Obesity is a global epidemic. The World Health Organization now places it as the world's leading non-communicable disease, ahead of even diabetes or cancer. And Americans are more obese than most.
Generally speaking, people believe that either genetics--if your mom or dad was obese, then you're likely to be as well--or personal choices are to blame. Most obesity researchers--and most diets--focus nearly exclusively on the individual and the daily food choices each of us makes.
New, fad diets or efforts to limit what we eat and drink make news constantly. New York Mayor Michael Bloomberg's efforts to limit the serving sizes of sugary sodas to combat obesity, for instance, drew constant ridicule from Jon Stewart at the Daily Show.
But what if it's considerably more complicated than that--and what if we're missing the collective forest for the trees?
David Kessler, in his New York Times best-selling book The End of Over-Eating, proved that nearly every large, multinational food processing company has known for years that marketing was successfully driving food consumers toward processed food that was almost certain to make them more obese.
Now, a new study in the journal Scientific Reports by researchers at the City College of New York has shown something rather remarkable: The environment in which we live may be even more important than either genetics or our individual food choices in determining the prevalence ofobesity.
Basically, the CCNY researchers found direct correlations between the obesity epidemic's geography in the United States and food marketing and distribution patterns.
Using county-level data provided by the U.S. Centers for Disease Control for the years 2004 to 2008, here's what they found: In certain parts of the United States, where there was greater opportunity and access to plentiful food and where marketing introduced them to a food economy--a high density of restaurants, bars, package stores, supermarkets--the obesity epidemic grew the most. It literally tracked the growth of the so-called supermarket economy.
"We found there is a relationship between the prevalence of obesity and the growth of the supermarket economy," said one of the study's lead researchers, New York physicist Herman Makse. "While we can't claim causality because we don't know whether obesity is driven by market forces or vice versa, the obesity epidemic can't be solved by [just a] focus on individual behavior."
The CCNY researchers studied the spatial patterns of the spread of obesity across the United States and concluded that "collective behavior" in certain areas was more responsible for the spread of the epidemic than either genetics or individual choices.
Because public health studies of the prevalence of other non-communicable diseases show "spatial clustering"--that such epidemics have "hot spots"--the researchers hypothesized that the spread of obesity might likewise show "high susceptibility to social pressure and global economic drivers."
In other words, they theorized, environmental factors might just be more important than anything else in determining the spread of the obesity epidemic--which would mean that Mayor Bloomberg is on to something.
And the CCNY researchers did, in fact, find such hot spots--places where a rapidly growing supermarket economy and an increase in food marketing led to a rapid increase in obesity. The two largest clusters of the obesity epidemic spread (spanning distances of 600 miles or so) were in communities along the Appalachian Mountains and in the lower Mississippi River Valley.
Makse said that the CCNY research team believes it showed a direct correlation between demographic and economic variables and the spread of the obesity epidemic--that areas with above-average concentrations of food-related businesses and marketing had higher-than-normal prevalence of obesity.
In short, poor communities that saw a surge in food economies and marketing saw a corresponding increase in obesity.
The CCNY research could pave the way forward for new public health approaches on obesity. Heaven knows, we need something, because no prevention strategy anywhere in the United States has worked yet.
It's fine that shows like The Biggest Loser on NBC inspire us and make us aware of the hole we've dug for ourselves. But until we recognize some of the root causes of the epidemic, we may be doomed to constant and endless failure in our efforts to keep our collective waistlines, as well as a host of obesity-related health problems, under control.