Environmental Influences - Why People Become Overweight: Obesity
Environmental influences
Genetic factors are the forces inside you that help you gain weight and stay overweight; environmental factors are the outside forces that contribute to these problems. They encompass anything in our environment that makes us more likely to eat too much or exercise too little. Taken together, experts think that environmental factors are the driving force for the dramatic increase in obesity.
Environmental influences come into play very early, even before you're born. Researchers sometimes call these in-utero exposures "fetal programming." Babies of mothers who smoked during pregnancy are more likely to become overweight than those whose mothers didn't smoke. The same is true for babies born to mothers who had diabetes. Researchers believe these conditions may somehow alter the growing baby's metabolism in ways that show up later in life.
After birth, babies who are breast-fed for more than three months are less likely to have obesity as adolescents compared with infants who are breast-fed for less than three months.
Childhood habits often stick with people for the rest of their lives. Kids who drink sugary sodas and eat high-calorie, processed foods develop a taste for these products and continue eating them as adults, which tends to promote weight gain. Likewise, kids who watch television and play video games instead of being active may be programming themselves for a sedentary future (see "The trouble with TV: Sedentary snacking").
Many features of modern life promote weight gain. In short, today's "obesogenic" environment encourages us to eat more and exercise less. And there's growing evidence that broader aspects of the way we live — such as how much we sleep, our stress levels, and other psychological factors — can affect weight as well.
The food factor
According to the Centers for Disease Control and Prevention (CDC), Americans are eating more calories on average than they did in the 1970s. Between 1971 and 2000, the average man added 168 calories to his daily fare, while the average woman added 335 calories a day. What's driving this trend? Experts say it's a combination of increased availability, bigger portions, and more high-calorie foods.
Practically everywhere we go — shopping centers, sports stadiums, movie theaters — food is readily available. You can buy snacks or meals at roadside rest stops, 24-hour convenience stores, even gyms and health clubs. Americans are spending far more on foods eaten out of the home: In 1970, we spent 27% of our food budget on away-from-home food; by 2006, that percentage had risen to 46%.
In the 1950s, fast-food restaurants offered one portion size. Today, portion sizes have ballooned (see Figure 4), a trend that has spilled over into many other foods, from cookies and popcorn to sandwiches and steaks. A typical serving of French fries from McDonald's contains three times more calories than when the franchise began. A single "super-sized" meal may contain 1,500–2,000 calories — all the calories that most people need for an entire day. And research shows that people will often eat what's in front of them, even if they're already full.
Figure 4: Portion inflation
Portion sizes for foods commonly consumed outside the home have increased over the years, and many experts believe this has contributed to overweight and obesity. Consider a typical fast-food meal that consists of a hamburger, French fries, and a soda. In 1955, consumers were offered only one portion size. Today they can select from multiple portion sizes. The chart above shows how all these portions compare, adjusting for size inflation over the years. Based on data from the Journal of the American Dietetic Association, February 2003, pp. 231–34. |
Not surprisingly, we're also eating more high-calorie foods (especially salty snacks, soft drinks, and pizza), which are much more readily available than lower-calorie choices like salads and whole fruits. Fat isn't necessarily the problem; in fact, research shows that the fat content of our diet has actually gone down since the early 1980s. But many low-fat foods are very high in calories because they contain large amounts of sugar to improve their taste and palatability. In fact, many low-fat foods are actually higher in calories than foods that are not low fat.
In one year, the average American adult eats 40 pounds of white bread, 41 pounds of potatoes, 30 pounds of cheese, and 77 pounds of added fats (butter, lard, and cooking oil), and washes it all down with 52 gallons of soda. True, vegetable consumption has risen by about 12% since 1990 — but two-thirds of these vegetables take the form of potatoes (including chips, fries, and mashed potato), iceberg lettuce, and other low-nutrient choices.
In all, the Department of Agriculture reports that food consumption rose by 8%, or about 140 pounds per person per year, during the 1990s. Our nation produces 50% more food than we need, and the food industry spends $30 billion a year to be sure it does not go to waste. It works: In 2001, Americans spent $110 billion on fast food, up nearly twentyfold in just three decades.
The exercise equation
The government's current recommendations for exercise call for an hour of moderate to vigorous exercise a day. But fewer than 25% of Americans meet that goal. On the other hand, more people are exercising than in the late 1980s. According to a 2004 CDC report, the percentage of people who say they do no leisure-time physical activity (such as walking, golfing, or gardening) dropped from a high of 32% in 1989 to 25% in 2002.
Our daily lives don't offer many opportunities for activity. Children don't exercise as much in school, often because of cutbacks in physical education classes. Many people drive to work and spend much of the day sitting at a computer terminal. Because we work long hours, we have trouble finding the time to go to the gym, play a sport, or exercise in other ways.
Instead of walking to local shops and toting shopping bags, we drive to one-stop megastores, where we park close to the entrance, wheel our purchases in a shopping cart, and drive home. The widespread use of vacuum cleaners, dishwashers, leaf blowers, and a host of other appliances takes nearly all the physical effort out of daily chores.
Stress and related issues
Obesity experts now believe that a number of different aspects of American society may conspire to promote weight gain. Stress is a common thread intertwining these factors. For example, these days it's commonplace to work long hours and take shorter or less frequent vacations. In many families, both parents work, which makes it harder to find time for families to shop, prepare, and eat healthy foods together. Round-the-clock TV news means we hear more frequent reports of child abductions and random violent acts. This does more than increase stress levels; it also makes parents more reluctant to allow children to ride their bikes to the park to play. Parents end up driving kids to play dates and structured activities, which means less activity for the kids and more stress for parents.
Time pressures — whether for school, work, or family obligations — often lead people to eat on the run and to sacrifice sleep, both of which can contribute to weight gain.
Some researchers also think that the very act of eating irregularly and on the run may contribute to obesity. Neurological evidence indicates that the brain's biological clock — the pacemaker that controls numerous other daily rhythms in our bodies — may also help to regulate hunger and satiety signals. Ideally, these signals should keep our weight steady. They should prompt us to eat when our body fat falls below a certain level or when we need more body fat (during pregnancy, for example), and they should tell us when we feel satiated and should stop eating. Close connections between the brain's pacemaker and the appetite control center in the hypothalamus suggest that hunger and satiety are affected by temporal cues. Irregular eating patterns may disrupt the effectiveness of these cues in a way that promotes obesity.
Similarly, research shows that the less you sleep, the more likely you are to gain weight. Lack of sufficient sleep tends to disrupt hormones that control hunger and appetite. In a 2004 study of more than 1,000 volunteers, researchers found that people who slept less than eight hours a night had higher levels of body fat than those who slept more, and the people who slept the fewest hours weighed the most.
Stress and lack of sleep are closely connected to psychological well-being, which can also affect diet and appetite, as anyone who's ever gorged on cookies or potato chips when feeling anxious or sad can attest. Studies have demonstrated that some people eat more when affected by depression, anxiety, or other emotional disorders. In turn, overweight and obesity themselves can promote emotional disorders: If you repeatedly try to lose weight and fail, or if you succeed in losing weight only to gain it all back, the struggle can cause tremendous frustration over time, which can cause or worsen anxiety and depression. A cycle develops that leads to greater and greater obesity, associated with increasingly severe emotional difficulties.
A widespread problem
Sixty percent of adults in the U.S. are overweight
One-third of American adults have obesity |
| Last updated: | June 20, 2007 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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