It would also depend a great deal on whether or not he had any level of liver dysfunction to begin with - because even a minor liver dysfunction (borderline high normal) could certainly develop while eating a very high carb diet, especially one high in HFCS - which he would have consumed a ton of by drinking 3 X-large sugary sodas daily. (or even 3 large sodas - supposedly he only supersized his meal if it was suggested by the cashier, and only happened 9 times during the 30 days)

It's entirely possible that switching from eating normal amounts of "normal" foods to the ridiculous amount of carby food he was consuming at McD's was enough to push it over the edge into true liver dysfunction.

The whole thing of supersizing his meals though - super sized meals did not have extra meat added to them - they had extra carbs added to them - a veritable TON of extra carbs: X-large serving of fries, X-large sugary (HFCS) soda.

As Tom Naughton pointed out:



I think he must be referring to the fact that Spurlock only had a supersized meal 9 times during those 30 days - just based on the current calorie counts for various meals and menu items, he would have had a very difficult time consuming 5,000 calories daily.