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Environmental Causes of Obesity

The last three decades have seen obesity transform into a pandemic of sorts. This has further translated into a heavy burden of human deaths and costs that end up being borne by the tax payer. We know that obesity is a multi-factorial condition, quite far from the simple calorie-in calorie-out model most tend to believe. Can our environment too contribute to unwanted weight gain? How do our environments encourage obesity?

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How does an environment encourage obesity?

The environments we live and work in can easily do two things:

  • Encourage high energy consumption
  • Discourage physical activity

An environment that encourage factors that influence obesity can be called an ‘obesogenic environment’, which is further defined as, “the sum of influences that the surroundings, opportunities or conditions of life have on promoting obesity in individuals or population”. ​1​

In this context, there are two types of environments: ​2​

  1. Built environment
  2. Food environment

Built Environment

Per Wikipedia, “In urban planning, architecture and civil engineering, the term built environment, or built world, refers to the human-made environment that provides the setting for human activity, including homes, buildings, zoning, streets, sidewalks, open spaces, transportation options, and more.”

A built environment can be said to have three components:

  1. The actual physical design
  2. The designated pattern for land use, such as residential, commercial etc.
  3. The transportation systems available in the area

All three together influence how much physical activity we generate as an outcome of living in that environment. For example, an environment that encourages residents to walk in order to reach local shops and to use public transport where possible. Compare this to the drive-in window in fast food environments that try and eliminate all possible barriers between a person and their burger, including all forms of physical activity, such as the simple physical act of parking a car and walking over to the counter to pick it up. ​3​

Population density is an important factor in this scenario, as the success of mass transport facilities among other similar infrastructure elements depends on this. Additionally, land use patterns and urban sprawl have also been positively identified as influences of adult weight status. ​4​

In fact, back in the 1960s, links were observed by certain US theorists, between suburban development and health issues, especially mental health problems related to isolation, alienation and dysfunctional family life. Since then, an entire body of evidence has been built, that illustrates links between the built environment, physical activity, obesity and chronic disease. The example of two neighborhoods in San Diego is particularly enlightening; the walkable one, i.e. one were residents were encouraged to walk based on the inherent design of the facilities, had 35% overweight folks, whereas the one that was less walkable had 60% overweight residents. The built environment matters and does play a vital role in our health and wellness. ​5​

Food Environment

Swinburn et. al., 2013 define a food environment as, “The collective physical, economic, policy and sociocultural surroundings, opportunities and conditions that influence people’s food and beverage choices and nutritional status.”

What this concise and yet wide definition refers to, is the ultimate environment that results from a number of input from different sources. These inputs include:

  • Is healthy food available to me as a choice, from the perspective of stocking at home, availability in close-by stores, stocking in my workplace and more?
  • Can I afford to buy healthy food, as a function of the cost of the food itself and my income?
  • Is healthy food in general more expensive or cheaper than unhealthy food, as a result of economic and commercial policy?
  • Does my culture tend towards healthy or unhealthy foods?
  • Do my immediate environments, including work and family, encourage the consumption of healthy or unhealthy foods?
  • Do my immediate environments, including work and family, encourage the healthy consumption of foods in general? For example, an environment that encourages main meals as opposed to one where snacks are constantly served all day.

The food environment is also impacted by different factors that seek to influence the manner in which we consume food, i.e. agencies that work towards public health goals and entities that work towards increasing their own profits. A prime example, is the instance of the food industry spending US $500 on promoting processed foods, for every $1 spent by the World Health Organization to improve nutrition. These numbers are from 15 years ago and are likely to have gone up since then. On the same lines, as per the 2003 Advertising Statistics Yearbook, GBP 15.2 million was spent advertising confectionary, as opposed to GBP 2.8 million on fresh fruit and GBP 1.2 million on fresh vegetables. ​6​

The answers to the questions above go into the make up of the food environments we exist in, which ends up impacting the kind of food we consume, the frequency of consumption and more.

Conclusion

While obesity can quite reasonably be termed a physiological phenomenon on different levels, there is no doubt that our built and food environments undeniably impact the many variables that ultimately cause obesity. If you’re looking at losing weight, apart from examining your own habits, remember to hold your environments accountable as well.

References

  1. 1.
    Swinburn B, Egger G. Preventive strategies against weight gain and obesity. Obesity Reviews. Published online November 2002:289-301. doi:10.1046/j.1467-789x.2002.00082.x
  2. 2.
    Lake A, Townshend T. Obesogenic environments: exploring the built and food environments. J R Soc Promot Health. 2006;126(6):262-267. doi:10.1177/1466424006070487
  3. 3.
    Townshend T, Lake A. Obesogenic environments: current evidence of the built and food environments. Perspect Public Health. Published online January 2017:38-44. doi:10.1177/1757913916679860
  4. 4.
    Mackenbach JD, Rutter H, Compernolle S, et al. Obesogenic environments: a systematic review of the association between the physical environment and adult weight status, the SPOTLIGHT project. BMC Public Health. Published online March 6, 2014. doi:10.1186/1471-2458-14-233
  5. 5.
    Hobbs M, Radley D. Obesogenic environments and obesity: a comment on ‘Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England.’ BMC Med. Published online March 18, 2020. doi:10.1186/s12916-020-01538-5
  6. 6.
    Julien Vandeburie. Millstone E. & T. Lang (eds.), The atlas of food. belgeo. Published online September 30, 2005:408-409. doi:10.4000/belgeo.12355

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