I spent a few weeks in the US for a vacation in NYC and Long-Island. I remember the way people looked in supermarkets and fast-food restaurants and I kept saying to myself and friends that something looked wrong about them. Of course, there were the obvious obese and even super obese, but even slim people looked weird, could not really say what but it had to do with the skin look, posture, some seemed to have the shakes or not move completely normally, etc. I have been in many places in Europe and North-Africa and I can't really compare. You do find sick looking people but it seemed more like the norm when I stayed in the US.