Capitalisn’t: The Money behind Ultraprocessed Foods

Marion Nestle: An executive of a very large food company said, “We would love to stop marketing to children, but our stockholders won’t let us.”

Bethany: I’m Bethany McLean.

Phil Donahue: Did you ever have a moment of doubt about capitalism, and whether greed’s a good idea?

Luigi: And I’m Luigi Zingales.

Bernie Sanders: We have socialism for the very rich, rugged individualism for the poor.

Bethany: And this is Capitalisn’t, a podcast about what is working in capitalism.

Milton Friedman: First of all, tell me, is there some society you know that doesn’t run on greed?

Luigi: And, most importantly, what isn’t.

Warren Buffett: We ought to do better by the people that get left behind. I don’t think we should kill the capitalist system in the process.

Bethany: So, food. It’s one of the great pleasures of life. Or, as Virginia Woolf famously said, “One cannot think well, love well, sleep well, if one has not dined well.” Or there’s Julia Child: “People who love to eat are always the best people.” True, in my experience.

Luigi, you’re Italian. You should have an opinion on this.

Luigi: Of course, I agree with you. And I think the best friends are made over a meal. But, of course, food is also a business and a big business. Packaged food and drink just in the United States is estimated to be $1.5 trillion in sales. Worldwide, according to Statista, it’s projected to go to almost $13 trillion by 2028, and it’s becoming an increasingly controversial business.

Food is, these days, engineered to make us eat more. Food is becoming as addictive as cigarettes by design, not by our choice. If the huge—pun intended—increase in obesity is one of the biggest problems facing us, whose responsibility is it to change things? Should Big Food behave more responsibly, or should the government step in, or are we 100% responsible for what we eat, and so, if we want to eat ultra-processed food, let us eat?

Bethany: Marion Nestle, one of the prominent thinkers and authors on food, has detailed in a recent piece how many times efforts to stop marketing unhealthy food to children—to children!—have been derailed. Maybe most prominently, she writes that in 2006, way back then, the Institute of Medicine published a remarkably damning report on food marketing to children, documenting the adverse effects of marketing on children’s food preferences, their demands for branded products, their eating habits, and their body weight.

This report urged the use of multiple policy changes to prevent childhood obesity. It even warned that if food companies do not voluntarily stop marketing unhealthy foods to children, Congress should enact legislation. Michelle Obama, a few years later, tried to change things, too. Really, nothing has changed.

Luigi: Are you saying that the food industry is more powerful than the US president or even the First Lady, who, as we know, runs the US president?

Bethany: Well, it certainly seems that the dollars that the food industry brings to bear are more powerful than seeming right and wrong, and we’ll have to debate this personal responsibility. I also think that what is problematic to me is that the food industry does very much externalize the substantial personal and medical costs of its consequences.

But I think about it all in the case of the food industry—and not just the food industry—as Obesity, Inc. The food industry makes us fat. And then the drug industry sells us drugs to deal with our unhealthiness. And the hospital industry provides all sorts of services and surgeries that help mitigate the consequences of all of our overeating. Everyone makes money, business makes money, but healthcare spending soars, which is a giant problem for our country and increasingly for countries around the world, and we have less productive, less long, and less enjoyable lives as a result of this.

Luigi: Paradoxically, all this industry seems to crash into a wall thanks to the invention of the Ozempic class of drugs that basically reduces the desire to eat and so reduces consumption. Now, Bloomberg has reported that Walmart’s CEO recognized that customers taking Ozempic buy less food. By the way, how does he recognize that? It’s because Walmart can mine its own pharmacy and grocery data to pinpoint that the very same customers that buy one type of drug actually buy less food.

I think that there is a tension because this might upend the entire industry. A team of Morgan Stanley analysts laid out how obesity medicine could dampen demand for food and reshape the food ecosystem. God forbid the food industry is going to come and ask for a subsidy because now, all of a sudden, they are firing people because Ozempic will make people buy less crappy food.

Bethany: Yes, I worry that the money people are spending on food simply shifts to another part of my Obesity, Inc., empire, and the money people are paying for food shifts to the money we or the insurance industry has to pay for the drugs to make them not eat the food.

