What sort of message should an anti-obesity campaign send, given that diet experts are still wrangling over such issues as whether low-fat or low-carb diets work better? "How about just eat less, move more and eat your fruits and vegetables?" suggests Nestle. Few people appreciate more fully than she just how difficult it would be for the Federal Government to approve such a message. "Move more" is not a problem. The Centers for Disease Control and Prevention (CDC) has budgeted $193 million for its Verb campaign, encouraging young Americans to be active. "Eat less" is another matter. In the past, federal efforts to tell Americans to eat less meat have been foiled by lobbying from the Cattlemen's Association. Attempts to tell people to eat fewer sweets have raised the hackles of the sugar and corn-refining industries. Ultimately, the government winds up putting out such bland advice as "Choose two to three servings of lean meats" and "Moderate your intake of sugars" rather than a clear "Eat less" message. "If you're dealing with obesity, people have to eat less," Nestle insists. "I'm all for activity, but if one of those 20-oz. soft drinks is 275 calories, that's 2 3/4 miles of walking to get rid of those calories right there. People can't easily do that. People have to eat less, and nobody wants to talk about that."

Nestle's experiences with the Department of Health and Human Services, which runs the CDC, and the Department of Agriculture, which controls the food pyramid, have convinced her that responsibility for messages on nutrition should be moved someplace less subject to political pressure. She is not alone in thinking so. In May, Senators Ted Kennedy and Peter Fitzgerald proposed a bill that would transfer authority to the Institute of Medicine, part of the National Academies of Science. "This legislation would give us a new general in the war on obesity," says Illinois Republican Fitzgerald.

How would the Federal Government fund a national campaign for healthier eating? Once again, the obesity warriors want to steal a leaf from the tobacco wars: if you want people to use less of something, put a tax on it. "Health economists have shown that the tax on cigarettes is the single most effective thing they've done to prevent smoking," says Brownell, so why not tax junk foods or soda? A big tax, like that on cigarettes, would not be palatable, but Brownell believes a small tax could go a long way toward funding anti-obesity campaigns on TV and in schools. Some 18 states, he notes, already place tiny taxes on soft drinks or junk food. Arkansas raises about $40 million a year from a soft-drink tax of about 2¢ a can. Nationally, he says, "we could raise $1.5 billion from a penny-a-can tax on soft drinks. With $1.5 billion, we could create a 'nutrition Superfund' to clean up the toxic environment. You could get Beyonce Knowles away from Pepsi and Shaquille O'Neal from Burger King and have them promote healthy eating instead."

A tax on junk foods? A ban on advertising to tots? A national nutrition campaign advising us all to eat less? Could any of this actually happen? In the days when the Marlboro Man was riding high on the airwaves, Brownell points out, no one thought you could ban cigarette ads. "I don't know at what point the country will be so desperate," says Nestle, but she thinks that point is approaching fast. "If you're a family that has kids with Type 2 diabetes, your life is not going to be pretty," she says. "Nobody has a clue how much this overweight business is going to cost us."

Health economist Kenneth Warner, director of the University of Michigan Tobacco Research Network, remembers when the world thought it was everyone's personal responsibility to cut down on smoking and when the government had little to say on the matter. In many ways, he says, where we are in fighting obesity today is similar to where we were with cigarettes in the early '60s: "We've identified a health-risk factor, but we're only now starting to get serious about conveying its importance and magnitude to the public."


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