On reddit today, there was a link to an animated map of obesity trends in the United States. When some commenters expressed a desire to discover the causes for this dramatic increase over the past 20 years, neolduser posted the following paper they had written for a Social Problems class. I found it to be really interesting and it wasn’t published anywhere else on the internet, so I obtained permission to post it here.

Many people, especially conservatives with their emphasis on personal responsibility, seem to see the problem as an individual pathology. If you’re not in shape, they might say, it’s your own fault and you can fix it just as well as anyone else. Through the study of genetics, however, science has shown that we all fight a different fitness battle. It’s a lot harder for some than others. James O Hill presented a more conclusive argument for obesity being primarily a social problem. “Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase in . . . [obesity] must reflect major changes in non-genetic factors."( Hill and Trowbridge 1998)

In a study of over 12,000 members of a single social network in which individuals were surveyed repeatedly over a period of more than 30 years it was found that ” A person’s chances of becoming obese increased by 57% if he or she had a friend who became obese in a given interval, among pairs of adult siblings, if one sibling became obese, the chance that the other would become obese increased by 40% and if one spouse became obese, the likelihood that the other spouse would become obese increased by 37%.” (Tamburlini et al. 2007) It is clear that interpersonal relationships and social learning play a significant role in the spread of obesity. Micro-sociological causes include social eating, lack of group exercise, group transportation (driving vs. walking), and group popularization of sedentary recreation such as video games or tv. The same principles of social learning can be turned around, however, to promote health through group pressure to maintain an appealing body shape, nutritious social eating, athletic group activities, and choosing active recreation. If an individual finds themselves in a health-negative social network they should exert themselves to change group behaviors or, if that fails, join more positive networks such as athletic clubs and nutrition blogs, or find health conscious meal companions.

On a more macro scale our society exerts pressures on us that are inescapable no matter our immediate social network. Advertisements may not be mal-intentioned as they pressure us to consume one product over another but the net effect is simply pressure to eat more. The rising standard of living means that many households have moved to two incomes to make ends meet, discouraging in-home preparation of nutritious meals. Increasing car ownership and distance from home to workplaces makes it easy to walk very little. Available work and entertainment are trending towards those requiring sitting in front of a computer screen for much of the day. “The proportion of income required to buy food in the United States is among the lowest in the world and has declined steadily since the 1950s”(6) Much of the most readily available foods such as those found in vending machines, given out at social events and cafeterias, or found in the nearest and cheapest restaurants are the worst types of foods we can eat.

As the universality and scale of these social forces increase, so must the scope of our institution and community based responses. Possible counters include programs to bring healthier foods to vending machines and cafeterias. Norms of what foods are provided at work or in social settings can be changed bit by bit by aware decision makers. Schools and employers can encourage physical activity with PE classes or gym memberships. Employers, religious organizations or social clubs can create sports leagues or plan physical community events. Healthcare companies can provide health information and surveys to their customers which at the same time will serve their interests by lowering claims.

Depending on political ideologies as to the proper role of government in solving social problems the government can get involved as well. In fact, as Barry Popkin, a professor of nutrition, points out the government already is involved in an arguably negative way. ““We put maybe one-tenth of one percent of our dollar that we put into subsidizing and promoting foods through the Department of Agriculture into fruits and vegetables,” he says. As a result, the price gap between high-sugar, high-fat foods and more nutritionally valuable fruits and vegetables is artificially large.””(Scott Fields 2004) It is predicted that removing subsides of corn, fats, and sugars would have a negligible effect to the end consumer but the effect would be much greater if the government subsidized fruit and vegetable growers so the costs would comparatively lower for these healthier foods. Incentives could be paid to workers willing to bike to work or join a gym.

Government could also theoretically place a “fat tax” on un-healthy foods then use the revenue for the healthy food subsidies or other government sponsored wellness programs. The end effect would be less money for advertisement of un-healthy foods although that could be regulated directly as well. Laws could dictate what foods are sold in public schools. Tax deductions could even be given to people who live a demonstrably healthy lifestyle.

The lack of current political discourse on these solutions is disturbing. The obesity epidemic is a real problem but it is framed as an individual problem instead of the largely social one that it is. Either ignorance, apathy, or entrenched corporate interests are impeding these issues and solutions from being discussed in our homes, workplaces, and halls of government.

o “Center for Disease Control” 2010. Retrieved April 5, 2010 (http://www.cdc.gov/nchs/fastats/overwt.htm)

o R. Peto and Others - 4 Mar, 2010 New England Journal of Medicine Volume 362:855-857.

o Wolf AM, Colditz GA.1998 “Current estimates of the economic cost of obesity in the United States” Obesity Research 1998;6(2):97–106.

o Hill, James O., and Trowbridge, Frederick L. Childhood 1998 “obesity: future directions and research priorities” Pediatrics. 1998; Supplement: 571.

o Tamburlini G., Cattaneo A., Knecht S., Reinholz J., Kenning P., Rosén M., Christakis N. A., Fowler J. H. 2007 “The Spread of Obesity in a Social Network” N Engl J Med 2007; 357:1866-1868, Nov 1, 2007.

o Scott Fields 2004 “The Fat of the Land: Do Agricultural Subsidies Foster Poor Health?” Environ Health Perspect. 2004 October; 112(14): A820–A823