It is not a virtually uncontested fact that obesity is the most pressing health problem facing the US. The obesity epidemic spans all demographic cohorts – no age, gender or ethnic background has remained untouched. Can we really reverse engineer such a complex issue that has been decades long in the making to understand: how did we get to this point?

A recent study in the Lancet reviewed in an article in the New York Times says yes….but it will take awhile.

The Smoking Gun: Obesogenic Environment
Experts undertaking a two year analysis of the contributing factors to the global obesity crisis have concluded that social and cultural forces – everything from our car-dependent culture to the unstoppable marketing might of the food and beverage industry – have conspired to create an obesogenic environment that defeats the body’s natural weight management programming.

In other words, we’ve inadvertently arranged our lifestyles in such a way as to have about the same chance of staying slim in our current environment as a snowball’s chance in Death Valley at high noon.

Happily, all is not lost. After all, a few decades ago smoking presented an equally if not more issue to the nation’s health, and we have made measurable progress in reducing smoking and associated diseases.

But it did not happen overnight – the effort to reduce smoking from a rate of 40% to 20% involved several coordinated, complementary policies, including a ban on tobacco advertising on TV, an increase in tobacco taxes, the advent of the nicotine patch, and a widespread ban on smoking in public places like New York bars and the entire city of Austin Texas (one of the first ‘smoke free’ cities to declare itself so).

The 70’s: When Fat Began to Flourish
One Australian obesity researcher, in Dr. Boyd A. Swinburn, have pinpointed the 1970s the ‘tipping point’ decade, , an obesity researcher at Deakin University in Melbourne, Australia, and his co-authors in one Lancet paper call that decade, when women began entering the work force, and fat- and sugar-rich rich ‘convenience foods’ began filling store shelves, the “tipping point.”

“The 1970s saw a striking rise in the quantity of refined carbohydrates and fats in the U.S. food supply, which was paralleled by a sharp increase in the available calories and the onset of the obesity epidemic. Energy intake rose because of environmental push factors, i.e., increasingly available, cheap, tasty, highly promoted obesogenic foods.”

The Road to Thin Is Paved in Calorie Reduction
So what will it take to return to our 1970’s-sized waist lines, a time when ‘vanity size’ had no meaning beyond the size of your bathroom sink?

1. People: consume 240 fewer calories a day for people with a BMI<35; 500 fewr calories a day for BMI>35
2. Government: a 10% tax on unhealthy food and sugar-sweetened drinks (a step that could earn states as much as $1.5 billion/yr)
3. Food Industry: Better, more clear labeling of empty calorie ‘junk’ food
4. Media: Limits on advertising junk food and sweetened beverages to children
5. School: programs to encourage healthier eating and and exercise habits
6. Home: reduce television watching

Fight the Power (of the junk food lobby)

Curtailing the marketing of junk food to children is especially important, the report says.

“very few children are born obese …but most American children grow up in an obesogenic environment”

~ Steven L. Gortmaker, sociologist at the Harvard School of Public Health

Child-targeted marketing strategies are so effective that parents with children obese by the age of 10 or 11 will need to take part in an active intervention strategy to prevent dooming their child to an obese adulthood.

“Children aged 2 to 19 consume seven trillion calories of sugar-sweetened beverages a year.

Of course implementing this 6-point solution requires the cooperation of the parents – not necessarily a given if the parents themselves are obese. In recent years the case of an obese family in Dundee Scotland caught international attention when two children (a 3 year-old weighing 56 pounds and a 13 year-old weighing 224 pounds) were taken into protective custody. Officials stated that obesity was not the sole reason behind the action, but the case did put a spotlight on the issue of ‘obesity as abuse’ and what can or should be done about it.

The study in the Lancet provides a roadmap to the solution, but researchers caution that despite the long-term nature of impact of the steps, they nonetheless must be implemented immediately, before the current generation of children becomes the first American children in more than 100 years to have a shorter life expectancy than their parents.