Luigi: To discuss this further, we wanted to have somebody who is, number one, extremely expert, number two, with a long track record of independence, and there is nobody better than Marion Nestle. She is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health, Emerita, at New York University, a department she chaired from 1988 to 2003 and from which she retired in 2017. But for her, retirement is to write more books. She has written or coauthored 15 books. She also received a James Beard Leadership Award in 2013 and 2014.

Bethany: We wanted to explore the issue of food through four different, albeit overlapping, lenses: the science of it, the business of it, the ways in which our perception is influenced, and the policy components.

We thought we’d start with the science. Why is ultra-processed food so bad for us? And when and how did it begin to creep into our diets?

Marion Nestle: Well, it’s a concept that was set forth just in 2009, so it’s a relatively recent concept. What it did was it singled out this specific category of junk foods that’s industrially produced and contains a lot of generally unavailable additives. Yes, it has salt, sugar, and fat, but that’s not what makes it ultra-processed. It’s the processing that makes it ultra-processed. And the idea was that the processing does something to the food that makes it more irresistibly delicious.

By categorizing foods in that way, the scientists who did this, Carlos Monteiro and his colleagues at the University of São Paulo in Brazil, made research possible. Once you have a definition of specific foods, you can now do research. Since 2009, there have been more than 1,600 studies of the health effects of ultra-processed foods, and these studies universally, across the board, come out with the same kind of results.

They show that people who eat a lot of ultra-processed foods are heavier, gain more weight, have more type 2 diabetes, heart disease, certain cancers, earlier mortality. All the bad things that you don’t want are associated with eating a lot of ultra-processed foods.

Now, those are observational studies. They don’t prove causation; they just prove association. But there is one incredibly well-controlled clinical trial done by Kevin Hall and his colleagues at NIH in 2019. He had volunteers who agreed to be in a metabolic ward for a month, and for two weeks, they were fed ultra-processed diets, and for two weeks, they were fed diets that were minimally or lightly processed or unprocessed.

The diets were totally matched for protein, fat, carbohydrates, vitamins, minerals, fiber, and palatability. The people who were in the study couldn’t tell the difference, but at the end of the study, to Hall’s enormous surprise, the people who had consumed the ultra-processed diet ate 500 calories more on average a day than the people who were eating the unprocessed diet.

This was a shocking result. And the foods are formulated to be irresistibly delicious, some people would say addictive, because they’re enormously profitable, and this is how food companies make their money.

Luigi: Now, as an Italian, I will define ultra-processed food as the one that is not made in Italy.

Marion Nestle: I define it as you can’t make it in your home kitchen.

Luigi: Which is pretty much the same definition.

Marion Nestle: Maybe we’re saying the same thing.

Luigi: This actually brings up a very important question, because I think I was lucky that I wasn’t exposed to anything very sweet early in my childhood. And so, I have a lot of defects, but one thing I don’t have is a particular sweet tooth. To what extent is early education—and I’m saying the first three months or the moment where you move from your mother’s milk to the first food—impactful in shaping your taste in a way that is long-lasting?

Marion Nestle: Yeah, I don’t think we know, because it’s certainly possible for people to change their dietary habits, but sugar is built in. We have an innate desire to eat sweet things because breast milk has lactose sugar, and if babies didn’t like the taste of it, they wouldn’t nurse, and they wouldn’t survive. So, it’s a survival mechanism from the earliest childhood.

Kids, if they’re given a lot of sugar, expect that that’s how foods are going to taste, and they’re going to reject foods that don’t have sugar if they have the opportunity to reject them.

Bethany: I get that we’re inclined to eat more of more-unhealthy food, but is unhealthy food actually more profitable, too, given that unhealthy food is often less expensive than healthy food? And is there a way to make healthy food more profitable than it is today?

Marion Nestle: The price of all food has gone up with inflation. Prices have basically doubled in the last 20 years, but the price of fruits and vegetables has gone up much, much higher than the price of ultra-processed foods, because ultra-processed foods are supported by the fact that their basic ingredients tend to be subsidized in one way or another, and also, given supply and demand, there’s just so much of it.

Let’s use corn for an example because it’s such a good example. Of the corn that’s produced in the United States, 45% is used to feed animals. Another 45% is fuel for automobiles. Get your head around that one. The reason that corn works the way it does is because it gets an enormous amount of federal supports, price supports, and insurance and subsidies in various ways. That’s our food system.

