Dear DOCTOR Owen:

I went to the movies the other night and bought a candy bar in the theater. They must specially make those bars for movie houses. This thing seemed to weigh a pound. I didn’t want that much, but eventually ate the whole thing. How many calories was that? Why are the portions so big? I remember when a box of popcorn fit easily between my legs. Now I can barely fit it on the floor between my feet.

No Control

Dear “Control”:

What we see at the movies is happening in every commercial establishment that offers food across America.

Food is cheap, relatively speaking. Consumers want “a deal.” Restaurants are in a footrace to give the most for the least. This is capitalism at its best!

There is no conspiracy driving this runaway train of big portions. Food producers and eating establishments are just responding to the human drive to want more. The average candy bar in 1985 weighed 3 ounces, but now weighs 8 ounces—1/2 pound! At 100 calories/ounce, this is 500 calories more per bar than in 1985. If you ate only one candy bar/week, you would eat an extra 25,000 calories/year. Since 3500 calories equals 1 pound, this would mean an extra 8 pounds/year on the body. In 10 years, you would gain 80 pounds!

Yet the same thing is happening everywhere. Soft drinks—the big gulp! The average drink in 1965 was 6 ounces; now it is 12. The large drink at fast food restaurants averages 20 ounces. At 12 calories/ounce, the average increase is 100 calories/drink.

The average plate size for commercial restaurants is now 1/3 larger than it was a decade ago. This is to accommodate the extra food. Marketing scholars have determined that the “doggie bag” percentage is one of the top predictors of success in the restaurant business. This sales technique requires no more staff, no special training, no more space, and no marketing. The doggie bag is the marketing tool. Customers leave a restaurant stuffed; then, next day they are reminded of that eating experience when they open the ‘fridge. There, they find an “extra” meal (a high-fat one at that) for no extra money! With that incentive, where will you go next time you dine out?

Burgers are bigger, fries are bigger, soft drinks are bigger, and everything eaten out is literally 30%–50% larger than it was two decades ago. The average American plus the family now eat more than 50% of their meals outside of the home. Many families have two-income earners who have little or no time to cook. And cooking at home is no longer the bargain it once was. The cost in money, time, and labor to prepare meals made with garden-fresh vegetables, organically grown food items, and juicy fruits is often greater than the choices listed on restaurant menus.

Many people are not aware, or even conscious, of these changes in portion sizes. People have no aversion to getting more for less. When talking about only 2–4 extra ounces, who’s counting? Your palate and your stomach don’t discern calories—they relate only to taste and fullness. (Even the taste of food often seems better in restaurants.) The whole world can now enjoy the delights of the Copelands, the Prudhommes, the Chacheres, the Folses, and the Lagasses of the world.

As I tell patients every day, managing weight requires a conscious method of eating and exercising. It’s hard not to enjoy the spoils of this great world. Most people have no idea how much payback—in calories—is required for many meals. For instance, in one of the classes conducted at my clinic, we diet and health counselors calculated the number of calories in an average breakfast and lunch at a familiar fast food burger joint. Total calories for both meals were 3000, which means that the average 150-pound woman would have to “pay back” 1500 calories in diet and/or exercise to break even and maintain her weight. Diet payback, in this case, would involve three days of 500 calories/day drinking a liquid food drink (because you cannot get balanced nutrition under 1000calories/day without pre-measured food). Would eating breakfast and lunch at this place be worth this payback?