The US Surgeon General has dubbed childhood obesity America's most serious epidemic. With one in three children overweight, these stark facts help explain why childhood obesity has focused the attention of US lobby groups, politicians, the Federal Trade Commission, media owners, food manufacturers and the ad industry like no other issue.
The gathering storm has culminated in the FTC issuing subpoenas last month to 44 food and beverage companies for a report it is preparing for Congress on marketing to children. Burger King, Campbell Soup, Coca-Cola, Dole, Procter & Gamble and Mars, among others, have to disclose how much they spend to reach young people through all media, and to provide marketing information by 1 November.
And while marketing to children is only one such ad issue under examination, the others being prescription drugs, alcohol and tobacco, it has become the most contentious. Its prominence also explains the unprecedented flurry of self-regulation by food and drink manufacturers.
In July, for example, 11 marketers, including Campbell's, General Mills and Pepsi, voluntarily adopted new limits on advertising to children under 12. And in June, Kellogg promised that, by the end of 2008, it would stop advertising cereals that don't meet self-imposed health standards to under-12s.
So, why is all this happening now? Adonis E Hoffman, the senior vice-president and counsel of the American Association of Advertising Agencies in Washington, and a director of the American Business Leadership Institute's Center on Responsible Media and Marketing, says it's all part of a new era of responsible marketing designed to protect consumers from marketing and media that is deemed harmful and socially irresponsible.
It has led, he says, to "a few people in power being pressured to save the republic from its descent into decadence".
"It has become accepted orthodoxy to blame marketing for the substantive ills of society," Hoffman adds. "The ensuing public policy fiction is that society's problems can be fixed by ceasing all marketing and commercials."
John Feldman, a lawyer with the Washington law firm Reed Smith, who works extensively on children's advertising issues, advising clients on promotional practices targeted to children, says: "The FTC is being bombarded with requests from public interest groups to take a more proactive view, which is one reason companies have decided to go the self-regulation route."
Another reason, he says, is because it's not a real issue: "With tobacco, it was - it kills you. But because chocolate coco crisps are probably bad for you, companies pretend they're taking some amazing steps. But in reality, if you look at what companies such as McDonald's have said they're going to do, they're already doing it. So this is not earth-shattering activity."
A number of lobby groups, the most prominent being the Center for Science in the Public Interest, and the Campaign for a Commercial-Free Childhood, are fuelling such activity, backed by the efforts of two Congressmen: the Republican Sam Brownback and the Democrat Tom Harkin.
In 2006, these two children's advocacy groups filed a lawsuit against Kellogg and Viacom. In the end, the suit was dropped, but Feldman points out: "CSPI is one of the most powerful advocacy groups because they threaten litigation, which is so expensive in this country and creates such a public issue that it's a very effective way of getting word out."
The UK, with its ban on all food advertising with a high sugar, salt or fat content to children under 16, has been a major influence. "The notion of banning advertising to children comes directly from Ofcom," Hoffman says. "There's an activist sector here, not as outspoken as in Europe, which points to research that says marketing is damaging and negative for the childhood. They try to draw a line between marketing and obesity, which has a tenuous connection at best."
And while most experts agree that childhood obesity results from a host of factors, Hoffman says food marketing has become ground zero in the policy debate.
But unlike the UK, the US has, as part of its constitution, the right of free speech. "Advertisers have actually given up some of their constitutionally protected rights, by voluntarily agreeing not to market certain products to children," Hoffman says. "And, if we wanted to litigate that all the way to the Supreme Court, I suspect we could win. We'd win in court, but lose in the court of public opinion."
Feldman argues that the concept of commercial free speech is not something the US should abandon. "The FTC and legislators know they can't make a law against it, because it would be unconstitutional, so the only way to make things happen is through self-regulation."
Not that the ad industry is exactly taking this lying down. Hoffman says: "We have an alliance of ad agencies, advertisers, media companies, broadcasters and publishers who fight aggressively at both the Congressional and Federal level, at every step of the way. Whenever there is a proposed regulation in the House or Senate, we band together and seek to defeat it."
Feldman adds a warning note: "The consumer advocates will one day wake up and understand that people are still going to be fat. And they'll tell food manufacturers: 'You didn't do enough.' This issue of progression is very important. Right now, the focus is on children under 12. In the UK, it's on children under 16. But if it's bad for children and adolescents, then why isn't it bad for adults? And suddenly you have this slippery slope situation."