We don’t have a food system that’s focused on food for people. Food for people is considered specialty crops by the Department of Agriculture, and they don’t have the kind of political power that corn and soybean growers have because they’re multiple products. They’re not a single product. They compete with each other instead of working together toward common goals. They don’t have that level of political power.

The other weird thing is we import fruits and vegetables, vast proportions of them, so we don’t even grow them here because there’s no incentive to grow them here. There’s no incentive for small farms and many, many disincentives. In fact, growing fruits and vegetables is an occupation that’s guaranteed to lose money. It’s crazy.

Bethany: You had mentioned all these studies that have been done looking at the dangers of ultra-processed foods, and I understand your point that these are correlation, not necessarily causation. Still, they found some pretty astonishing things, that the effects are similar to people using nicotine and alcohol and other addictive drugs, that there are links to mental health, to sleep problems and to more. Is there anything in here that you find particularly worrisome or particularly believable, or is it all of a piece?

Marion Nestle: Well, this is why I think the Kevin Hall study is so important, because of the idea that these foods induce you to eat more calories and you’re not aware of it. We know that the foods are designed to encourage people to do this because Michael Moss, a writer who has written a couple of books about this, got interviews with food companies where they told him that this is what they were doing, and they’re not doing this because they want to make Americans fat or anybody else fat. They’re doing this because they want to sell products.

As I’m fond of saying, food companies are not social-service agencies, and they’re not public-health agencies. They’re businesses. The shareholder-value movement is predominant, and that means that corporations’ primary goal is to sell products and make profits for shareholders. They don’t have to attend to social values; those are irrelevant.

In a sense, the only thing that matters to a food corporation is selling food at as high a price as it can get away with and as much of it as possible. Food companies, in order to do that, have created a food environment that encourages people to eat too much food. There is sufficient explanation for obesity. You don’t need anything else besides large portions to explain it.

Luigi: But does it mean that if you were the CEO of one of these companies, you would actually engineer the food in order for people to eat more? If you were a scientist hired by this company, would you spend your days engineering how to basically trick people to eat more calories than they need?

Marion Nestle: Yeah, they wouldn’t look at it that way.

Luigi: I’m asking you, if you were in that situation, would you do that?

Marion Nestle: No, I would quit, but that’s me. But if your job is to work for a food company, your job is to make products that are going to sell. That’s what you’re there to do.

Luigi: I actually disagree. I don’t think your job is to make more money at the cost of people’s health. Even Milton Friedman would not agree with that statement. So, I think that takes away any responsibility. I think they do have a responsibility.

Marion Nestle: Well, you may think so, but they don’t see it that way. I’m not saying that these are evil people. I think their job is to make products that will make money for stockholders. I was once at a meeting in Washington—at the White House, actually—on marketing to children, which I think you and I would agree is totally unethical, to market junk food to children. And so, this was a meeting to talk about that.

It was during the Obama administration, and Michelle Obama was running the meeting and gave an eloquent speech on the need for food companies to stop marketing junk foods to kids. After the speeches, we broke up into smaller groups, and in the group that I was in, an executive of a very large food company said, “We would love to stop marketing to children, but our stockholders won’t let us.” That person has a choice. That person could quit, that person can reveal, that person can exercise ethics, or that person can keep his job. I don’t think it’s my job to say whether he should keep his job or not.

Luigi: But the funny thing is, the stockholders are us. You probably have a 401(k) plan invested in the S&P 500, invested in the very same company.

Marion Nestle: Actually, I don’t. I specified to my advisor that he not invest in food companies.

Luigi: Maybe not you, Marion, because you don’t invest in food companies, but in some ways, we are shaping the incentives of those people, and there is no way in which we shareholders have a way to change the system. I think most of us don’t want the companies to engineer dangerous food, and we don’t want to make money out of that. And so, there is something fundamentally wrong in the way corporate governance is working today.

Marion Nestle: Yeah, I couldn’t say it better. No, it’s exactly the way it is. And if people want to keep their jobs, they do what they’re expected to do. If they think that what they’re doing is unethical, they quit. That’s a personal choice. That’s a difficult one. And it’s not one that I feel I can impose on people.

