WASHINGTON (AP) – Americans are sitting around and eating themselves to death, with obesity closing in on tobacco as the nation’s No. 1 underlying preventable killer.

The government is offering constructive, even lighthearted, advice to fight what it calls an epidemic of expanding waistlines. Americans will be told in a new ad campaign they can lose midsection “love handles” and double chins one step at a time if they eat less and exercise more.

“We’re just too darn fat, ladies and gentlemen, and we’re going to do something about it,” Health and Human Services Secretary Tommy Thompson said Tuesday at a news conference.

A poor diet and physical inactivity caused 400,000 deaths in 2000, a 33 percent jump over 1990, said a study released Tuesday by the federal Centers for Disease Control and Prevention. Tobacco-related deaths in the same period climbed by less than 9 percent and the gap between the two narrowed substantially.

The report predicts obesity will surpass tobacco if current trends continue. “Our worst fears were confirmed,” said Dr. Julie Gerberding, the CDC’s director and an author of the study.

The study is the latest in a long line of research documenting widespread weight gain – and its consequences – among Americans, from children to seniors.

Heart disease link

The researchers analyzed data from 2000 for the leading causes of death and for those preventable factors known to contribute to them. Like tobacco, obesity and inactivity increase the risks for the top three killers: heart disease, cancer and such cerebrovascular ailments as strokes. Obesity and a sedentary lifestyle also strongly increase the risk of diabetes, the sixth leading cause of death.

The results appear in Wednesday’s Journal of the American Medical Association.

A separate report by the Rand think tank, meanwhile, found that increases in obesity threaten to erase improvements in health among middle-age and older Americans. At current rates, health care spending on obesity among people 50 to 69 years old is expected to increase by 50 percent by 2020, the study said.

Americans’ fast-food lifestyle, increased use of computers and a decline in school physical education programs all were cited by Thompson and other officials as factors contributing to the nation’s fat problem. Two out of three adults and 9 million children are overweight or obese, they said.

Rather than call for dramatic changes in diet and exercise, Thompson said Americans could begin a gradual exercise program. They could get off the bus a block farther from their homes, he said, and slowly cut back on unhealthful foods.

The new public service announcements debuted by Thompson use humor to tell people they can slowly trim their waistlines. In one ad, someone turns in a pair of love handles found near the stairs in a shopping mall. “Lots of people lose them taking the stairs instead of the escalator,” says a clerk at the lost and found.

In another ad, a shopping cart gets stuck on a double chin that someone lost near a supermarket’s fruit and vegetable display.

Thompson, a fierce anti-smoking advocate who has trimmed his own waistline since coming to Washington, drew parallels between the drives to stop smoking and to get Americans to eat less and exercise more. But unlike his campaign to end smoking, he is advocating only voluntary measures at this point.

In addition, the Bush administration is seeking to cut funding for the VERB campaign, a CDC project to promote physical activity among 9-to-13-year-olds, from $36 million this year to $5 million in 2005. Gerberding said the program has resulted in a 30 percent increase in exercise among those children.

The Food and Drug Administration also is expected to issue a report on obesity later this week. The FDA has been considering whether to require restaurants to provide more nutrition information and change nutrition labels on food sold in grocery stores and other outlets to help consumers.

McDonald’s has announced it will end supersize fries and drinks in its more than 13,000 U.S. restaurants by year’s end except for special promotions.

Several soft-drink makers also have announced steps to offer a larger number of healthier products.

Fast food lawsuits

The House will debate a bill Wednesday that would shield restaurants and fast food franchises from lawsuits seeking to blame them for obesity and health problems related to it. The bill was prompted by the fast-food industry’s complaints about a rash of lawsuits that fault their food for Americans’ bulging bellies.

Many states are making attempts to slow the increase in obesity among children. About two dozen of them are considering bans or limits on vending machine products in schools. Roughly 20 states already restrict students’ access to junk food until after lunch.

The Texas Agriculture Department is revamping rules on what foods public schools in the state can serve to their 4.2 million students, cutting out deep-fried foods and reducing fat and sugar in menus.

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AP Medical Writer Lindsey Tanner contributed to this report

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On the Net:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov

AP-ES-03-09-04 1938EST