Fixing a Fat Nation

Since the 1950s, health experts have been warning Americans to lose weight and telling them how: by eating less and exercising more. Over that time, obesity rates tripled. It's time to admit that we are losing the battle against obesity and, given the rate we are dying from it, to start treating obesity like an infectious epidemic. Combating obesity and its many attendant illnesses will not require more cholesterol-lowering drugs, diet books, or workout videos, but rather a retooling of our environment to get us moving again and to put the doughnuts a little farther out of reach. To blunt the epidemic, we can: regulate junk food with a Twinkie Tax; regulate junk food industry advertising, at least to kids; limit the availability of junk-food/fast-food outlets, especially around schools; strengthen and enforce USDA regulation of foods sold in schools; redesign the environment to create more densely built neighborhoods that integrate residential and commercial real estate and include bikeways and walking paths for getting around; design buildings to encourage the use of stairs; expand PE classes in schools. None of these ideas are new, but they are hampered by government agencies with misdirected priorities, lack of regulatory power, and conflicting missions, as well as the view that health is exclusively an individual responsibility. History has shown that in dealing with epidemics of all sorts, ultimately collective, not individual, action radically improves public health.