I think I’m in a very privileged position in that I had a tenured academic position that paid me enough money to live on—not a lot, but enough money to live on—and I didn’t have to worry about my income or my retirement or any of those kinds of things and had complete independence. I can’t even begin to tell you how rare that is. So, I can afford to be ethical.

Bethany: I think I’m a little bit more on Marion’s side, Luigi. She said, and I love this quote of yours, “The single biggest driver of obesity is what Wall Street does to companies.” And it’s the same argument here as it’s been in other places.

I remember Angelo Mozilo telling me after the financial crisis that he had no choice but to sell subprime mortgages, even though he didn’t really believe in them, because if he didn’t, his market share was going to shrink, and his profits would shrink relative to his competitors, and his board of directors would fire him, or activist investors would demand his ouster. And the same problem applies to food companies and Wall Street’s need for growth. And, of course, that doesn’t make it right. I don’t think that’s what anybody is saying, but I think it is an absolute fact of modern corporate life.

Marion Nestle: We agree that there’s something wrong with the way corporations are working, absolutely. How are you going to change that system? You change that system by changing the way our campaign laws work. You overturn Citizens United, the Supreme Court decision that allowed an unlimited amount of corporate donations to election campaigns. You put limits on how much candidates can spend, and maybe you would get candidates for federal office, for Congress, who were more interested in public health than corporate health and weren’t totally conflicted by the time they took office.

Bethany: You’ve written a lot about the multiple attempts to make Americans healthier, none of which have really gone anywhere. And you wrote that in the case of Michelle Obama’s initiative, the White House had no authority to force food-company compliance with marketing or any other public-health measures that might reduce sales, and its efforts to promote even minimum regulation were consistently and effectively blocked by heavily funded, concerted opposition from the food industry. Which of the various initiatives that the government has tried to do over time was the most disconcerting or upsetting to you to see it blocked and to see it go nowhere?

Marion Nestle: Oh, I think the marketing to children one. These companies are brilliant at marketing. It teaches kids that they know more about what they’re supposed to eat than their parents do, that there’s foods that are for kids and that they need to demand from their parents that they have those foods.

In 1995, a major report from the National Academies came out on marketing to children, which said it’s really bad. It has an enormous effect on kids’ food choices, preferences, demands, and effects on their health, and it really needs to stop, and that if it doesn’t stop, Congress should come in and start doing some regulating. Well, that’s absolutely out of the question. Just totally out of the question. Congress isn’t going to do that.

Luigi: Criticizing Congress is easy. You’ve done something much more difficult, that is, criticize your colleagues and nutritionists, who very often provide distorted advice because they are funded, paid for, and in many ways influenced by the industry. So, can you tell us about how severe this problem is and how important it is in the way people behave?

Marion Nestle: For people who work at universities, one of the requirements now is that they get grants to fund their research. The federal government’s funding for nutrition research is extremely low in proportion to its funding for lots of other things. And food companies have moved into the gap. I get letters from food trade associations all the time saying, “We have $50,000 or $100,000, and we’re looking for research proposals that will demonstrate the benefits of our product.”

Sometimes they’re flat out just saying that, so they’re not going to fund anything that’s unlikely to show a benefit. If you are funded by a company to do a particular study, the way you design the research often appears to be influenced by the funder. And this occurs on a largely unconscious level, the studies show. It’s not that people are bought. They think they’re doing science.

The scientific quality of the studies is almost never criticized. Usually, the science is just fine. It’s the way the study is designed or the way the study is interpreted. I write a daily blog Monday through Friday, foodpolitics.com, and on Mondays every week, I post the industry-funded study of the week, which is usually the funniest one I can find. Many of them are very ridiculous because they’re studies of single foods, and it’s very hard to know how a single food in your diet, once in a while, could possibly have an effect on obesity or heart disease or cognition or any of the other things that you’re worried about. I can’t think of a food or a food product or a company that hasn’t done this.

Luigi: Now, in one of your blog posts, you talk about these Nutri-Scores that some European countries use to evaluate how healthy the food is. Why is the FDA not requiring something like that in the United States?

