US cities and states address the weight of the nation

The bathroom scales tell them every day and so do their consciences. But now government is joining the chorus of admonition to millions of Americans, young and old: you are gravely overweight and you must shed some pounds.

The bathroom scales tell them every day and so do their consciences. But now government is joining the chorus of admonition to millions of Americans, young and old: you are gravely overweight and you must shed some pounds.

This year has seen a surge of initiatives and laws, mostly at the state and city level, aimed at trimming the nation's waistlines.

The Centres for Disease Control reported recently that two out of three Americans are either obese or overweight. Obesity had become an "insidious epidemic" it warned.

Many of the measures are aimed at children. The CDC found that a quarter of US children are obese or overweight, double the level in the Seventies.

New York City has banned fizzy drinks, sweets, crisps and donuts from vending machines in its schools. Louisiana passed a law requiring schools to teach physical education. Arkansas and Mississippi approved similar laws to encourage such classes. Until this year, Illinois was the only state to make physical education mandatory.

Arkansas has also started body-mass-index testing - which measures weight-height ratios - in six schools. The results are sent to parents and those with children at risk from obesity are urged to feed them less.

Arguably the most startling initiative has beenin Louisiana. In an effort to cut the cost of health care for government workers, the state is offering free gastric bypass surgery - otherwise known as stomach stapling.

These actions have often been prompted by the rising cost of health care. Obesity has been linked to numerous diseases, notably diabetes, heart disease and even cancer.

The US Department of Health and Human Services estimates that obesity-related diseases cost $120bn (£68bn) a year. The American Medical Association reported that 300,000 deaths per year are linked to excess weight.

West Virginia recently calculated that the cost of treating its obese employees has doubled from $37m to $78m since 1995. The state has put up billboards showing sagging stomachs. "Put down chips & trim those hips," the billboards proclaim.

Government intrusion into private lives advising how much people should weigh and eat is not so shocking. Recent years have seen an avalanche of laws to discourage smoking, precisely because of its health risks.

But not everyone is pleased. Many anti-fat laws fell by the wayside this year, including a schools vending machine initiative in Texas.

The climate is one of "fear and hysteria," said Mike Burita at the Centre for Consumer Freedom, an advocacy group for the restaurant and food industry. "We're allowing government and public health groups to dictate our food choices to us."