In an age of gluten-free, superfoods, kale, chia, green tea, vitamin supplements, protein shakes and shake weights, PX-90, Zumba, and a long list of skinny and buff celebrities, one would believe that Americans are generally getting healthier. The belief that we are healthier is actually far from the truth; while there are thousands of health products on the market, Americans still boast a 35 percent obesity rate, a 10 percent Type 2 diabetes rate, and heart disease is still the leading cause of death in the United States, attributed to one in every four deaths in the U.S.

It is common knowledge that unhealthy foods and beverages have an adverse effect on our health, yet we continue to consume them. Perhaps the food and beverage companies are to blame, but they aren’t force feeding us this junk. Perhaps individuals are at fault. This question has been divisive for decades among professionals, public health officials and decision-makers. While the question of who is to blame for the greatest public health epidemics of our time remains, there has been increased efforts and plenty of energy put into battling the issue of obesity and the health effects associated with obesity.

The question is whether they can and will work, and if Americans — specifically young people — care about their long-term health enough to listen. What will it take for us to say, “Enough is enough” and take action, change our behavior and reverse the last 30 years of high obesity, Type 2 diabetes, and heart disease rates?

More than just a cosmetic issue

Someone is classified as obese if they have a body mass index equal to or greater than 30. BMI is a calculation of body fat based on a person’s height and weight. This means that an individual who is obese looks visibly heavier, but obesity goes beyond just being heavy, thicker or fatter. The problem with obesity is that it affects our body in more ways than adding a few extra pounds. Obesity is a leading cause of death, disability, healthcare utilization, healthcare cost, and being overall unhealthy in the U.S. According to the Public Health Law Center, it is an issue that, aside from making us visibly fatter, increases the risk of other chronic illnesses such as Type 2 diabetes, hypertension, heart disease, stroke, and some cancers. Overall, obesity increases the risk for up to 20 other health issues and chronic illnesses.

Another problem with obesity is that we tend to think that it is a disease that affects middle-aged people and not young people with active lifestyles. This assumption could not be further from the truth: in the past 30 years, childhood obesity has doubled and obesity among adolescents has quadrupled!

Obese young people have higher risks of having high cholesterol, high blood pressure and prediabetes. The myth that kids will lose weight into adulthood is very much that — a myth. Obese children and adolescents are more likely to be obese adults. So the notion that baby fat exists is false; obesity affects young people and it’s serious.

Another tricky thing about obesity is that one does not need to be visibly overweight, to be considered obese. The term “skinny-fat” is a real term. Scientists call this term TOFI, or “thin on the outside, fat on the inside.” People who are TOFI are just as unhealthy, if not more unhealthy, than visibly obese people.

Dr. Mark Hyman is the director of the Cleveland Clinic Center for Functional Medicine, and explained in his Huffington Post article the issues that TOFI people share with people who are visibly overweight and obese. People who are thin on the outside eat what they want without having to worry about gaining weight, but symptoms similar to obesity include, “Low muscle mass, inflammation, high triglycerides, low good cholesterol, high blood sugar, and high blood pressure,” which means that visibly obese people are not the only people who have to worry about being unhealthy. This phenomenon has transcended far beyond a disease that affects a select few of Americans, but rather an epidemic that proves to be one of the most pressing public health issues of our time.

Americans’ obsession with food

The obesity epidemic didn’t happen overnight. The combination of readily processed foods, fast-food restaurants, and the notion that we should reward ourselves with food has created a recipe for obesity. We see food as more than nutrients; we intertwine food into almost every social interaction. It could even be argued that we are obsessed with food. This can be proven by science. Scientifically, our bodies crave food and beverages that are packed with sugar, salt, and fats. We get an almost uncontrollable urge to buy something sweet and rich when we are sad, we crave salty snacks when we are bored, and we crave sugary drinks when we need a pick-me-up. This obsession is no accident; it is rooted in science. Combine our bodies’ urge to consume unhealthy food with constant messages about food and beverages, and you have a formula for obesity.

