More than 60% of Americans get no form of exercise. • One in four Americans visits a fast food restaurant every day. • McDonald’s characterizes 70% of its customers as “heavy users” who frequent the chain about once a week and 25% of its customers as “super heavy users” who frequent the chain three to five times per week. McDonald’s feeds 46 million people worldwide every day. • McDonald’s spends ~ $1.4 billion annually worldwide on direct media advertising, much of it aimed at recruiting children. In fact, the average American child watches 10,000 food ads on TV each year. Similarly, Pepsi spends more than $1 billion annually in direct media advertising. By contrast, the direct media advertising for the “5-a-Day” fruit and vegetable campaign amounted to $2 million dollars.

1 Economic costs of diabetes in the U.S. in 2002 - Report From the American Diabetes Association: Reviews/Commentaries/Position Statements, March, 2003 Diabetes Care. 2 Actually, going to check this statistic – we recalled that it was published in JAMA last year – we were reminded that the risk is one in three for males, but even higher for other groups - 40% for all females, and 50% for Hispanic females, the highest risk group. Narayan KMV, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. JAMA 2003 October 8;290(14):1884- 1890. • Law Professor Banzaff accuses McDonald’s of luring in children with playgrounds, birthday parties, Happy Meal toys, the Ronald McDonald clown, and television cartoons. • Renowned food expert Marion Nestle describes how the food industry employs extremely powerful lobbies in Washington (e.g. GMA—Grocery Manufacturers of America) that try to ensure favorable legislation and government agency actions. • Neal Barnard of the Physicians Committee for Responsible Medicine notes that it’s a drug effect of the food in the brain that keeps people coming back again to fast food restaurants. Fast food is filled with addictive components that trigger chemical reactions, he says, e.g., a slab of meat, cheese, sodas with sugar and caffeine, etc. • Public school food suppliers and food lobbies claim that they are trying to educate students and parents to make healthy choices. In reality, many children are eating junk food and high-calorie food that is made easily available to them. • Soft drink companies sell sugar-laden drinks from school soda machines and cafeterias. Although in some environs this is changing, for many schools, ‘royalties’ from such sales represent an important source of revenue. • The average American who works at an office setting, drives to work, and takes an elevator to the office may take as few as 2500 or 3000 steps a day. Many Americans walk less than 500 steps a day. Americans eat 40% of meals outside the home. • Approximately $30 billion was spent on diet/weight loss programs last year — 2.5 times estimated spending on health/exercise/fitness.

We do point out that there were several considerations on which Spurlock did not comment that nonetheless are an important element of the examination of obesity in America. First, income and geography help determine whether McDonald’s is an infrequent treat or a frequent, economical necessity. For low-income families, buying healthy but expensive organic foods and working out at a health club are usually not viable options. Second, obesity is unevenly distributed across racial lines. Finally, genetics and metabolism certainly play some role in the equation. Indeed, these three elements often go hand-in-hand, forming a double or triple threat for many US populations.

Call it coincidence, call it cause, but it is no secret that McDonald’s recently decided to phase out the Super Sizing by the end of the year, to introduce new Go Active adult happy meals (complete with bottled water and pedometer), to introduce high-quality salads, and to include the choice of fruit (“fruit not fries”) in children’s happy meals.. McDonald’s insists that its recent decisions were made in the public interest without any outside pressure, but if “Super Size Me” did play a role in sparking these merchandising changes, as Spurlock implies, such an achievement alone is enough for us to deem the film a great success. Commercially, “Super Size Me” has pulled in over $12 million at box offices worldwide, which for a documentary, is a stellar result! Given that Spurlock had no backing for the film, and that he financed its $65,000 budget on credit cards, we take another moment to applaud Spurlock’s idea and its execution—yes, in more ways than one, it is a sweet victory of epic proportions.

--Close Concerns Super Size Me Review Team - Brad Lee, Olayinka Olowoyeye, Anthony Wilson-Elizondo, Melissa Ford, and Kelly Close