Despite the effort and expense that some Americans spend on losing weight, two-thirds of the population are overweight to obese. Given that the U.S. weight loss industry has topped $66 billion, there’s a clear need for better long-term solutions. Two key groups could play a bigger role in helping people manage their weight: primary care doctors and mainstream food makers.

Roughly half of American adults are unhappy with their weight, according to a new study by Ipsos on behalf of MDVIP. Two in five of those surveyed are currently on a diet or trying to maintain their ideal weight. While most U.S. adults say they know how to eat right, more than half flunked a Fat IQ test of their dietary knowledge as part of the survey. Just 2% got grades of 80% or better.

It’s not that people don’t care about their health. Two-thirds of Americans say they are most motivated to diet and exercise for their long-term health. Even more people say they would feel better if they tried harder to stay in shape. But two in five people say they’ve yo-yo dieted and gained back the weight they lost.

Americans’ new normal

Given the prevalence of weight problems, “that’s the new normal,” says Kevin Nielsen, a senior vice president at Ipsos. He can relate to the challenge. Nielsen developed a dad bod and then went on the popular 21 Day Fix diet. He ended up in what he says was the best shape of his life. He’s also stuck with it. “It’s true that it only takes three weeks to form a habit, and many people have converted to a healthier lifestyle,” he says. “But in the instant gratification culture that we live in, there are people who look for a quick fix and grow impatient and resort back to their usual habits when results are not immediate.”

A big part of the problem is motivation. About six in 10 people say life is too short to always be watching what they eat. That’s helped to fuel programs from The Whole 30 to Weight Watchers that market clear, easy-to-use eating plans. Four of five people say hearing from a doctor that they need to lose weight would influence them. But just one in five have asked their primary care doctor for help.

Accessibility may be a factor, according to J. Graham Thomas, co-investigator with the National Weight Control Registry. It tracks 10,000 individuals who have lost 30 pounds and kept it off for at least a year. He says the health care system doesn’t support people consulting their primary care doctor about diet. At the same time, he acknowledges the popularity of branded weight loss plans. “There’s something appealing about having very clear instructions and having a time limit on it,” he says. “It may be more intimidating to think about changing your diet for the rest of your life.”

Like with healthcare, Americans are choosing alternate food options to improve their diet. Nielsen says that the big food companies face a difficult decision between staying with what they know and venturing into new, unfamiliar segments. “We’ve seen several big players in the industry choose the acquisition route to add proven ‘on-trend’ fresh and upstart brands to their portfolios.”

Food makers as behavioral change coaches

In addition, food brands can help promote behavioral changes, says Tamara Janoscik, a senior vice president at Ipsos. “If food manufacturers want to be a partner in consumers’ health journeys and build engagement with their brand, they could develop an online community where members can share pictures of healthy meals or snacks, ‘sweaty selfies,’ etc., and earn recognition from their fellow community members,” she says. “This rewards the process of becoming healthy and offers immediate gratification on the way to the long-term reward of good health.”

“Another strategy is to identify trends in health food by listening to consumers for what’s the next kale or quinoa and then bring it to the mainstream,” she says. For example, people are currently buying nutritional yeast in bulk from specialty and health food markets, she says. But the cheesy-tasting flakes “could be packaged and positioned as a popcorn topper and branded by a snack maker like the way large CPG manufacturers have made quinoa a mainstream side dish,” she says. “This approach brings health-forward foods to the mainstream in a way that is easy and accessible to consumers.”