Food is literally everywhere. Whereas in the past we had to search for food, modern advances have made it so that food can be found just about anywhere at any time. Unhealthy snacks and drinks are sold by every retailer, readily available in vending machines at work and school. If you’re looking for a hot meal or a quick snack, fast-food restaurants can be found on almost every corner. The ease of accessing food that we crave creates an environment where there is constant stimulation of our senses, tempting us to consume unhealthy food. The smells, the sounds, and the sight of food triggers something in our brain that makes us have an insatiable urge to eat or drink sugars, fats, and salt. This answers the question of why we keep consuming unhealthy food: because we are scientifically prone to do so and it’s easy to access.

We are essentially addicted — our craving for unhealthy food is an addiction.

Dr. Mark Hyman explained this addiction by comparing it to being addicted to cocaine, heroin, and cigarettes. “If you examine your own behavior and relationship with sugar, in particular, you will likely find that your behavior around sugar and the biological effects of overconsumption of sugar match up perfectly [with drug addiction].” Dr. Mark Hyman continued to explain that food companies concoct recipes that are hyperpalatable. Hyperpalatable essentially means that the product tastes really good, but not just really good — it’s so tasty that it triggers the response in the brain that you can’t have just one, which sounds awfully close to addiction.

The blurry line between healthy and unhealthy

While companies have been hard at work creating recipes that keep consumers coming back for more, they have also worked to alter their products to be low-fat, low-carb, low-sodium, and practically low-everything that is unhealthy. For more than 30 years, stores have featured products that claim to be good for our health. Examples include all-natural, fat-free, reduced sodium, reduced fat, low cholesterol or cholesterol-free, made with whole-grain, multi-grain, vitamin-enriched, contains antioxidants, no sugar added, real-cane sugar, no high-fructose corn syrup, low-calorie, zero or no trans-fat, immune support, free range, light, made with real fruit, organic, omega-three fatty acids, and many more.

“Some natural products will have high fructose corn syrup and companies will argue that since it comes from corn, it’s healthy,” Stephan Gardner, director of litigation at the Center of Science in the Public Interest said. These nutrition claims make it difficult to decipher what products are genuinely nutritious and which products are packed with preservatives, chemicals and sugar.

“Most people don’t know how to properly read a nutrition label, or are in a hurry, so we trust that the label isn’t lying to or misleading us,” Elizabeth Soto, 18, environmental science major at Mt. San Antonio College said. “I don’t think most people know that these companies can lie to us just to get sales.”

The thin line between good-for-you and harmful is worked into more than just the claims the product makes or the ingredients in the product. When someone decides to be mindful of what they are going to consume, reading the nutrition label is helpful because they are counting the calories they are consuming. Calories on a nutrition label however, are not a good indication if a product is healthy for you. Currently, there is little oversight as to how food companies can alter their products’ nutrition labels.

“To make products appear healthier, some companies have started increasing the number of servings listed per container, thus lowering the number of calories per serving. All of that adds to consumers’ confusion,” Gina Mohr, a marketing researcher from Colorado State University said in a 2013 NY Daily News article. This means that when the average person looks at the back of a nutrition label, they are likely to see low percentages in fat, sodium and cholesterol, which makes them more inclined to buy the product because they think they are making a healthy choice. When you think about it, nobody ever really eats just 11 Doritos.

While on the topic of nutrition labels, it’s important to point out that one of the food vices is omitted in the daily recommended value. The FDA lists daily recommended values for vitamins, minerals, salts, and fats. There is a sweet exception: sugar. Fats and salts have daily recommended values so that consumers can monitor their intake, but sugar intake has never been monitored on food labels.

Fortunately, this might change soon as the federal government continues to propose changes to the longstanding food label that has confused consumers. It looks like the Department of Agriculture will soon begin to recommend a daily value for sugar. According to a recent report released by the FDA, “The percent daily value would be based on the recommendation that the daily intake of calories from added sugars not exceed 10 percent of total calories.” Ten percent accounts for about 25–35 grams of added sugar, which is the same amount of sugar found in one 16-ounce can of Coke.

Combating and obesity: More than just exercise and kale

Obesity, and all the health effects associated with it, affect the quality of life for everyone. Health officials predict that the health of our country is not showing any signs of improvement and because of this, millennials are expected to lead shorter lives than generations before.

Without drastic social, cultural and environmental changes, the future of America’s health isn’t looking so great, Jeff Levi, executive director of the Trust for America’s Health explained in a 2014 Huffington Post article. “With six million new cases of diabetes, five million cases of heart disease and stroke, and more than 400,000 cases of cancer in the next 20 years, we are on a tragic course that will have a horrible impact on the quality of life of millions of Americans and could overwhelm an already overburdened health care system,” Levi stated.

