The Italians are not only slimmer than we are, they're thinner than most other Europeans (including Spaniards and Greeks). Let's take a look at comparative behavior between Italy and the US to get an understanding of this.
-Italian food is better than American food. This is also true of authentic French, Chinese, and Japanese cuisine-and these populations are also slim. Quality over quantity.
-Italians are on the average better cooks and have more extensive food knowledge. In particular, they are much more skilled with a variety of vegetables and herbs than we are.
-Italians eat smaller portions.
-They take more time eating and eat less in informal settings- at the desk, in front of the TV, at the wheel.
-They snack less. A lot less.
-They consume less sugar- even their pastries and desserts are less sweet.
-They eat less meat than Americans. Meat is often an ingredient and not a main dish.
-They eat more fruit than we do. This allows them to feel fuller with fewer calories and more nutritional value.
-They drink a lot less soda and a lot more water.
-They drink less hard liquor and they drink less outside of meals.
-Despite what you've heard about breakfast being the most important meal of the day, neither the Italians nor the French are big on it.
-They eat out less, they use delivery and take-out less, drive-through is rare, they use convenience foods and microwaves less, they go to fast food places a lot less.
-Italians drive less than Americans. This is also due to the layout of their cities and towns, and the shorter distances between places.
-Italians are less sedentary than Americans. This is not so much a matter of gyms and sports as a matter of moving more in a variety of life activities.
-They are among the most fashion-conscious, along with the French, and this goes with being slimmer.
-Many Italians will disagree, but life is generally less stressful there, and there is less nervous eating.
-Marketing and the food industry is not as insidious as it is here, for example, candy and chips are not found at every check-out counter. There are fewer vending machines.
-There is a higher level of social control in Italy and a greater stigma attached to being overweight, and especially to being obese. I don't see the Italians taking up the Fat Acceptance thing anytime soon. Or ever.