Marion Nestle: Well, since you’re Italian, I’m going to ask you why the Italians are so against it, which they are. Nutri-Score is a composite score based on good attributes of foods plus bad attributes of foods. It gives them grades from A to A-B-C-D-E. The FDA doesn’t like negatives, and the reason the FDA doesn’t like negatives is because the food industry doesn’t like negatives, and they put a lot of pressure on the FDA.

So, the FDA is working on a seal that will say “healthy.” But the problem is that seal won’t go on very many products. If you go to a grocery store in Mexico City, for example, as I did a few months ago, half the products or more in the center aisles of supermarkets have warning labels on them. The food industry in the United States isn’t going to stand for that. I just heard somebody at the FDA said that he didn’t think it was the FDA’s role to pressure the food industry. And if that’s true, then the FDA is not going to stand up to food-industry pressures on this kind of thing.

Bethany: Well, I guess you can argue that if the FDA did pressure the food industry, and food became a lot more healthy, then we wouldn’t need a lot of the drugs that the FDA approves. Hence, the FDA would be putting itself out of business. Hence, for their own survival, they should do exactly what they’re doing. How’s that for cynical?

Marion Nestle: Oh, you’re as cynical as I am. The food industry’s job is to sell the products that it makes, and it doesn’t worry about consequences because those consequences are not anything that they are required to pay. They don’t have to pay the health consequences of people eating their products, and they don’t have to pay the environmental consequences of the way they produce their products. But these federal agencies are captured by corporations and are very unwilling to take them on, the regulatory agencies. We need stronger regulation, not less regulation.

Luigi: But what about referenda in this area? As far as I know, when you have a proposal, for example, a soda tax, and this is brought in front of voters, it always wins with a vast majority. If we were to push more initiatives at the state level and the city level, maybe we could change the system.

Marion Nestle: Yeah, I mean, that’s certainly true. I like to use the Berkeley soda tax as an example of a referendum that was enormously successful. It was voted in by a plurality of 76%, which is practically unheard of. But that effort was done by a group of extremely sophisticated and talented community organizers, who did a phenomenal job of organizing rich areas, poor areas, and everybody in between in Berkeley, convincing them that a soda tax would be good for the city, which was to use the funds that were collected from the tax for social purposes, which the city council did.

Other attempts to do that have not been quite so successful because it takes a lot of money to run a campaign like that. Berkeley had some Bloomberg Philanthropies funding that helped a lot. Lobbyists are paid. That’s another unfairness in the system.

Bethany: Maybe we should create a system whereby if any company, not just a food company, pays a lobbyist, they have to set aside an equal amount in a pot for community organizers to offset their lobby. I like that idea, too.

Before we run out of time, I wanted to get to the question of the day, which is Ozempic-style drugs. Do you view them as a game changer and a good game changer, or are we simply trading one corporate overlord, food companies, for another, drug companies?

Marion Nestle: Well, it’s mixed, of course. For people who have struggled with obesity all their lives, these drugs look like a lifesaver. And, yes, the irony is absolutely there that, once again, it’s a victory for the drug companies.

One of the things that’s really interesting to me about Ozempic and some of the other drugs is that Novo Nordisk, the drug company that was responsible for it, spent hundreds of millions of dollars on physicians and other influencers to encourage them to push those drugs through as quickly as possible.

I am uncomfortable being enormously critical of the drugs because I know so many people who view them as an absolute lifesaver and something that they’ve been waiting for all their lives. So, I don’t know, I mean, I prefer food approaches. I still think that eating less and moving more absolutely works if you can do it. The problem is that most people can’t. So, I don’t know. I think the jury is still out on the drugs. We’ll see what happens when people have been taking them for a while.

Luigi: Before we let you go, I would like to bring the discussion more to the international level because so far, we’re focused mostly on the United States, where fortunately, we have some compensating forces. For example, The New York Times shames Coca-Cola, and so, Coca-Cola stops doing certain things, et cetera.

But that’s not necessarily true in many developing countries. And my impression—but I would like to know your opinion, Marion—is that many food companies are investing massively in marketing in developing countries, where regulation is even worse than in the United States or nonexistent, where they can do an enormous amount of damage in the long term. So, what can we do to stop that?

