"The Biggest Loser" is a popular primetime TV show in which morbidly obese men and women struggle to lose weight while being supervised by nutrition experts, exercise trainers and psychologists. Personally, I find the title offensive, as there is a clear subliminal message supporting the notion that all morbidly obese individuals are losers. Even worse, their approach to weight loss is unrealistic for a huge number of obese Americans, and once the show is over, the success of keeping the weight off is not that good.

The Institute of Medicine, in response to the overwhelming obesity epidemic, has issued a new plan it hopes will reverse this national health crisis. First and foremost, they dispel the notion that obesity occurs only in weak individuals with no willpower. Instead, they place the blame on every aspect of our society and criticize the food industry for not providing healthy choices, farmers for not having the opportunity to grow crops that promote health, and businesses and schools for not doing enough to help solve the problem.

Their proposal is simple but implementation will be difficult. It will require the involvement of everyone, no matter his or her size.

The institute proposes a fivepoint plan to 1) make physical activity an integral aspect of our lives. 2) Develop food and beverage choices that promote an ideal weight and are readily accessible and inexpensive. 3) Transform messages about physical activity and nutrition obesity. 4) Expand the roles of health care providers, insurers and employers. 5) Urge schools to be the focal point of efforts to avert the obesity trend.

The 478-page report provides specific approaches to address each issue. To improve physical activity, they insist that communities develop easily accessible places and programs where exercise can occur safely and enjoyably and that physical activity be promoted and required for children.

The report is particularly aggressive in suggesting ways to create healthful foods and beverages. They require that fast food restaurants decrease calorie-dense foods for children and offer healthier choices; that rational nutritional standards for all foods and beverages be set; that the concentration of fast food outlets in low-income communities be reduced; and that a presidential task force be created to review agricultural policy and farm subsidies that favor foods promoting obesity.

The institute also proposes an "or else" threat to beverage, media and restaurant businesses to improve their marketing messages to children. The federal government is asked to do more to create culturally appropriate messages for specific audiences to increase awareness of key issues in the prevention of obesity.

The institute recommends a greater health care provider role in prevention and nutrition education and insists that insurance companies cover obesity prevention, screening, diagnosis and treatment. Finally, there must be a major commitment by schools to develop nutrition-savvy students who have many opportunities to be physically active and make good food choices in school and elsewhere. And federal law must be changed to mandate physical education programs at all grade levels that will be continuously evaluated to assure proficiency.

Before the ink dries on this report, the influential lobbyists representing industries and special interest groups affected by these recommendations will do everything they can to minimize any financial impact. Politicians will certainly balk at more government spending and involvement in our lives. But we must all understand the economic cost of failure to reverse obesity. Currently, the impact of obesity on health care is estimated to be $190 billion annually, and the cost of inability to work, illnesses and decreased productivity adds additional billions.

The institute must be congratulated for its boldness, but do we as a nation have the stomach to address another societal program that is so easily blamed on the individual or someone else?

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging."