Mr Critser starts his study by explaining that palm oil was introduced in the US in the 1970s, cheaper and tastier than vegetable oil but containing 45 % saturated fat. At the same time, soft drink companies switched to high-fructose syrup saving the companies 20 % in sweetener costs and allowing the production of calorie-dense convenience food, the so-called "TV dinners". Still at the same time, meat production soared world-wide as feed costs of soy meal and corn fell. And so at fast food stands, portions became bigger and cheaper. "Value meals" became popular and the presence of more food for the same amount of money induced people to eat more. By the end of the 20th century, supersizing reigned in the fast food world. Another factor responsible for the rise of obesity is the habit of consuming high-calorie snacks between meals, particularly in schools where most cafeterias stopped cooking proper meals anyway in the favour of "outsourcing" - contracting an outside source to deliver pre-plated meals. The author then shows how obesity is associated with high levels of religiosity and how obesity is made to a cult on TV with some popular singers revering their own overweight body in their lyrics.
Other factors contribute to obesity: lack of physical education in schools, disproportionate TV-viewing (where up to 40% of children advertising is for high-fat foods) which can lead children to develop type 2 diabetes, particularly among the working poor who have the "impulse to eat for today, tomorrow being a tentative proposition at best". Poverty, class and income are thus the key determinants of obesity. A report from the RAND/University of Chicago states that "The economic and personal health costs of overweight and obesity are enormous and compromise the health of the United States."
Finally, in the last chapter the author suggests a series of measures to improve the current situation. An altogether well-researched and valuable study which tackles various issues: social, medical, economic, educational, cultural and culinary.