Health care reform in the United States is impossible without tackling the country’s obesity epidemic, author and food activist Michael Pollan has warned.

“Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet,” Pollan wrote recently in The New York Times.

“That’s why our success in bringing health care costs under control ultimately depends on whether Washington can summon the political will to take on and reform a second, even more powerful industry: the food industry.”

Pollan notes that it costs the U.S. health care system $147 billion every year to treat obesity. It costs another $116 billion each year to treat diabetes, “and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet.” According to the Centers for Disease Control and Prevention, 75 percent of U.S. health care spending goes to treat “preventable chronic diseases,” including those linked to diet. A recent study found that obesity is responsible for 30 percent of the increase in health care costs in the last 20 years.

“But so far, food system reform has not figured in the national conversation about health care reform,” Pollan writes. “To put it … bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup.”

According to Pollan, widespread food reform is an essential part of health care reform, “everything from farm policy to food marketing to school lunches.” He notes that a recent study from M.I.T. and Columbia University concluded that the best way to reduce rates of childhood obesity would be to develop a diverse, regional food economy and move away from globalized agriculture.

“Passing a health care reform bill, no matter how ambitious, is only the first step in solving our health care crisis,” Pollan says. “To keep from bankrupting ourselves, we will then have to get to work on improving our health — which means going to work on the American way of eating.”