Marion Nestle: You’re absolutely right. Most food companies view the developing world or the low-resource world as the source of growth, because what you have to understand is, it’s not enough, under the way the investment system works.

I’m not against profit; I think profit is fine. The problem is you have to grow the profit. You have to report constant, continual growth to Wall Street at all times in order to keep your company from getting into bad graces and your stockholders from getting upset. We already have, in the United States, 4,000 calories of food available per capita—men, women, little tiny babies—for every day, which is roughly twice what the country needs. It’s not what people are eating. It’s what’s available.

The ability to grow food-company profits in the United States is extremely difficult. There’s already more than enough food available. So, what are you going to do with your products if you have to grow? You’re going to move them abroad and try to sell them in South Africa or Ghana or Nigeria or wherever or Asia. American products have an aura of Westernization, modernity. It’s really hard to fight that. And there are now books coming out and reports coming out of what food companies did to clear the way for sales of their products in those countries.

It’s just like Novo Nordisk. They spent fortunes on greasing the wheels, encouraging officials to allow them to do things, forming partnerships, forming all kinds of alliances in order to get their products into these countries. So, it’s up to the countries to fight that. I mean, you can already measure the effects of the introduction of these products and the normalization of these products on body weights in the countries. You can already see that. This is all being documented. The only way to stop it is through regulation, and I don’t see very many governments eager to do that.

Luigi: So, I’m actually a bit surprised. She seems to be forgiving the companies a lot from their responsibilities. I think I was in her position probably 15 years ago, and then I realized it’s not sustainable. In a sense, you are saying, oh, companies are lions, and it’s not their responsibility that they eat people. It’s the responsibility of the politicians to put them in a cage and tame them. That’s a tenable position, until you realize that, actually, the reason why the politicians cannot tame them is because the companies prevent them. So, they’re not just lions that eat people. They’re also impeding the politicians from doing their job. So, I think that gets them off the hook a bit too much, in my view.

Bethany: I heard what she said as an explanation for why it is so but not an excuse. And I always try to draw a line between explanations and excuses. She says that because of Wall Street’s demands on the food industry, they have to figure out how to grow profits in basically any way possible, which involves pumping us with more and more calories we don’t need. But I didn’t see her as letting companies off the hook.

Luigi: You’ll be proud of me because after we interviewed Marion, I went to my class. This is a class that is this mix of undergraduate MBA’s and master’s students in public policy. I did an anonymous survey, and I said, suppose that you are the CEO of a soda company. Your business is not doing particularly well in the United States because this is blamed for the rise in obesity, and so on and so forth.

You are hired, and you have two possible strategies. One is you can aggressively market your product in Africa, where health concerns are not widespread, and as a result of this, your profit net of advertising costs will grow 5% a year for the next 10 years. However, as a result of your aggressive marketing, it is estimated in one treatment, 1,000 more people will die prematurely each year. The other said 100,000 more people will die prematurely every year.

And then I said, the alternative is you don’t market aggressively in Africa, and your profit will be flat for the next 10 years. What fraction of the students replied that you should market aggressively in Africa?

Bethany: I want to say, it’s the University of Chicago, and it’s business school, so I’m going to say 100%, but I don’t know because they might not say what they would actually do because there might be, these days, judgment. So, maybe I’m wrong, and maybe it’s zero. I could actually see it being one or the other. I don’t know. I think they all, probably, put into the position of being a public-company executive, would choose to market aggressively. But whether they’ll admit to that or not is the question.

Luigi: What is interesting is that 59% said they would market aggressively if confronted with 1,000 deaths, and 43% if confronted with 100,000 deaths. In one case, the explanation really struck me. It said, because I have a duty to shareholders to maximize profits. I said, so you have a duty to shareholders to maximize profit, but you don’t have a duty to society not to kill people?

This person was very embarrassed when I pointed this out, but I found it fascinating because I got the same impression, to some extent, of Marion Nestle that, at the end of the day, she was saying, these guys have a duty to maximize shareholder value, so they will do it.

Bethany: I think she was wishing that the Wall Street ecosystem was different, but the reality is, there are all sorts of companies that do things that are very bad for people in the name of maximizing shareholder value, so I thought she was actually being quite a realist by acknowledging that pressure on companies.

