Until recently, obesity has largely been viewed as a personal issue. However, in 2001, the U.S. Surgeon General issued a wake-up call to prevent and decrease overweight and obesity. At that time 40 million Americans were considered obese, and this was contributing to $99.2 billion in estimated medical costs, and 200,000-280,000 adult deaths a year because of related comorbidities (1, 2, 3, 4, 5, 6, 7, 8). To address this, the U.S. Surgeon General assigned responsibility to all strata of society – individuals, families, communities, schools, worksites, health care, media, industry, and government.As dieticians, health professionals, and researchers, one of our roles is to better understand what contributes to excessive weight gain. We are uniquely trained to look beyond the “easy answers,” and to look toward those that may be less obvious, but which have data to support new ways of thinking and new ways of counseling.Indeed, while both physical activity (9) and the amount of dietary intake (10) contribute to obesity, research suggests that dietary intake, and not a decline in physical activity, is the major behavioral factor that increased obesity during the last 20 years (11, 12). Although many factors influence dietary intake (9, 13, 14), a growing growing body of research suggests that environmental factors (15, 16, 17, 18) may have a much more insidious influence that previously thought. While some of these environmental causes of weight gain are well-documented (19), others are more allusive because very slight – even unknowing – increases in daily consumption can influence weight gain over the course of months and years. There is growing evidence that people may not be aware of all of the small factors that influence their consumption (20)