Levi’s report, “F as in Fat: How Obesity Threatens America’s Future 2012” recommended that states take steps necessary to reduce the Body Mass Index of the residents within their states. This places the responsibility of reducing the obesity rate into the hands of individual states.

Many states, counties, and cities have already taken steps to enact policies that address the obesity epidemic at their level of influence. One example of this is the city of Berkeley’s soda tax. According to an Ecology Center website, “Berkeley’s soda tax is a penny-per-ounce tax paid by distributors of sugary drinks, like soda, energy drinks, and sugary coffee syrups. The soda tax established a panel of health experts to advise Berkeley’s City Council on how to use the tax money to support programs to reduce sugary drink consumption and improve children’s health.”

The notion that the government should step in isn’t widely accepted as a solution to obesity. “America will end its so-called obesity epidemic if and only if obese people make a personal decision to eat smaller portions, eat healthy foods, and exercise,” Heather Peoples from Atlanta, Georgia commented in response to a TIME article. “Our government should not be in the business of attempting to control my behavior by imposing a tax on fast food or mandating the portion size I can be served in a restaurant.”

Past public health issues and their solutions provide a different story than a “hands-off” government.The rhetoric of the government not intervening in public health issues that concern personal choice is nothing new. California has learned many lessons from their successful fight against tobacco that are currently being put in practice in hopes to reduce the obesity epidemic. These lessons, according to their Obesity Prevention Plan, include “changing social norms, changing the environment and increasing access to services.” Policy experts argue that lessons from tobacco prevention efforts are great lessons to follow because they are proven to be effective. “Fifty years ago, 42.4 percent of U.S. adults smoked. Since then, that figure has declined by more than half, reaching a record low 17.8 percent in 2014,” said Jesse Rifkin, a Huffington Post- Healthy Living contributor. Among his rationale for this drastic drop in smoking rates, he cites: prevention efforts aimed at young people, anti-smoking laws at all levels of government, cigarette taxes, real scientific studies proving tobacco’s harmful effects and media or popular culture no longer glamorizing smoking. These changes paved the way for Americans to drop their smoking rates.

There are many lessons to be learned from tobacco prevention; there are also many similarities between tobacco companies and food/beverage companies. Seasoned public health professionals recognize that food industries are using the strategies of big tobacco. In an interview titled “Food Industry Pursues the Strategy of Big Tobacco” Kelly D. Brownell, who studies food policy and obesity, compared sales strategies of tobacco and food companies with a tobacco researcher and they concluded that both industries utilize the same methods to sell their products.

These similarities include dismissing as “junk science” peer-reviewed studies showing a link between their products and disease, paying scientists to produce pro-industry studies, sowing doubt in the public’s mind about the harm caused by their products, intensive marketing to children and adolescents, frequently rolling out supposedly “safer” products and vowing to regulate their own industries, denying the addictive nature of their products, and lobbying with massive resources to thwart regulatory action. These similarities force public health officials to treat the problems like one another.

We can continue to deny that the obesity epidemic is real. We can also try to deny the link between food and beverage industries and obesity. We can even hope that we are lucky and we do not succumb to the negative health effects of unhealthy food. However, our best option is to be proactive and take steps to address this issue. If we treat obesity like tobacco, we can be proactive in changing the norm. This starts with individual changes, which lead to policy changes that make it more difficult to access unhealthy food, make food contents more transparent and hold food companies more accountable.

Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation, the nation’s largest philanthropy dedicated solely to health, believes policy changes are key in changing the outcome of our health. “At every level of government, we must pursue policies that preserve health, prevent disease and reduce healthcare costs. Nothing less is acceptable.”

Alfredo Camacho Lopez studied journalism at Mt. San Antonio College where he served as an editor of the Mountaineer student newspaper and Substance magazine. He received a bachelor’s degree in political science from Loyola Marymount University. He has been involved in local government empowering youth voice for over 10 years. He currently works as a policy assistant at Day One, a community-based nonprofit organization with a 25-year history of providing effective, high quality and culturally-sensitive public health education.

This story is a part of a special alumni series. Students who have graduated or transferred from Mt. San Antonio’s journalism program are featured weekly.