Why Do People Get Fat? The Answers Aren't All That Simple

Poverty and race are factors—but not always, as new data show.

obesity in the usa

(Photo: Brendan Mcdermid/Reuters)

Steve Holt writes about food for 'Edible Boston,' 'Boston Magazine,' 'The Boston Globe,' and other publications.

Obesity is such a touchy subject. As individuals, we are obviously super-sensitive about our weight. The messages we too often receive communicate to us that thin equals beautiful, and many of us take this to heart.

On a macro scale, the reasons why we weigh what we weigh can be just as touchy. Some would simplify the cause of obesity to a problem of “eating too much.” Others blame external factors such as socioeconomic status, race, and neighborhood environments. A prevailing line of thinking in recent years is that low-income individuals of color are far more susceptible to obesity, a perceived problem many policies and programs have been instituted to address.

The truth about obesity’s causes, though, is much more complex than that.

Take the recently released report and graphics by the Pew Research Center, which, ironically, many Americans likely missed because of its release during the run-up to our nationally sanctioned Day of Gluttony, Thanksgiving. Distilling data collected in the National Health and Nutrition Examination Survey between 2005 and 2008, the Pew study throws more than a few wrenches in the conventional wisdom that obesity is primarily a problem of the poor.

For one, while it is true that the likelihood of obesity goes down as women’s income goes up, the opposite is true in men. Of men surveyed—and the process included weighing Americans and recording their body mass index—29 percent of men making less than 130 percent of the poverty level were obese, compared with 33 percent of men making equal to or more than 350 percent of poverty-level wages. While men with incomes between 130 percent and 349 percent of the poverty level had a slightly higher obesity rate—34 percent—than the other two categories, the data still contradict the myth that “poor equals fat.”

In men of color, the common beliefs about obesity are especially inverted. Close to 45 percent of black men earning at the highest levels are obese, compared with 29 percent earning less than 130 percent of the poverty level. Among Mexican-Americans, 41 percent of higher-income men are obese, while obesity is 30 percent among men earning less.

Cornell University economist John Cawley, who researches the economic causes and consequences of obesity (and works toward treatment and prevention), attributes this phenomenon to what some have dubbed “the portly banker effect.” In other words, a bit of extra poundage may be seen as a sign of success in men. But only in men.

“Women don’t have the same luxury,” he says. “That extra weight doesn’t send the same signal.”

For women, the data clearly show a correlation between lower incomes and obesity across all races. What isn’t clear, Cawley points out, is why.

“Is it that people who grow up poor are more likely to be obese?” he asks. “Or is it that heavy women get paid less?”

Women who are overweight or obese earn less in the workplace than women who are at “normal weight,” Cawley has found. He says that while the health of obese female workers may have some effect on their overall wages, because weight-related problems can cause them to miss work, discrimination from bosses plays a part, “without any reasonable doubt.”

But what is behind the staggering data showing that men of color earning more are more likely to be obese? To find out, Cawley said research would have to control for external factors such as neighborhood—something the NHNES study didn’t do. Urban neighborhoods populated by families of color, for instance, typically have fewer supermarkets and other sources of fresh food.

Whatever the reasons, the lesson we should take from the latest research on obesity, income, and race is this: Obesity is a problem that affects all of us, not just the poor. Any effective public health solution will have to incorporate an overall cultural shift in how we view health and nutrition rather than focusing on targeted fixes for so-called food deserts.

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