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)
- 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)
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?"
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.