Fake. Everything is fake. The polite term is "substitute", there are entire shelves of respectable economic literature on how to deliver fake goods and services to consumers so they don't notice.

* The food supply is fake. Anecdote. Back in the '80s the Eastern Block went through a deep crisis, including a low grade famine. After the communism fell, the food supply improved. One item stood apart: the American frozen chicken. Three times the size of a domestic one, tasting like moist cardboard. Most people would not touch it, unless positively starving. These days, everything is tasteless fake: bread, chicken, milk, eggs, veggies. For somewhat better quality, the prices are at least 2x, possibly quite some more. Good quality produce is nearly impossible to find, the fakes have pushed real farmers into bankruptcy long ago. Even the meager subsistence farmers markets of the Eastern Block of old had noticeably higher quality offerings (caveat: in season).

* Americans don't prepare food at home. The American woman was pushed into the workforce and doesn't have time, energy, will or knowhow of basic homecooking. What, you reminisce of (grand)mother's comfort food? What kind of barbaric misogynist are you? No, men didn't step up to take on the traditional feminine role. Realistically, they will never do. No amount of nagging NYT editorials will change that. The food industry happily filled the void with processed fakes.

* The mass restaurant network delivers fake food. The staples are ground meat & fried potatoes, fake chicken & rice or pasta. Sometimes industrial tofu or shrimp. If you are really "health conscious", there is "gluten free" for you. Sure, there is a dazzling variety of sauces and presentations, but the basis is pauper. You have to search hard for ethnic restaurants to even find a veggie basis, and even then the most popular offering is American Indian, with dubious thick sauces.

* Americans eat way too much sugar. The food industry drops ridiculous amounts of sugar in everything, including savory foods if they get a chance. Anecdote. Coming from a different culture, American sweets literally make me sick. Making sweets at home, using about 1/4 - 1/3 of the American recipe sugar recommendation is about right.

* Americans don't walk. Old World cities are (were?) built in such a way that doing basic life functions require walking. Buying groceries, going to school, going to church, going to see friends, going to work (walk + public transport). Americans drive everywhere, because everything is too far away for walking. With Amazon and Amazon Fresh, even the meager shopping trips are vanishing, which will lead to an extra bump in obesity. Removing the reward for walking mostly removed walking itself. Shaming people for not hitting the gym often enough doesn't work, we are built to pick the path of least resistance.

* American kids don't roam the streets. Something happened and kids simply don't just go out to play with their friends for hours on end. At the minimum the parents must setup activities, playdates & transportation. In practice, this leads to sedentary overweight depressed kids. Let's buy them the latest networked gaming console instead, that will keep them socialized, active, and healthy.

* American culture is increasingly adverse to generating signals for distinguishing healthy and unhealthy. In the name of "inclusivity" we are implicitly promoting deeply unhealthy lifestyles. We are good people and wouldn't want to hurt feelings, right? Right, except that we are depriving our kids of the ability to identify and model healthy behaviors.