About 1 in 3 Americans are overweight and obesity is now at epidemic levels in the US, experts warn. But with $11 billion spent annually to advertise foods, huge increases in portion sizes in restaurants, and more hours spent sitting at the computer or in front of the TV, Americans face an increasingly uphill battle against obesity. In this report, nutrition experts suggest that immediate, national action is needed to combat this growing problem.

In their report, Dr. Marion Nestle of the department of nutrition and food studies at New York University and Dr. Michael F. Jacobson, executive director of the Center for Science in the Public Interest (CSPI), note the pressures in American society that encourage people to overeat and remain inactive.

The researchers highlight the fact that in the US, the 170,000 fast-food restaurants and 3 million soft-drink vending machines combine with an automobile culture to lead people to take more "energy in" while expending less "energy out." Seemingly helpful modern conveniences that most people have come to depend upon -- such as e-mail, air conditioning, central heating, mini-malls, and superhighways -- are listed as factors responsible for reduced activity levels across the nation.

And reduced funding for public school physical education classes as well as the lure of high-sugar and high-fat food options in the form of TV advertising geared to adolescents contribute to a culture of obesity.

The problem is not simply a question of changing individual behavior -- such as by dieting -- but rather a broader problem that involves changing the way society encourages people to become fat and sedentary.

In their report, the authors list a variety of ways the federal government could affect change. For example:

• Use media outlets to advertise healthy foods such as fruits and vegetables;
• Sponsor a "No-TV Week" in order to remind people that adolescents watch an average of 3 to 4 hours daily and thereby get enormous exposure to high-calorie food advertisements;
• Promote physical activity by making parks safe for children, building more public bike paths and swimming pools, and creating pedestrian malls in downtown areas;
• Make physical education a standard requirement in schools and ban marketing of high-calorie/low-nutrition foods in school cafeterias;
• And by getting the revenue to pay for such public construction, education and programs that promote healthier eating and activities by adding a 2/3-cent tax on 12-ounce soft drinks, a 5% tax on new TVs and video equipment, and a $65 levy on new cars.

The object of the food industry is to sell more food -- not less. Enormous amounts of advertising goes into getting people to eat more -- not less. Portion sizes are large, and fruits and vegetables aren't particularly profitable... but at the national level, there are huge numbers of policies that promote the current food system, and these could be changed.

Public Health Reports 2000;115:12-24