His references are American but he could just as easily be talking about Down Under ...
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I watched a brief segment on SBS last night, the show 'Unplanned America' where the lads dropped into the 'Heart Attack Grill' and ordered a multi layered hamburger of 20,000 calories.
They were served by waitresses in saucy nurses outfits and if they didn't finish their meal, had their backsides paddled.
The manager claimed it was his way of raising awareness of unhealthy diets and reinforced this strange notion by carrying a bag of the cremated remains of a close friend who had a heart attack and died in the restaurant......bizarre.