Solf,

I didn't say you were criticising my family.  Please read and not assume.  You do criticize and are judgmental toward fat Americans in general.  As for how one knows the health status of all family members well, we are a close knit family.  Diabetes is considered a terrible, horrible disease to have and we do share such information.  We are very open with each other.  Usually, at family reunions that info gets passed around.   We don't feel like illness is a source of shame so no one hides those kind of things.  You tell one family member, it gets passed along to everyone pretty quickly.  

Jane is wrong about the middle class.  Most of the middle class in our areas (and they are solidly Middle class) are overweight.  In urban areas, people do tend to be thinner.  There is a middle class outside of urban areas (although it is shrinking).

I don't believe that a big Mac necessarily 'causes' diabetes, although a constant stream of such foods, day in and day out, certainly wouldn't be a good idea for anybody and might lead to health problems.

However, the sugary drinks and the fries are no better, either.

The whole meal is, in fact, something that should be, at best, a rare treat, and nothing more.