In a nation where obesity is the second-leading cause of death, 33 million Americans don't know where their next meal is coming from -- a year-round paradox that only becomes more pronounced during the holidays.
Esther Ramos, 30, may not fit the image of a hungry person. Looking somewhat stout under her winter coat, she was among several dozen people waiting in line on Thursday morning at a food pantry in New York, where up to three days' worth of meals are handed out for free.
Ramos comes to the West Side Campaign Against Hunger food pantry once a month. She said that although she has a job, it is still a struggle to put food on her family's table.
"I need this food to have Christmas dinner," said Ramos, joined in line by her three children, ages 4, 8 and 12.
Experts say what is striking about America's hunger problem is that so much of the country -- two-thirds of the population, according to the federal government -- is either overweight or obese.
"There's no getting around it. It's a paradox," said Parke Wilde, a food economist at Tufts University School of Nutrition Science and Policy.
Faced with figures from the U.S. Centers for Disease Control and Prevention that show some 400,000 Americans die annually from health problems linked to poor diet and physical inactivity, Health and Human Services Secretary Tommy Thompson warned this year that extra bulk is "literally killing us."
Americans have taken the battle of the bulge to heart. Some 50 million of them will spend more than $30 billion on weight loss products this year, but only about 5 percent will succeed in keeping the weight off.
In image-conscious America, thousands battle eating disorders like anorexia and bulimia, while others who can't afford three square meals a day opt for cheaper junk food, which is ubiquitous.
"Fresh produce is more expensive than junk food. Fresh fruit and vegetables are harder to get than junk food," said Ertharin Cousin, chief operating officer of America's Second Harvest, the nation's food bank network.
The U.S. Department of Agriculture pegs the number of "food insecure" Americans -- its term for hungry people -- at 11.2 percent of the population, or about 33 million. Washington hopes to cut that ratio to 6 percent by 2010.
Ramos represents what experts say is a growing segment of America's hungry: the working poor.
Jan Pruitt, executive director of the North Texas Food Bank, said the U.S. hourly minimum wage of $5.15 is a major obstacle to proper nutrition.
"They just can't pay the rent and put food on the table at $5.15 an hour," Pruitt said.
Hunger doesn't end with the holidays, although food donations do trail off, according to food pantry officials across the country.
"The issue of hunger comes off the plate right after Thanksgiving," said Pruitt. "Helping the needy becomes all about toys. But hunger is a year-round problem."