WASHINGTON -- Americans, as a group, are big and getting bigger. Government statistics show 69.2 percent of adults are overweight, and 35.9 percent are obese.
So who - or what - is to blame?
Some would say it's a matter of individual choice and willpower, that too many people choose to eat far more calories than their bodies can burn.
But Dr. Deborah Cohen, a physician, researcher and author, says it isn't that simple.
Cohen has been studying obesity for years as a senior natural scientist at the RAND Corporation, a think tank in Santa Monica, Calif. She says "the food industry is making billions by making millions of us sick."
In her book, "A Big Fat Crisis," Cohen outlines the scope of the problem and suggests a prescription for ending the obesity epidemic.
She says it's time for a national conversation about food marketing in all its forms.
"Everywhere we go, there is always food available - lots of junk food; restaurants serve extra-large portions, they are advertising everywhere."
Fifty years after the launch of the government's successful anti-smoking campaign, Cohen says we should take the lessons learned from the battle against "big tobacco" and apply them to "big food."
The key is gaining control of what she calls "the food environment." She suggests starting with implementing standardized portion sizes at restaurants, based on government recommendations for healthy eating already in place.
Another step would be limiting where food can be sold. Cohen notes that 41 percent or more of non-food businesses, like hardware stores, now sell sodas and candy at the cash register.
She says these changes are not that different from regulations already in place for alcohol.
"If you are going to buy alcohol, you can't get it everywhere. It is not in a vending machine; it is not sold at the cash register. A lot of states limit the number of stores that can sell it," she says, noting that standard serving sizes for beer, wine and spirits are set by law.
Critics of these kinds of changes say they amount to reining in free enterprise. And the ridicule that accompanied former New York Mayor Michael Bloomberg's plan last year to ban oversized sodas shows it's tough to sell the public on the wisdom of such action.
But Cohen says there really is no choice.
"Obesity is the public health crisis of our time," she says.
She emphasizes she has no fear of opponents who claim she is promoting a nanny state.
"To a certain extent, I am," she says with a smile, likening her cause to that beloved character of children's literature and movies, Mary Poppins.
"Do people remember she was a very early advocate of portion control? She recommended one spoonful of sugar, right?" says Cohen.
She says contrast that with the 16 spoonfuls of sugar contained in a typical 20-ounce soda.
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