Even more than that, I actually liked her the more for that, because I think it would be easy to be very righteous and be an academic with your head in the clouds and not understand that it was that pressure that led companies to do this.

Luigi: But what is the solution?

Bethany: Well, that’s where it gets tricky. What is the solution, right? In a world where we can’t even halt the marketing to children of things that are terrible for them and are going to lead them to have a much less healthy life, and we can’t even do anything about that because the food industry is so powerful? That is just utterly, I think, utterly devastating.

It’s an indictment of the industry. It’s an indictment of how inept—if inept is even the right word—how corrupt Congress is, how little they are out for our best interests and how much instead they’re out to line their pockets. I am so utterly appalled by that that I am not sure what to say. I know none of this answers your questions, which was then, how do we stop it, because it is all bound up in each other?

Luigi: I think it does address my question, which is the only way to do it is to now go straight to the responsibility of the companies and the CEOs, because the companies have so much power that they can undo everything else. Unless we go straight to that power and we make them accountable, and we make, to some extent, ourselves accountable because we are invested in those companies, I think that there is no solution.

Bethany: But that sounds really good. How do you do that? How do you make those companies accountable in a world where, say, a CEO tried to do what we perceive as the right thing and said, OK, I’m going to stop selling this product, I’m going to stop pushing this, I’m going to stop marketing to children, and the profits fell? You know what would happen. An activist investor would come in and push for management change in order to get somebody in who would run the company in order to maximize profit. I don’t know. It’s easy to say, make the companies accountable. How do you actually do that?

Luigi: In America, people like to use the carrot. I like to use the stick. And the stick is, at a minimum, shame executives that go down that line. I think that we have lost the shame argument. The former CEO of Boeing, Jim McNerney, who is probably one of the most responsible for what is happening at Boeing today, is on the board of trustees at Northwestern University. He’s considered a very nice person in the city of Chicago, and everybody respects him and loves him, instead of being somebody who is sort of not leaving his house because of his responsibility. He can have all the money he wants, but if the social pressure is holding him accountable, he has a very bad life.

Another board member of Boeing is Caroline Kennedy, the only surviving child of John F. Kennedy, the president. She was appointed by President Biden as ambassador to Australia as a reward for how well she behaved on the board of Boeing. In the old days, we were sending the convicts to Australia, right? But now it is not like a penal colony, it is like a puffy ambassadorship. I think that’s appalling.

Bethany: I agree with you, and I think this broader concept of the loss of shame in our society is really problematic and something we should talk to one of our future guests about, because I do think that was a reason that the United States chose a different tack in the 1950s and 1960s. It was this concept of shame, of people living in a community and wanting to be able to hold their heads up high in that community.

But I think that undercuts your point, rather than augmenting it, when you say that you want the action to come from companies. Nobody cares. And people in the world in which very wealthy people travel don’t care, and institutions like Northwestern would rather have somebody on their board who has a lot of money than somebody on their board who does not have money, even if the person who does not have money is incredibly admirable. And I don’t know how we . . . The problem is so deep and multifaceted.

Luigi: But Bethany, no university would put J.K Rowling, who is a billionaire, on their board of trustees because she spoke about transgender people. It’s not that this society is not willing to impose costs. It’s just that the focus is on different priorities.

Bethany: You’re right. There is a willingness to look past any kind of what could be perceived as moral transgressions in the business world, maybe in part because people don’t understand it, in part because businesspeople are admired even when they shouldn’t be. Maybe in part because it takes a while for the reality of somebody’s legacy to catch up with the perception of them.

Luigi: I’m not saying that just the companies need to change. We need to change as well. We need to be more active and exposing, starting with journalists exposing companies, asking, “How many kids have you killed today?” Remember, during the Vietnam War, “LBJ, how many kids have you killed today?”

If you had journalists going in front of Coke and saying, “How many kids have you killed today?” I think that that would be so annoying that we would start considering it. From academia, we should not have those people on our boards of trustees, even if they have money. We should really investigate seriously their consequences. With our portfolios, I think that we should be more active in asking our institutional investors to sanction this behavior.

