Two-thirds of American adults are obese or overweight and in the past year obesity rates have continued to rise in 31 states. Eighty-five percent of Americans believe that obesity is an epidemic, according to a new poll conducted by Trust for America's Health (TFAH). Poor nutrition and physical inactivity are increasing Americans' risk for developing major diseases, including type 2 diabetes, heart disease and stroke, and some forms of cancer. But while the obesity epidemic has garnered increased attention, a comparable increase in action has yet to occur.

While many promising efforts are being initiated across the country, there is no national commitment to address the problem. Researchers and practitioners know a lot about nutrition and exercise. There are well agreed upon standards for basic nutrition and minimum levels of physical activity for sustaining good health. However, much less is known about how to effectively encourage people to make healthy choices. Individuals are often told to take personal responsibility and lose weight, but with two-thirds of American adults obese or overweight, many Americans are struggling with their weight. More than $35 billion is spent annually on weight loss-related products and services. Clearly, the strategy of focusing on personal responsibility alone is failing.

People do not make decisions in a vacuum. They are influenced by their relationships with family, friends, neighbors and colleagues; their home, workplace, neighborhood and school environments; their economic limitations; and their genetics, physiology, psychology and life stages.

This fourth annual edition of the F as in Fat: How Obesity Policies are Failing in America report explores both the current policy weaknesses and the new, grand scale changes that need to be considered to address the obesity crisis nationwide. While we need to make big changes to the places we live, work and play to help improve our health, the good news is that research shows even small changes in individuals can have big health benefits. This year's report provides an update of trends in obesity rates and policies at the federal and state level. The report also includes findings about potential strategies for dealing with obesity from two surveys; one of on the ground experts and the other of average citizens. The various policies and approaches discussed in the report help build a national evidence base for what efforts are effective as the country seeks improved strategies for addressing the obesity epidemic.

TFAH's top recommendations for combating the obesity epidemic include:

• Improving federal leadership;
• Fighting obesity in the workplace;
• Helping all Americans become more physically active;
• Helping Americans choose healthier foods; and
• Accelerating and escalating the research into ways to promote lifestyle changes.