‘Ultra-Processed People’ Review: The Problem With Irresistible

While hardly a surprise—no one thinks of Häagen-Dazs as a food source teeming with healthy nutrients—the disclosure is emblematic of a wider problem. Nestlé is one of many purveyors of the ultra-processed foods that now account for about 60% of adult calorie consumption in the U.S. (The ratio is even higher for children.) The growing popularity of these foods over the past few decades has contributed to rising obesity rates and wreaked havoc on health along the way.

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Chris van Tulleken, a physician and BBC broadcaster based in the U.K., argues that ultra-processed foods “subvert the systems in the body that regulate weight and many other functions.” In “Ultra-Processed People,” a persuasive mix of analysis and commentary, he shows how these foods affect our bodies and how their popularity stems in part from shady marketing and slanted science.

Dr. van Tulleken defines an ultra-processed food as anything that’s “wrapped in plastic and has at least one ingredient that you wouldn’t usually find in a standard home kitchen.” A kindred definition has it that the more ingredients one finds on a food label—Nestlé’s steak-and-cheese Hot Pocket has about 75—the greater the degree of the processing involved. Ultra-processed food, says one scientist quoted by Dr. van Tulleken, shouldn’t even be called “food” but rather “an industrially produced edible substance.”

Though broadly gauged, Dr. van Tulleken’s analysis includes one vivid episode of first-person reporting. For a month, he made ultra-processed foods account for 80% of his daily calorie intake. The effects were unsettling, to say the least: He gained 13 pounds, slept poorly, experienced constipation, and began craving Diet Coke, drinking six cans a day. His appetite hormones became “totally deranged,” and he was hungry even after eating. “In just a few weeks, I felt like I aged ten years,” he writes. “I was aching, exhausted, miserable and angry. Ironically, food often felt like the solution rather than the problem.”

Dr. van Tulleken cites reams of studies to show the effects of ultra-processed foods, pausing to give special focus to a paper published in 2019. Twenty people lived around the clock at the federal government’s National Institutes of Health for a month. For two weeks, 10 of them ate nothing but unprocessed food (including fruits and vegetables as well as chicken and roast beef). The other half got 80% of their calories from ultra-processed food. The groups swapped diets for the remaining two weeks. Throughout the study, they were free to eat as much as they wanted.

The result? Participants in the unprocessed-food phase of the experiment lost weight while the others gained weight, consuming on average 500 more calories per day. The study probably underestimated the contrast, Dr. van Tulleken notes, since it included no marketing or health claims, both of which lead people to consume even larger quantities of ultra-processed food. Such foods in the marketplace are often described with meaningless terms such as “natural” and “low carb,” while unprocessed fruits and vegetables get no health claims at all.

Marketing strategies aside, the appeal of ultra-processed foods is typically said to rest on a trio of seemingly benign attributes: They are inexpensive, easy to prepare and delicious. But Dr. van Tulleken sees the appeal deriving from something more insidious. With the aid of various additives and sophisticated chemical modifications, these foods have been manufactured to become addictive. He points to the speed of the reward (akin to the “hit” of snorted cocaine) and to the manipulation of brain signals. “By speedballing different tastes and sensations,” he writes, these foods “can force far more calories into us than we could otherwise handle, creating enormous neurological rewards that keep us coming back for more.” It’s not that people utterly lack agency, of course—the problem for many is less coercion than seduction. Ultra-processed foods surround us—they are prevalent in every drug store and grocery store and are the foundation of every fast-food outlet. As such, resisting them requires a greater degree of willpower than many of us routinely possess.

And there is a price to pay beyond mere money. Dr. van Tulleken cites one study showing that for every 10% increase in ultra-processed food consumption the risk of cancer rises by the same amount. Other studies link these foods to cardiovascular disease, type 2 diabetes, hypertension, depression and dementia. The high levels of salt, sugar and fat are not the only problem, Dr. van Tulleken emphasizes. Some scientists see the very act of processing—which can mean inserting harmful ingredients and stripping out healthy nutrients—as the fundamental risk.

Given such harm, what are we to do? Dr. van Tulleken’s proposals are modest. He says the Food and Drug Administration needs to be more vigilant about regulating food additives, and he favors marketing restrictions and warning labels. But he shies away from the government using its powers to channel people toward more nutritional food. “That’s not the business of politicians,” he writes. He prefers “a world where you have real choices and the freedom to make them.” That means the freedom to make unhealthy choices—say, devouring multiple scoops of Häagen-Dazs—as well as healthy ones.

Mr. Rees is editor of the Food and Health Facts newsletter and a senior fellow at Dartmouth’s Tuck School of Business.