Sunday, August 29, 2010

Obesity and income (part one). Did the Stepford Wives have it right?

First of a two part posting, observing the topic of obesity and weight control at two very different ends of the economics spectrum.  This week:  affluence and attitudes toward weight loss.  Not being either judgmental or instructive here, just making a few observations on this endlessly fascinating topic...

What is the relationship between obesity and income?  From a broad macro perspective, obesity is a - pardon the pun - mass issue.  There are 1.6 billion adults around the world who are overweight and another 400 million who are obese (i.e., BMI > 30).  The World Health Organization is forecasting this number to increase to 2.3 billion overweight by 2015 with more than 700 million obese.  This would suggest that obesity affects most people, not just poor or wealthy people.  Further to the point, in the early 1970's in the US:
  • 21% of people below the poverty line in the US were obese
  • 12% of people who were 2X above the poverty line were obese (i.e., 8 percentage points lower)
In the period of 2001 to 2004:

  • 35% of people below the poverty line in the US were obese
  • 31% of people who were 2X above the poverty line were obese (i.e., 4 percentage points lower)
In other words, the obesity gap between poor and less poor over the past 30 years appears to have narrowed.  Sadly, obesity has become more of an issue for most people.

If all this is true, what's the deal with the town I live in?  Herein lies today's blog topic.  Affluent people and their weight.

First off, a little public disclosure is in order.  I didn't grow up in a town like the one I live in today.  I grew up an extremely middle class kid with a father who was a lifelong basic research chemist for the US government (National Bureau of Standards and then Department of Energy).  His was a noble calling, but hardly a lucrative one.  That said, I didn't grew up poor either.  As a result, the lives of people who had little and people who seemed to have everything was always an abstracted reality to me.  It was something I could read about, but never knew personally.

My first exposure to wealthy people was in college when I was fortunate to get accepted to Duke University (I am still assuming as the result of a fortunate clerical error).  Since that time, I've worked hard and had more than a little good luck.  I consider myself extremely fortunate to have the job that I have and to be able to provide the life I can for my family.  Said differently, I live in a town in Fairfield County, CT.

My town in Fairfield County, CT is part of what has been historically known as the Gold Coast of CT.  This stretch of towns along Long Island Sound (Greenwich, Stamford, Darien, Westport, etc.) is filled with people who commute back and forth to largely well paying jobs in NYC.  I live in a place where affluence and abundance is largely the norm.  There are obviously many places like it across the country, so what I say about my town would certainly apply to both upscale bedroom community and fancy urban setting alike.

From an anthropological observation perspective, living in my town is fascinating, particularly as it relates to my job.  Why?  Most people who live here are thin.  In the case of my town, they are also mostly blond (real or otherwise).  They dress well (depending on how one feels about whale pants), and they drive nice cars.  But I'm always struck by the observation my parents made when they first visited me here 10 years ago:  "where are the heavy people?"

It is telling that the original version of the Stepford Wives was filmed in a Fairfield Count town.  Maybe all the heavy people of my town were replaced by robots?  More likely, I would attribute the thinness of my town to the metaphorical lesson from the Stepford Wives:   peer pressure plays a massive role in how we live.  In my curious town, it seem that it's just expected that one be thin.

There is a research basis for all of this.  There have been a number of ground breaking research papers exploring the role of social networks and obesity based on the findings of the epidemiological data from the half-century and counting Framingham Heart Study.  This research showed how close relationships between people, particularly women, can predict incidence of obesity.  If most of your close friends are obese, there is a good chance you will also be obese, even when controlling for other factors such as income.

As I look around my town, it seems the opposite is also true.  If all your friends are skinny, you want to be skinny too.  There is an old expression/truism that women dress for each other,  not for their spouses.  If one lives in an affluent town, one wants to be able to rock a Chanel dress because one's friend can rock a Versace dress (in the case of Fairfield County, maybe the a Lily Pulitzer dress).  It's how affluent people maintain a sense or order in their community.  In the case of my town, the affect of peer pressure seems to be an issue for virtually all the women and maybe 10% of the men -- it seems that golf fashion does not require an innate level of fitness or thinness.  Even the women of my town who do not count themselves as "thin" are frankly completely healthy from a BMI/health risk factor perspective.  Most of the women who live in my town are way beyond worrying about weight for health reasons.  Looking good and feeling accepted is the driving consideration.  I suppose in this sense, Fairfield County, CT is no different than the upscale parts of Manhattan, LA, San Francisco or Dallas, TX.

