The Weight of the Nation: HBO's blunt examination of the fat epidemic in the US

HBO takes an unflinching look at obesity in America with The Weight of the Nation, a documentary series on the science, economic toll and human misery of the struggle to be thin.

Shaquilah Davis measuring Mark Mertin in a scene from The Weight of the Nation on HBO. photo: Jessica Dimmock/courtesy of HBO TV

Obesity is crushing the United States into oblivion. Its citizens are digging their graves with a knife and fork.

One can't help but arrive at this conclusion after watching The Weight of the Nation, HBO's blunt four-part examination of the fat epidemic in the US through case studies, consultations with experts and profiles of struggling individuals and their families. Filmed in partnership with the Institute of Medicine, the Centers for Disease Control and Prevention and the National Institutes of Health, it doesn't pull any punches.

Obesity costs the US economy close to US$200 billion (Dh734bn) a year, says the producer John Hoffman, but that's nothing compared to the human toll in a culture that keeps salty and sugared foods within arm's reach. Seeing is believing, especially when autopsied hearts are held up to the camera.

"Foods that are affordable usually are high-fat, high-sugar foods that activate the pleasure centres of our brain in the same way that drugs do," says Hoffman. "It's the dopamine system, the pleasure-reward system of the brain. And so we've refined these products to be as potent as we can for that reward. Are you going to ask people to not experience pleasure?"

The first part, Consequences, shows the scope of the epidemic and spells out the health consequences of being obese. The second, Choices, reveals what science has shown about how to lose weight, maintain weight loss and prevent weight gain. The third, Children in Crisis, traces the damage obesity is doing to kids.

Through heart-rending stories, this film reveals the strong social forces that cause children to consume more calories than they burn off: unwholesome school lunches; the decline of physical education; the demise of school playtime; and the "powerful, pernicious and predatory" marketing of junk food.

The fourth film, Challenges, examines the major driving forces causing the obesity epidemic, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture and the strong influence of the food and beverage industry.

If you're one of the lucky dieters who does manage to shed their excess poundage, expect the battle to be never-ending.

"Even after 10 years of maintaining significant weight loss, the body doesn't readjust," Hoffman told USA Today. "Your brain still thinks you're in a state of deprivation, and it manipulates your body in ways you don't even notice: you're hungrier, less easily satisfied and frequently tempted by sweet and fatty foods; you are less inclined to exercise. Losing weight and keeping it off requires a renovation of your entire life for the rest of your life."

Yet Hoffman allows some optimism, thanks to the past success of public health experts in changing cultural norms about smoking and seat-belt use in cars. "[But] I am pessimistic about the willingness of the food and agricultural industrial complexes to make the transformations that have to occur. The profits that they're making from the unhealthiest foods are so enormous," Hoffman told PBS Newshour.

"We have an expert in the fourth episode who says: 'If every American were to reduce his or her intake by 100 calories per day, it would cost the food industry between $30 and $40 billion.' What sector of the economy is going to willfully reduce the size of their industry by $30 to $40 billion?"

The Weight of the Nation will be broadcast at 2pm today on OSN News and continues for three more weeks