Bethany: I don’t think your original idea idea of journalists doing more work exposing food-company wrongdoing will do that much to change consumer behavior. It’s one of the many ways in which we have a two-tiered system in the United States because those of us with privilege and money already understand all of this. We don’t eat like that, and we don’t eat many ultra-processed foods, if at all. It’s people with less socioeconomic advantages who need cheaper food, who fall victim to the food companies’ marketing, and especially in these days of inflation, have less of a budget to spend on food. I would bet that inside the headquarters of food companies, they know exactly what impact an exposé from a journalist has on their sales, and I would bet they think it’s not going to be much.

Luigi: But the political impact would be important in a sense that your shares and my shares of the 401(k)s are supporting this behavior and indirectly are profiting from this behavior. And so, we need to find a way to have them voted in a way that respects our values.

Bethany: Yeah. Well, this comes back to this broader question of corporate governance, and how do we actually get the values that companies live by the products they sell to reflect what we all believe? I think you’re right that the food industry is a really perfect case for that because the harms are so obvious, and it is such a problem for our country. That study that Marion talked about where people ate 500 calories more a day when they were eating ultra-processed food is just shocking.

That’s all you need to know. That’s all you need to know. And the repercussions of it in terms of everything, but particularly our healthcare costs, are so inordinate, if we continue to let food companies get away with this, it’s the end of our society. We cannot have a healthy society. We can’t pay for it all.

I guess maybe Ozempic can fix it if we can get it to enough people. I’d rather see the money going to a drug company than to the food industry, because at least it’s not a building problem in that case. But still, there’s just something so appalling about it in a world where so many people are starving, and in a world where food should be this beautiful thing, to have it be the way it is instead.

Luigi: And, by the way, Bethany, it’s important to know that 500 calories more a day means a pound a week. It means that in a year, you gain 52 pounds. So, that’s a gigantic amount, OK?

Bethany: God. Are you favorably predisposed toward the Ozempic class of drugs, or do you view them as more of a Band-Aid?

Luigi: I think they are a Band-Aid, but I think that one initial step, in my view, should be a huge campaign to tax the ultra-processed food to finance this class of drugs. The cost of this will be gigantic. Did you know that the GDP of Denmark went up significantly as a result of the sales of Ozempic? So, it’s going to be a massive transfer, and in part, just because we don’t have the courage to do something about it.

Bethany: I really like that idea, actually. But again, I think it’s in the realm of the theoretical and probably not in the realm of the probable, because it would require government action or corporate acquiescence, neither of which we’re going to get. But I think taxing the profits that come from the sales of sugary sodas and ultra-processed food and sending it into a fund that would pay for Ozempic to people is an absolutely brilliant idea.

And I liked the idea that I came up with on our podcast, which should apply to all companies, not just to food companies, but if you hire lobbyists to lobby for your point of view, then you also have to put money into a fund that can go to community activists who will lobby for the opposite point of view. So, at least then, in that case, it’s a battle of ideas, a real battle of ideas, which is what it should be, not a battle of dollars. I think both those things would make the world a much better place, but I don’t think either one is ever going to happen.

Luigi: But actually, in many states, there are laws of popular initiative. So, it’s not out of the question. It cannot be done at the federal level, but at the state level, you can certainly do it. And it doesn’t take a lot to get the signatures for a law like this. And so, I think that the chances to pass it are much bigger than you imagine.

Bethany: You know what? You might be right, Luigi. It’s one of those things that seems . . . Maybe I’m being too cynical, because it seems undoable and it seems undoable, and then, suddenly, it’s doable. Because after all, if the world were really as I’m laying it out, then cigarettes would still be sold without warning labels and without any kind of taxation and without the price per carton having been raised so dramatically to dissuade people from buying them.

You’re right, things do eventually reach . . . I hate using the phrase “a tipping point,” but there does reach critical mass in things where, suddenly, there is action. Maybe I’m being too cynical.

Luigi: And I can see, actually, a lot of attorneys general in various states that are going to be saddled with the Ozempic costs to go after the food industry for damages, exactly like they did for the opioids, that when they had to pay for a massive amount of rehabilitation, then they . . . Unfortunately, this always happens ex post, after the damage has been done, but at least we hope it’s going to be a fix for the future.

Bethany: Well, you heard it here first . . . What’s going to be the name of the state? It’s going to be some state versus Big Food, and we predicted it on our podcast.