Going from Starvation to Obesity

A study by researcher David Holben
in the latest Preventing Chronic Disease (never heard of it) shows that so-called "food insecure" Appalachians are more likely to be obese and have obesity-related disease.

This puzzling statement can be clarified somewhat by changing the phrase "food insecure" to "poor," in which case these results are not particularly surprising.

A total of 2,580 people participated in the Ohio University project, with 72.8 percent from food secure households and 27.2 percent from food insecure households that may or may not be experiencing hunger. That's higher than the national average: In 1999, the year the Ohio University study was conducted, 10.1 percent of U.S. households were food insecure.

Food insecurity is associated health problems such as stress, obesity, diabetes and heart disease, as well as with poor management of chronic disease, said Holben, who recently wrote a major position paper about the problem for the American Dietetic Association.


While it might be surprising that someone can be overweight while experiencing hunger, Holben explained that low-cost foods such as fast food "are lower in cost, usually are high fat and high sugar and taste good," which makes it easier for families to rely on these foods. He also pointed to preliminary studies conducted elsewhere that show that malnourishment at a young age can result in adults whose metabolism works more slowly, predisposing them for quick weight gain.

Basically, poor equals access only to the worst food on the market equals nearly inevitable heart disease and diabetes.

We have a big problem with this in our society. We have been overwhelmingly successful in eradicating starvation, but we have substituted bad food for no food. I am not sure I have a good answer on how to fix it, but I think it will involve some combination of encouraging healthier options and government steps to help make healthy food cheaper.

To bring it all into stark relief I highly recommend listening to this report by Michelle Norris of NPR. She remembers seeing pictures in her childhood of starving people in the deep South after the bottom fell out of the agricultural economy. She revisits those same places today and finds that while starvation has been solved, obesity has overwhelmingly taken over. It brings a more human side to this story.


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I'd also be interested in finding out how poverty-level jobs affect the weights of workers. I very briefly had an assembly-line summer job as a high-schooler. I usually went home completely exhausted without having had any real exercise, which seems like a concise description of a lot of poorly paid service, retail, or factory jobs. Impose that experience on someone who's a lot older than 16, is doing it for survival rather than for optional extra spending money, has no better work options, and subsists on a poor-quality diet, and there's an obvious problem.

I worry that exercise is fast becoming a privilege of people who have both leisure time and a safe place to enjoy it. If you work long hours in a job that tires you out, don't have either the money to buy good food or the time to prepare it, and live under circumstances where recreational exercise is unsafe or impractical, you'd be at considerable risk for obesity.

Any studies on this combination?