“Fat, Sick & Nearly Dead”

This is the second of two film reviews that focus on a “food journey” theme in a documentary.  “Food journey” is loosely defined by me as focusing on personal experiences with food, where food is the antagonist or protagonist of the story. This film, like Super Size Me, will be graded according to how well-made and enjoyable it is as well as how accurate it is with its nutrition claims.

The second ‘food journey’ film review is of Joe Cross’ Fat, Sick & Nearly Dead. Our main character, much like Super Size Me, is the filmmaker himself, Joe Cross. Unlike Morgan Spurlock, Joe Cross intends to lose weight and regain his health on his ‘food journey.’

Cross starts the film as an Australian entrepreneur who weighs over 300 pounds and is suffering from an autoimmune disease called urticaria, which is a health condition associated with hives and rashes. His goals include losing weight and eliminating prednisone, the steroid medication he takes for urticaria. He decides to try a 60 day juicing diet while traveling around the United States. Cross never explains why he chose this particular method of weight reduction, but he manages to get an ‘American celebrity doctor’ named Dr. Joel Fuhrman to supervise his diet. Dr. Fuhrman has Cross complete a blood panel every 10 days to ensure he remains healthy through the fasting juice diet.

At the outset of the diet, Cross looks miserable and admits to feeling miserable. He refers to the juicing fast as being ‘food free.’ And it isn’t easy being ‘food free’ in the United States. While showing footage of Cross lying in bed, he states that he does not want to be around people, and he does not want to go outside or watch TV, because he will see images and signs of food everywhere. Much like Spurlock in Super Size Me, Cross intermixes images of his own journey with his diet with interviews with people on the street as well as with experts in the field of nutrition. One of the experts he interviews is a Registered Dietitian (RD) and a Senior Clinical Nutritionist named Stacy Kennedy (MPH, RD, LDN). Kennedy makes an argument that juicing is a healthy way to ‘drink nutrients’ from fruits and vegetables. She states that it is a potent way to get nutrients into your body, because they are rapidly absorbed.

Kennedy’s viewpoint is interesting in its limited scope and failure to look at the implications of following a juicing diet for 60 days. Optimistically, Kennedy’s true viewpoint and/or advice was simply edited out due to not conforming with Cross’ viewpoint of juicing and its benefits. There are a lot of nutritional concerns with juicing, especially if you follow a juicing regime for 60 days. When you juice fruits and vegetables, you lose important fibers and you drastically increase your glycemic response due to the lost fibers. This means you’re your body releases significantly more insulin in response to the sugars being rapidly absorbed. There is also a serious concern with protein deficiency and essential fat deficiency. One of Cross’ green drink recipes (light and breezy green juice) has on average 240 calories with limited to no fiber and an insignificant amount of protein, and this is supposed to be a complete meal. Following this juicing diet for 60 days results in lean muscle loss, and if you follow Cross into his sequel (Fat, Sick, and Nearly Dead 2), you find that Cross consistently struggles with weight regain and weight loss cycles. He struggles to maintain his weight within a 30 pound range.

On his trek around the U.S., Cross meets a trucker named Phil Staples who weighs 429 pounds and also has urticaria. After Cross successfully completes his juicing fast, he manages to lose around 100 pounds and is completely off his medication, Staples reaches out to Cross and asks for help to change his life. Cross decides to assist Phil in his quest to lose weight and get off of his medications as well. By the end of the documentary, Staples has successfully lost over 200 pounds and is off of most of his medication as well.

There are many problems with this film. First and foremost, juicing is marketed as a weight loss method as well as a detox method, but ‘there is no strong scientific evidence to support these benefits as compared with eating fruits and vegetables’. In fact according to an article, ‘Popular Weight Loss Strategies: a Review of Four Weight Loss Techniques’ in a November 9th publication of Current Gastroenterology Reports, some juicing diets lead to a rise in stress hormones including cortisol which causes appetite stimulation which can lead to rebound weight gain from binge eating and some juicing diets have led to manganese overdose, laxative abuse, and severe hyponatremia. There have also been cases of acute renal failure.

The weight gain rebound is barely addressed in this documentary other than Cross making a statement that he thought the juicing would be very difficult, but he did not take into account the difficulty of weight maintenance. Staples struggled with maintaining his weight as can be seen in a blog that he published after regaining the 200 plus pounds he lost during the making of this documentary.

Cross preaches about personal responsibility and spends time interviewing people on the streets with the intent of convincing them to take their health into their own hands. At one point, he states: “I can’t believe people say they can’t do this without even trying.” This perspective, coming from a wealthy man who has the means and resources to stop working for 60 days while he travels around the U.S. funding a documentary about how he’s regaining his health, is poorly conceived. His analysis of the obesity epidemic stemming mostly from people’s choice to engage in an unhealthy food system is simplistic, preachy, and totally unaware of his own privilege. Obesity is driven by a number of complex factors, including marketing, the current food systems, as well as the built environment, culture, and government policy.

Cross also dredges up inaccurate statements about food. At one point in his many ‘educational monologues,’ he describes fruits and vegetables as micronutrients and everything else (as the camera pans over egg rolls, pies, and other fried foods) as macronutrients. These are poor definitions for macronutrients (fats, carbohydrates, and protein) and micronutrients (vitamins and minerals). For a better look at macronutrients and micronutrients visit the USDA website.

Cross also states “The closer the food is to its natural states, the better it is for you.” This is a blatant plug for his juicing approach, but it is also misleading as steaming and cooking certain vegetables actually unlocks nutrients by making them more bioavailable.

In my opinion, this documentary is, at best, a self-serving lecture and, at worst, a misrepresentation that could have adverse consequences for those who take it seriously. There is a scene where Cross is interviewing two young women about his juice fast and when Cross asks the women whether or not they would do a 10 day juice fast, one of them replies: “I would never fast. I don’t like not eating. It doesn’t seem healthy to me.” I couldn’t agree more.

Critic’s Score: D-

Copyright: All content © 2020 Nutrition Strategy Advisors LLC. Photographs © Donna P Feldman, unless otherwise attributed. Reproduction or use without permission is prohibited.