I was wondering how you could get such a high impact overall. But it seems one in 6 households are on GLP-1 drugs in the US.
In my friend circle in Germany I don't even know one single person on this stuff.
It's insane to me that so many people need these to get off the processed foods killing them in the US.
I can buy pre-chopped Cole slaw, diced peppers / onions, etc. Whole Foods is best in class (Alnatura doesn’t come close)
While to me, the layman, it seems health regulation in general in Europe is more conservative about what can be put on the body / be consumed, I think it’s mostly Americans don’t want to eat healthy. And the portion sizes here are insane (just look at the evolution dinner plate. 1960s plates at an antique sale only pass for salad plates)
In the US I heard there is now parity in terms of quality products, but maybe culture takes some time to adapt to such environments.
In North America there are a lot of "food deserts" especially in poorer neighbourhoods. "Healthy" foods become a class marker. Distribution of higher quality food is through more upscale grocery stores.
Same goes for walkability in neighbourhoods. To live in a place that has transit accessibility, green grocer and bakery you can walk to -- that's not possible for the vast majority of North Americans because it exists only in urban areas that have gentrified beyond the reach of most people.
When I moved to Toronto in the mid-90s it was possible for a middle-income earner to rent or live in a home adjacent to some of the corridors in the city that offer this (e.g. Roncesvalles/High-Park, Spadina/Chinatown, College&Clinton, etc) and you could see a higher diversity of people living near the stores and in the neighbourhoods off them. As a person in my early 20s making not very much money, I could make it work. That is now no longer possible, the city has become a wealthy fortress. I imagine the same for parts of Brooklyn&NYC, Chicago, SF, Vancouver etc.
Almost nowhere in the US walks to go to the grocery store. Exceedingly small portions of major cities. Where I live in Chicago is quite walkable, but the vast majority of my neighbors load up the car for the vast majority of their shopping trips. There are pockets of course, but they are rare.
My neighborhood also happens to be much more fit than the national average - obesity is somewhat rare to see. The correlation is with wealth. Why there is such a correlation is much more interesting, and it likely is not as simple as people want to believe.
Same goes for the poor inner ring suburbs where I lived in my 20's in a different state. Very high rates of obesity. In the rich outer suburbs obesity levels were visibly less.
It's far cheaper to meal prep and make your own food from base ingredients. It doesn't need to be fancy. When I grew up poor (working class) this is how we made it work. By buying staples in bulk and buying other items opportunistically on sale. We didn't even own a car for most of that time - and the nearest grocery store was at least 3 miles away. It simply wasn't an option to exist off of junk food since it was too expensive.
Eating junk is easier and more convenient. It feels good in the immediate moment and is low-effort. It's the default, and the environment around you encourages it. Add in lack of any peer pressure and it being normalized by those around you and I believe that explains nearly everything. Lack of walkability certainly hurts, but it's not a primary driver anywhere I've lived.