It’s no secret that the land of supersized meals has produced supersized people. Two-thirds of American adults are overweight; one-third are obese. That’s double the obesity rate from 30 years ago. Among children ages 6 to 11, 19 percent are overweight. It was 4 percent in the 1970s.

Excessive weight gain has become a public policy issue, because we all pay for it. Obesity is linked to maladies including heart disease, diabetes, high cholesterol, sleep apnea, arthritis, depression and some cancers. The cost is estimated to be $123 billion a year. Obesity costs employers $45 billion in medical costs and work loss, according to the Conference Board.

The costs also come in unexpected ways. An increase in the average passenger’s weight has forced airlines to spend about $275 million more a year on fuel, according to an American Journal of Preventive Medicine study.

So it should be no surprise to find that a record 51 percent of Americans were taking one or more prescription drugs last year, according to a survey by Medco. In the United States, more drugs are used per person than in any other country. Many of those pills, such as those designed to control blood pressure and reduce cholesterol, have direct links to weight.

While it’s good news that so many drugs have been developed to manage these day-to-day conditions, these breakthroughs have provided no-sweat options for those who could have prevented their maladies with healthier lifestyles.

All of us – whether fat, skinny or just right – have an interest in controlling the weight of the population. The government should ramp up its public education campaigns. Employers and insurers should intensify efforts aimed at exercise and prevention. Doctors need to offer patients frank assessments on their patients’ weight. Dr. Sidney Wolfe, of Public Citizen’s Health Research Group, places part of the blame on doctors for spending more time writing prescriptions than counseling patients to make lifestyle changes.

But the best solution starts with us. We need to walk and bike more. Perhaps the high price of gasoline will spur an epidemic of exercise. The U.S. Department of Transportation reports that half of schoolchildren walked or biked to school in 1969. Now only 15 percent do.

The trend of little exercise, big meals and pill chasers has Americans bursting at the seams. We can’t trim costs without trimming the fat.