Again, I'm not judging this kind of motivation as good or bad.  I'm merely making an observation.  From my personal point of view, health and well being has always been by far the biggest reason to drive toward a healthy lifestyle.  It is what gets me motivated to come to work each day.  Yet, vanity and acceptance have played a role (for better or worse) when it comes to weight management for decades.  

There are of course, the extremes.  From Bonfire of the Vanities, Tom Wolfe did an excellent job describing and categorizing what he called the Social X-Ray woman (Urban Dictionary definition:  a very thin/anorexic female socialite).  I recently heard a new label for it:  the lettuce and Chardonnay crew.  It is a lifestyle of perpetual hunger, combined with hard hangovers resulting in a certain base level of harshness in social interactions.  From what I can see this is much more stereotype/anecdotal than reality, even in my crazy little town.  Most of the women I know in my town seem to strike a reasonable balance.  They are definitely careful, but they haven't gone off the deep-end.

So what defines the lifestyle of a woman in my town?  First off, they workout like convicts.  They scoff at the US Physical Fitness Guidelines of 150 minutes of moderate activity per week.  This crowd does a brisk business in yoga, pilates, spin classes, bootcamp death classes, personal training, tennis, etc., etc., etc.  They pretty much work out every day, and they often workout hard.  They are competitive and intense when it comes to their exercise, and they take no prisoners.

From a food perspective, they eat 90% clean.  Fish, chicken and salads are their mainstays.  They watch their portion sizes (even when they claim to be gorging -- "I ate a whole sandwich!  I'm so bad!").  They keep their deserts in check.  Just a few years ago, we had people in town with "Bring Whole Foods!" bumper stickers (a few eventually came).  If they have one source of caloric vice, it's probably in their wine.

Again, is this bad?  It's easy to make fun of this crowd ("Eat a sandwich!"), but allow me to re-characterize their lifestyles:  they exercise a lot and they watch what they eat.  Not a bad way to go as long as not taken to the lunatic (and potentially dangerous) extreme.  In fact, if the entire country exercised a lot and ate clean, we would not have the runaway train of rising health care costs.  Obviously, I fully recognize that affluent communities have access to any and all of the resources to help them stay on a healthy lifestyle.  Gaining access to healthy choices is a much more difficult process for the great percentage of society, and it borders on nearly impossible for the impoverished portion (see next week...).

One interesting possibility from this little anthropological survey is the hope that adopting a healthy lifestyle could become a population-wide trend.  A moderate amount of peer pressure to make healthy choices could help.  I'm not advocating for a nation of Social X-Rays and Hollywood celebrities.  I'm advocating for a society where people take a vested stake in their own health.  What if healthy became fashionable and the thing to do?  I'm also not advocating where peer pressure is used as a stick or source of punishment.  A balancing act is in order, and focusing on healthy choices, not six pack abs is a good place to start.  

What about me?  I exercise all the time, and I also try to eat clean.  I go for the salad (dressing on the side thanks!), not the steak.  I kind of like to buy pretty clothes (flat front trousers rule!).  Holy smokes.  Have I become a Fairfield County mom?  Well, one male friend has started calling me Skinny Bitch (SB for short).  If I can be healthy and fit as a result, I'm OK with that kind of teasing.

Next week:  Part 2.  The very real (and obviously much more important) issue of obesity and poverty.




  1. Your message is clear--exercise more, eat less, but Weight Watchers is about being accessible to the average person, which this lifestyle you discuss is not. Having all the time in the world, all the money needed to hire trainers, join clubs, consult nutritionists, and not work is simply not a reality to most. We need tools to help us eat right on a budget, exercise when we have less than 30 minutes a day to do so, and an education that helps us understand that often the cheap foods are the ones that make us obese.

    I applaud your blogs--I enjoy them thoroughly. I hope the next part of this blog brings light to the other side of the story, the struggling family having to make poor food choices to survive.

  2. Susan, I couldn't agree more! Weight Watchers is indeed an affordable service intended for all (!). You are right in guessing the direction I'm going in my next post (it's the stuff you are talking about).

  3. I've never considered my surroundings as my motivation to lose weight, but I think you might be opening up a new world of thought for me.

    When I moved to Manhattan in 2007, I found it terribly hard to get around. Depending on my morbidly obese body to carry me from point a to point b to point c was so daunting for the first few weeks. And taking the subway was just as intimidating because the speed of the traffic in the stairwells was much more intense than I had ever experienced.

    Fast forward to 2009...I began losing weight. I joined WW and made exercise part of my daily lifestyle. I walked with purpose rather than just walking. And I joined New York Sports Club because it was close to home - and because that's where my friends went.

