Unprotected sex, drinking and driving, smoking — all behaviors with potentially deadly outcomes — have been the target of major public awareness and ad campaigns aimed at prevention.

Maybe the same should be done for the behaviors that lead to obesity, suggests Bruce Greenstein, secretary of the Louisiana Department of Health and Hospitals.

“We haven’t linked consequences to obesity,” Greenstein said at the Childhood Obesity and Public Health Conference held recently at Pennington Biomedical Research Center.

“I think the obesity issue has been studied phenomenally,” he said. “There have been many attempts to try to address this, all noble causes.”

But with Louisiana sitting in the middle of the country’s “obesity belt,” with more than 30 percent of its adults overweight and close to 48 percent of its children overweight, “We’ve been too soft” about the seriousness of the issue, he said.

Greenstein spoke Wednesday at Pennington’s fourth annual conference on childhood obesity and public health, an event that every year draws together professionals including doctors, nutritionists, exercise specialists, educators and others to tackle the issue of obesity.

“We set the table and serve the food in schools,” he said of families and professionals.

Greenstein said he was once taking a tour of a Louisiana hospital with the hospital’s chief executive officer, when they visited the emergency room — and saw the lunch being served to the patients there: fried chicken, mashed potatoes and a white roll.

He said he put his arm around the CEO’s shoulders and asked, “My friend, what are you doing?”

Hospitals and schools all over the state should be a beacon for healthy food, Greenstein said.

It’s time to stop blaming TV, restaurants and the food production industry, he said.

Instead, it’s time to take up the issue of personal responsibility.

“The message of increasing personal responsibility, through education, has been weak,” Greenstein said.

A study by the Centers of Disease Control of youth during the years 1991 to 2007 shows that “people are actually becoming more responsible,” he said.

On the behavior issues of engaging in unprotected sex; driving without a seatbelt; using alcohol and riding with an impaired driver, the trend was that youth during those 16 years were involved in less and less of those behaviors, Greenstein said.

Much of that is because of heavy public awareness campaigns showing “real consequences of poor decisions,” he said.

He showed one particularly riveting anti-smoking ad: as a parade rolls through a downtown, bystanders are aghast to see one colorful float manned by people in hospital gowns showing the ill effects of tobacco use. Some are on oxygen tanks and some have disfigured faces, apparently due to surgery related to tobacco-related cancer.

While smoking is still a major problem, “fewer kids” are smoking now, Greenstein said.

Greenstein said he’s seen only one such TV ad campaign devoted to changing behavior related to obesity and it’s being shown in Georgia.

“It’s the first set of ads that I think speaks to this problem in a respectful way, yet an honest way,” he said.

In one ad, a young teenage girl faces the camera and says, quietly, “The doctor says I have hypertension. I’m really scared.”

In another, an overweight woman and an overweight boy about age 10, enter a room from separate sides and sit down in metal chairs, facing each other.

“Mom, why am I fat?” asks the child.

“Personal responsibility hasn’t failed. I just think we haven’t done it yet,” Greenstein said.

One of several initiatives the state Department of Health and Hospitals will be launching in the coming months is a website, called “Living Well in Louisiana,” that will provide online toolkits that individuals and businesses will be able to use to improve their health status, Greenstein said.

The department also plans to launch a comprehensive, statewide action plan to coincide with Pennington’s November release of its “2011 Louisiana Report Card on Physical Activity and Health for Children and Youth,” he said.

Making real change “is about every single individual making a true effort to combat obesity. People have to do it; individuals have to do it,” he said.