A paper published in Thursday’s New England Journal of Medicine argues that the prominent placement of unhealthful food items in stores contributes to the obesity epidemic — and that it therefore should be curbed.

Deborah Cohen of RAND Health in Santa Monica, Calif., and Susan Babey of the UCLA Center for Health Policy Research write in their Perspective piece “Candy at the Cash Register — A Risk Factor for Obesity and Chronic Disease” that our response to the nation’s obesity problem has relied on a “basic misconception” that our food choices are conscious and deliberate and are guided by our actual desires. But if that were the case, they observe, people who say they want to lose weight would easily be able to do so; their desire to lose weight would compel them to seek foods that comport with that goal.

Instead, the authors say, our food choices are largely guided by our responses to outside signals and stimuli. In the grocery store, it’s those chips, sodas and baked goods displayed on the end-rack shelves and the candy at the checkout line that do us in; vendors pay extra money to have their products placed in such prominent positions, and the foods so displayed beckon to us, even though we haven't sought them out.

In this realm of “impulse marketing,” much of that enticement takes place on a subconscious level, so we’re pretty much helpless when it comes to resisting temptation. As the authors note, “Often people regret their purchases of candies, sodas, chips and cookies. They may recognize that they were impulsive but have no way of avoiding being confronted with these goods, even if they initially went into the store seeking other products.”

And that, the authors argue, poses a big public-health problem:

Placement of foods in prominent locations increases the rate at which they're purchased; purchase leads to consumption; and consumption of foods high in sugar, fat, and salt increases the risks of chronic diseases. Because of this chain of causation, we would argue that the prominent placement of foods associated with chronic diseases should be treated as a risk factor for those diseases. And in light of the public health implications, steps should be taken to mitigate that risk.

Those steps, the authors suggest, might include developing “regulations that could govern the design and placement of foods in retail outlets to protect consumers” and “limiting the types of foods that can be displayed in prominent end-of-aisle locations and restricting foods associated with chronic diseases to locations that require a deliberate search to find.”

“Harnessing marketing research to control obesity could help millions of people who desperately want to reduce their risks of chronic diseases,” the paper concludes.

What do you think about this? Do you often succumb to the charms of prominently displayed junk food? Or are you generally able to resist those charms as you navigate the grocery store?