Ultra-Processed People: Why Do We All Eat Stuff That Isn't Food… and Why Can't We Stop?

by Chris van Tulleken

UPF now makes up as much as 60 per cent of the average diet in the UK and the USA.5–7 Many children, including my own, get most of their calories from these substances. UPF is our food culture, the stuff from which we construct our bodies. If you are reading this in Australia, Canada, the UK or the USA, this is your national diet.

if it’s wrapped in plastic and has at least one ingredient that you wouldn’t usually find in a standard home kitchen, it’s UPF. Much of it will be familiar to you as ‘junk food’, but there’s plenty of organic, free-range, ‘ethical’ UPF too, which might be sold as healthy, nutritious, environmentally friendly or useful for weight loss (it’s another rule of thumb that almost every food that comes with a health claim on the packet is a UPF).

In fact, let me back up a moment on obesity. We’re still figuring out the language for this discussion. The word is rightly offensive to many people and calling obesity a disease is stigmatising. Many people don’t live with obesity as a disease but as an identity. For others it’s just a way of being, and an increasingly normal way of being at that. Weight gain is not inevitably associated with increased risk of health problems and the risk of death is in fact lower for many people who live with overweight than for those who live at a ‘healthy’ weight. Nonetheless, I will sometimes use the word obesity, and I will sometimes frame it as a disease, because diseases get funding for research and treatment, and sometimes the disease label reduces stigma: a disease is not a lifestyle or a choice, and the word can help to shift the burden of responsibility away from the affected person.

It’s based on there being some failure of willpower – a failure to move more or to eat less. This idea doesn’t stand up to scrutiny, as I will show repeatedly. For example, since 1960, the US National Health surveys have recorded an accurate picture of the nation’s weight. They show that – in white, Black and Hispanic men and women of all ages – there was a dramatic increase in obesity, beginning in the 1970s.8 The idea that there has been a simultaneous collapse in personal responsibility in both men and women across age and ethnic groups is not plausible. If you’re living with obesity, it isn’t due to a lack of willpower; it isn’t your fault.

Children in the UK and the USA, countries with the highest rates of UPF consumption, aren’t just heavier than their peers in nearly all other high-income western countries, they’re shorter too.11,12 This stunting goes hand in hand with obesity around the world, suggesting that it is a form of malnutrition rather than a disorder of excess.

Just as artificial sweeteners don’t seem to reduce overall calorie intake or protect against disease (something I’ll come back to), using novel synthetic molecules to make these low-fat versions of mayonnaise, and many other products, doesn’t seem to work. The best independent evidence shows that UPF products like these are strongly associated with weight gain and other diet-related diseases (as we’ll see in the next chapter). Additionally, since the introduction and widespread use of such low-fat products, rates of obesity have continued to rise. This may be because we eat more of these products (since we’re not quite getting the fat that we’re actually after), or it may be because some of the molecules that replace the fat seem to have a range of directly harmful effects (which I’ll also come back to later … a lot).

Here’s the theory: the main reason for the rapid increase in overweight and obesity throughout the world, especially since the 1980s, is the correspondingly rapid increase in production and consumption of ultra-processed food and drink products.

Leicester is a food swamp. UPF is everywhere but real food is harder to reach, both geographically and financially. There is a clear correlation between poverty and the density of fast-food outlets, with almost twice as many in the most deprived areas compared with the least. In one deprived area in northwest England, there are 230 fast-food outlets for every 100,000 people, compared with an England-wide average of ninety-six per

‘Most UPF is not food, Chris. It’s an industrially produced edible substance.’

Remember our rate of consumption is determined by the food and our genetics – it is not a conscious decision. Anyone who has tried to match the pace of a slow or fast dining companion knows how hard it is.

if a Jaffa Cake were, in fact, a chocolate-covered biscuit, it would be subject to VAT, but if it were a chocolate-covered cake it would be exempt. In the end, McVitie’s were spared the tax.

The destruction of the food matrix by physical, chemical and thermal processing means that UPF is, in general, soft. This means you eat it fast, which means you eat far more calories per minute and don’t feel full until long after you’ve finished. It

It is a source of constant amazement to public health doctors that you can buy a cold Coke almost anywhere on earth but keeping a vaccine cool enough to get it from a factory to a child is a huge problem. The companies that make our

In the UK, poverty is estimated to cost the government around £78 billion per year in increased healthcare, education, policing, criminal justice, and social care costs and lost tax revenues.43 This is more money than it would cost to end it. So, it’s not just morally right to end poverty, it is way more cost-effective to do so than to spend money fixing the lives it shatters. The