    I used to wish I could rock workouts on the elliptical when I saw other girls doing it, and now I do. And with well over 100 pounds lost now, I've begun to try trendy classes because it's so much fun to say "Yeah, that spinning class was insane today," etc.

    Wow...I can't believe I have never considered my environment when trying to answer the big question...what finally made you change your lifestyle?

    I still have a long road ahead, but I love being at the gym - as long as my gym outfit is cute-ish. It seems I am a little more vain than I realized, but if these changes keep happening as a result, I'm fine with it.

  4. David,

    I think you've got a great point here. Peer pressure is a huge motivator when it comes to losing weight. I started on my WW journey just over a year ago. 90+ pounds later, I've recruited three of my colleagues to WW, corralled several others to try out "my" meeting (the one I attend on Sunday mornings), and I believe the one reason they've all been so receptive and motivated is because they've seen my results. I couldn't have done it without all the folks at my meetings.

    The down side, of course, is the fact that one person's lifestyle is not going to work for others. I'm very good at following schedules, and building routines. I work full time, I'm a mom of a child who has some special needs, I volunteer for school and town government, and as such, I don't have the time or resources that your neighbors do. A 30-minute workout a couple of times a week for me is a luxury, not a chore. And for some of my friends, they haven't seen the success I have, because they don't have the same kind of regimented a schedule as I do. It helps that your neighbors all have similar lifestyles.

    But even with my very full and busy days, I've had success losing lots of weight on WW. Why? Because I've identified MY compelling reason, too. Your neighbors' compelling reason is to keep up with their peers. Well, mine is a little bit different -- it's to ensure that I'm alive and healthy to see my son get through high school and college, and grow into a successful adult.

    Is one goal more valid than the other? Nope. Is peer pressure somehow less meaningful than overall health and longevity? Not if it works. We're all in different places in our lives, and we all have our priorities. Would I enjoy having the luxury to participate in yoga, pilates, and ladies' lettuce lunches? I suppose, but I surely wouldn't give up what I have now to do it. :-)

    What it all boils down to -- and this is one of the most valuable things I've learned from my leader -- is "why". Why is it important to you to be at a healthy weight? What is it that's going to change in your life when you get there? Whether it's peer pressure or better career prospects or health and longevity, I think the secret is to cleave to that one thing that works as *your* motivator. Not just a pair of skinny jeans, but where your new body will take your life.

  5. Being able to afford Lipo can't hurt either...

  6. Eating healthy is expensive. I don't buy junk food so when we have to cut corners the first things to go are fresh produce. From there it goes to homemade bread, beans, meat only if it is on sale, canned goods and pasta (the cheap kind not the whole grain version). Add to that the stress of having to cut corners a little emotional eating and voila.

  7. Thank you so much for sharing it.
    Mostly people use the bathroom scales in order to keep track of their body weight and this way they are able to control it perfectly

    Bathroom Scales

  8. I really enjoyed this post, and I will be interested in the next one as it will speak to the issues in the city where I grew up and still work. I have been on WW for almost a year (this time), and was doing quite well until summer. Now, I've gained some weight back. I think that Kerri makes a good point in that you have to have "your" motivator and you have to stick with that. I've lost my motivation, but now I want to get back on track! And, maybe, as Kenz said, some cute workout clothes are in order as part of that motivation!

  9. seeing an even slightly "heavy" person in our gym is akin to a Bigfoot sighting!(often with the same assumed reaction:mild shock)...i have been told i was "representin' the curvy women in the gym" by a member that i have never seen 5'8" and 135lbs i am the Delta Burke of the gym!That being said, Catherine deneuve once quipped that at a certain age a woman has to choose between her ass and her face.(obviously this was a pre-restylane era)i think 99% of the members have a healthy obsession (and it's great socially in a sorority type vein)...i enjoy my normal healthy bmi but have also observed if i fluctuate on the lower side of curvy the more populated my classes become!emma ps ReAL MEN dO PILATES!!!!!

  10. You know, I always thought that peers and in general one's environment has a lot to do with one's weight and the way we look at ourselves. In my younger years my career was in elementary and special education... and I always noticed how, at least the part of the world that I saw, that there was a big tendency for people who care for others, to be overweight or obese! Social workers, nurses, educators... and strangely enought, many people who work on the radio also have this tendency -- again, in what I have observed. After moving on and now having been in the corporate world for over 12 years, this is a whole different story. People try to watch their weight, try to excercise, although you do see some overweight people but not like in the other professions.