In the US, fast food is becoming the new tobacco, New York correspondent Rodney Dalton reports:
BY some quirk of culture, the US is one of the few countries where entree refers to the main meal.
And in the land of the huge, large is too small. Would you like to supersize that, sir? It'll only cost a few cents more.
It's an offer more and more Americans can't refuse, and the nation's healthcare system is buckling under the strain of a $US117 billion ($204 billion) obesity bill.
In a call to arms just before he left office in December, US surgeon-general David Satcher warned overweight and obesity among Americans had reached epidemic proportions, with about 300,000 deaths a year linked to the nation's ever-expanding waistline. If this trend continues, Satcher says, overweight and obesity will soon match cigarette smoking as the leading cause of preventable disease and death. Most disturbingly, obesity rates among children -- prime targets of the fast-food industry -- have exploded over the past 15 years.
And in the US, where there's smoke, there's a lawyer. Fast-food companies have been put on notice: food is the new tobacco. A handful of lawsuits are in the works and the companies, mindful that the flood of tobacco litigation started with a trickle, are taking them seriously.
Enter Professor John Banzhaf, a veteran of the tobacco wars, who has lost none of his appetite for a fight.
"When those [lawsuits against tobacco companies] were first proposed everybody laughed," he told The Weekend Australian.
"The lawyers who took them were called frivolous and foolhardy. Today we call them multimillionaires. I'm not going to tell you it's [suing the food companies for the US's obesity problem] a slam dunk, that it's 50-50 ... quite frankly it's a reach, but it's possible."
The progress of the anti-fast food lawsuits will be watched closely in Australia and Britain, where obesity is a significant and growing public health problem, particularly among children.
The threat of tobacco-style lawsuits has hit the radar screens of food and beverage makers such as McDonald's, Coca-Cola and tobacco giant Philip Morris, which owns 84 per cent of Kraft Foods, and they are supersizing their public relations campaigns in response.
Industry group the Grocery Manufacturers of America doesn't want to buy into the blame game, arguing that the answer to the US's obesity problem is education, not "frivolous" lawsuits.
GMA spokesman Gene Grabowski says: "We take the issue seriously [but] we think the idea that food is similar to tobacco is wrong.
"There's nothing you could argue that's good about tobacco. That's one level where the analogy wears thin.
"We think this issue is not about lawyers and litigation, we think it's about getting good information into the hands of parents."
Particularly galling for the food lobby are comments by consumer advocate Ralph Nader, who last week described the double cheeseburger as a weapon of mass destruction. But the evidence is mounting that many Americans, left to their own devices, will not lead a healthy lifestyle. A National Alliance for Nutrition and Activity report, From Wallet to Waistline, finds that consumers are the losers when they supersize their fast-food meals. Opting for larger serving sizes only costs a little more but the calorie and fat content rises substantially.
As portion sizes have increased in the past two decades, so has the rate of overweight or obesity, which affects 61 per cent of Americans. The decline in eating habits was explored in Eric Schlosser's bestseller Fast Food Nation, which traced the impact of the fast-food restaurant on the US economy, workforce and culture.
Schlosser says that on any given day, 25 per cent of the adult population will visit a fast-food restaurant. His advice to parents: "Just say no" when their children scream for a McHappy Meal.
The obesity problem has not gone unnoticed in the White House. Fitness buff George W. Bush this week urged Americans to exercise more. He made the comments as Southwest Airlines announced plans to charge larger passengers for two seats if they cannot fit into one. A full-scale tobacco-style assault on fast food and snack producers may be some time off but lawyers will be watching as a number of cases go before the courts.
There have been some small victories so far. McDonald's was forced to apologise -- and cough up $US12 million -- for using beef fat to precook fries it claimed were cooked in vegetable oil. That class action was initiated by a student of Banzhaf's public interest law class at George Washington University.
The Seattle-based attorney who fought that case, Harish Bharti, is not done yet, filing a complaint against Pizza Hut over its Veggie Lover's pizza.
The suit alleges Pizza Hut, in an effort to attract the vegetarian dollar, engaged in "false and fraudulent marketing" of a vegetarian pizza. It says the pizza contained beef product, causing emotional distress to vegetarians who bought it.
In Manhattan, Meredith Berkman, 37, filed a $US50 million class-action suit against the maker of a popular snack -- Pirate's Booty -- after analysis by Good Housekeeping magazine showed that labelling on the packet greatly understated the fat content. Lawyers see such cases as the start of a broader assault on the food companies that may, among other things, force them to put health warnings on their products.
"The specifics in this case are about fat content," Berkman told Newsweek. "But it's not really about fat content, it's about truth in labelling."
In a similar case in Florida, the maker of an ice-cream that is sold in schools faces a class-action suit over false labelling.
According to Banzhaf, food and beverage producers have an advantage over tobacco producers in that they can clean up their act. Tobacco producers did not have the option of producing a safe cigarette when the the lawsuits started.
"I can't think of any way we can legislate that people go out and jog a mile a day. But we can change how fast foods are advertised, promoted, sold," he says. "We can adopt taxes on fast foods so the losses are borne much more by people who eat them."
The idea of a fat tax or twinkie tax is the ultimate red flag to libertarian groups. The Centre for Consumer Freedom has attacked the "food police" and the GMA last month urged a congressional panel not to blame individual foods for the obesity epidemic. In the US, it seems, freedom includes the right to get fat.
It's all grist to the mill for Banzhaf, who began arguing the case against tobacco companies in the 1960s. The campaign picked up momentum when Mississippi lawyer Dick Scruggs sued tobacco companies to recoup money spent on healthcare for smokers. In 1997, the industry agreed to pay $US368 billion and Joe Camel smoked his last cigarette.
"Like sharks smell blood, lawyers smell money -- so I'm sure many of my colleagues are looking out and saying if McDonald's will cave for $US12 million, who else can we go after?"
Food and beverage companies prefer to talk of educating parents to instil better eating habits in their children and making physical exercise part of the school curriculum.
In two weeks, the industry-backed International Food Information Council begins an online marketing campaign called Activate that aims to get American children off their ever-widening butts.
McDonald's dietician Ann Rusniak Gallagher says: "We recognise that McDonald's may sometimes be used as a symbol for these kinds of issues but we are confident and proud of the nutrition content and quality of our menu."