In the Middle Ages, alchemists sought to turn common metals into gold. Today some doctors and scientists seeking to prevent and treat obesity in the United States are attempting an equally difficult transformation. They want to change people, their willpower, their lifestyles, their metabolism, even their DNA to make it harder to gain weight and easier to lose it.
However, transforming people with drugs, weight-loss surgery, genetic engineering, hypnosis and other extreme steps is not the answer to obesity, because people are not the problem.
The problem is the food industry, which provides us with the calories we consume but washes its hands of responsibility for causing the worldwide obesity epidemic. Food industry marketers say they are only offering people what they want and that individuals choose what they put in their mouths.
Is it plausible that two out of three Americans have an eating disorder? And if we really believe that people are choosing to eat foods that are making them fat, does that mean we think that two-thirds of Americans are foolish, stupid, and lazy? Or that overweight and obese people have weaker characters and are morally inferior to people who have a normal weight?
The food industry spends billions of dollars each year to develop products, packaging, advertising and marketing techniques that entice us to buy more food because selling more food means making more profits. And businesses exist to make profits.
Food marketers test whether the color, the font size of words and the images used to market food will grab our attention by studies of eye movement. They conduct focus groups to come up with catchy names and symbols that recall positive memories and thoughts to condition a response that may lead us to purchase their products. And food marketers work to increase the frequency with which we see their products and their presence in stores, wanting to make their products always available.
The food industry also alters the nutritional content of foods to make them longer lasting on store shelves by increasing fats, sugars, and salt, making it less healthy for the average person to consume them.
Much evidence shows that individuals are not the cause of America's obesity epidemic. A wealth of research on marketing and decision-making reveals that people are easily manipulated, biased and influenced to make decisions that are not in their own best interests by how choices are presented to them.
Daniel Kahneman and Amos Tversky won a Nobel Prize by proving that rational decision-making is limited. Another school of research indicates that people typically make decisions about what and how much to eat unconsciously and can be manipulated to eat excessively without their awareness, simply by altering factors such as portion size, variety, ambience and packaging.
Just as a bell became a cue for Pavlov's dog to salivate, the current environment has ubiquitous cues that condition people to eat, even when they know they shouldn't. It is very difficult for people to resist the largely reflexive and automatic nature of our response to available food.
We can throw up our hands and say that's the way it is, and let the marketing that is leading more Americans to become obese and ill go unchecked.
A wiser choice would be to demand that government bring more regulation to the food environment, making sure that what is available is healthy, and that the contents of foods are transparent and easily understandable, even to those who are illiterate. Such regulation could reduce the magnitude of flawed decision-making by individuals by presenting us with healthier choices. And such regulation is literally a matter of life and death.
Food marketing efforts are the modern Sirens, leading us inexorably to chronic diseases and sometimes to early deaths. Just as Ulysses was able to defeat the Sirens by having his men plug their ears and tie him to the mast, today we need active protection from an aggressive food industry that is luring us to obesity and illness.
People who are overweight and obese are unknowing victims of a food environment created for corporate profits rather than health. When people suffer from an unhealthy environment that is cutting years from their lives, they need help from government to assure healthy conditions through regulation and enforcement.
As a society, regulation has served us well. We regulate building construction as a means of assuring quality and value. If contractors use substandard materials or techniques, good inspectors will require the work to be done right before approval is granted.
We regulate the car industry. Seat belts and air bags have saved tens of thousands of lives. We regulate the alcohol industry, only allowing sales in licensed establishments to people 21 and over, and have found fewer alcohol-related traffic fatalities in localities with more controls. We regulate water quality, air quality and tobacco.
Today we view clean air and water as a right to which we are entitled. Regulation is an assertion of, and not an infringement to, our rights. Regulation of the food environment is the next right we need to claim.
An estimated 150 million Americans are overweight or obese. Too many will die before their time due to heart disease, diabetes and other ailments. While the nation remains focused on waging war on terrorism, which has claimed thousands of lives, millions are dying prematurely because they aren't getting the government protection they need from the Sirens of the food industry.
Deborah Cohen is a physician and a senior natural scientist at the RAND Corporation, a nonprofit research organization. She is the co-author of the book "Prescription for a Healthy Nation, a New Approach to Improving Our Lives by Fixing Our Everyday World" (Beacon Press).
This commentary originally appeared in Washingtonpost.com on February 21, 2007. Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.