“A bountiful food supply with abundant choices of relatively inexpensive, calorically-dense food products that are convenient and taste good.” If this phrase conjures up images of fresh fruit, fish and coconuts, think again. It refers to an American diet including many calorie-packed convenience foods, soft drinks and snacks, but in the sanitized parlance of the new plan for obesity research from the US National Institutes of Health (NIH). This bountiful supply, it tells us, is to blame for “the current ‘obesogenic’ environment that promotes increased caloric intake”.

Such vernacular fits a consistent trend across the Bush administration's so-called anti-obesity policies: to tiptoe around calling a hamburger a hamburger, and state unequivocally that many of the foods marketed to the public are the biggest single cause of the obesity epidemic. If government or the NIH tells people to eat less, they must then say less of what, and will be in trouble with the powerful food industry. The administration's new anti-obesity strategy (see page 244) is a series of half-measures, doling out lessons to eat better and exercise more, dressed up as personal freedom and choice. It blatantly shirks committing the government to regulating the food industry.

Individual choice is just not working (see page 252). Obesity is spiralling out of control, with 130 million Americans, or 64%, overweight or obese. They are desperate for help, spending $37.1 billion annually on diet books and fads offering instant remedies. Bold government intervention, including compulsory calorie labels and a clampdown on junk-food marketing, is needed.

“We're just too darn fat, ladies and gentlemen, and we are going to do something about it,” Tommy Thompson, head of the US Department of Health and Human Services, told a press conference last week to launch the new strategy. “We need to tackle America's weight issues as aggressively as we are addressing smoking and tobacco.” Fighting talk, in contrast with his department's efforts to dilute the World Health Organization's Global Strategy on Diet, Physical Activity and Health, which highlights the food industry's role in reducing obesity.

Americans deserve better. The medical and other costs of obesity to the United States total more than $117 billion a year. With obesity overtaking tobacco as the main preventable cause of death, this is an issue of national importance. Scientists and others now need to make their voices heard, and to call on the candidates in the forthcoming US presidential elections to clearly state that they will stop tiptoeing around the elephant in the room in the obesity debate.