The History of Obesity in the United States

It is a well-known fact that obesity contributes to a slew of health problems and risks. Thus, in present day, we tend to think of being overweight or obese as unhealthy. However, this has not always been the case. Our perceptions of excess weight and susceptibility to obesity have changed significantly over the course of centuries thanks to changes in our environment and technology. This article will discuss the history of obesity, touching on the past, present, and future.

What is obesity?

Obesity is an incredibly common yet dangerous public health issue in the United States. Being overweight or obese means that you have excess fat cells within the body. Obesity has multifactorial causes, including things like sedentary lifestyle, inappropriate diet, lack of sleep, genetics, and medication. These factors contribute to weight gain, and excess weight increases one’s risk for conditions such as heart disease, diabetes, and cancer (1).

Where do we stand with obesity today?

Today, almost 75 percent of adults in the US are considered overweight or obese. Additionally, up to 20 percent of children are obese (1). These statistics are striking, but this has not always been the case. In the past two decades, the prevalence of obese individuals in the US has increased from 30.5 percent to 41.9 percent. Within the same period of time, severe obesity went form 4.7 percent to 9.2 percent (2). There are several contributing factors to this rise in incidence. The rest of this article will explore the history of obesity, explaining how we got to where we are today.

Evolution and weight

While we know obesity to be negative to your health and wellness today, from an evolutionary standpoint, this has not always been the case. In the prehistoric days, famine and disease were far more prevalent than they are today given the hunting and gathering nature of the time period. During this time, those that could store larger amounts of fat with less food were more likely to survive, and thus such individuals had an advantage in the realm of natural selection. This phenomenon manifested in cultural forms, depicted as heavier women in several forms of art. Having extra fat was considered desirable, as it communicated that an individual was well-fed and likely wealthy. Excess weight was only achievable amongst the elite and wealthy (3).

The development of agriculture and technology

As the years went on, agriculture and animal domestication became more prevalent, eliminating the need to hunt and gather to the same degree. Humans could now produce food on their own, without needing to exert as much energy and resources. Likewise, famine became less common.

Additionally, technology became more advanced, thus minimizing the need for physical labor and increasing one’s amount of time for leisure. As a result, physical activity decreased while food became more accessible, with meals available both in the home or in close proximity at a grocery store or restaurant. This shift resulted in a rise in overweight and obese adults after World War II (3).

It was not until the eighteenth century when medical professionals started to fully understand the impact of being overweight and obese. In the 1700s, issues such as fatigue, breathing troubles, and gout were documented in medical literature as risks with obesity. However, it was not until actuaries associated obesity with decreased survival where it was recognized as a true health issue (3).

The obesity epidemic has only accelerated over the last several decades due to the availability of fast food. Fast food offers a convenient option for meals that are often cost-effective and delicious, contributing to an increase in obese individuals. Likewise, the amount of calories individuals consume from fast food has increased rapidly, up to five times, over the last three decades in adolescents. Today, roughly 30 percent of children and greater than 50 percent of college students consume fast food every day. One study even found that consuming fast food was associated with abdominal obesity (4).

An individual’s environment can greatly impact one’s ability to engage in a healthy lifestyle and maintain a healthy weight.  Some individuals live in what is considered “food deserts”, where access to grocery stores are limited, leading to poorer diets and increased risk of obesity. Additionally, convenience stores may offer an alternative option, but they are more likely to sell unhealthy snacks and foods. Convenience stores are also more frequently located in lower income neighborhoods with high minority populations (5).

Another major contributor to the rise in obesity over the last several years is the use of food marketing. The Federal Trade Commission (FTC) stated that in 2008, the food industry spent nearly 10 billion yearly to market food and drink across the US. The industry targets children and adolescents in particular, accounting for 1.6 of the 10 billion. Food marketing can play a distinct role in promotion of poor diets and unhealthy habits amongst the youth (5).

These patterns have only become exacerbated with further developments in technology, particularly those used amongst the youth. Smart phones, particularly social media, offer several ways and channels for the food industry to access both children and adolescents. There was once a time where advertisements were primarily on the TV and radio. Now, they are present in just about every app available on a smart phone.

Conclusion

While obesity is well-known as a negative health problem, this has not always been the case. In prehistoric times when famine and disease were prevalent, having extra body fat was considered desirable. Early history often depicts overweight and obese individuals in art, as this was considered a sign of wealth and prosperity. Only in recent centuries have we fully contextualized the disadvantages of carrying excess weight. Despite knowing these risks, the development of agriculture and technology has made food more accessible, if not too accessible, to many. Fast food chains, convenience stores, food marketing, and more sedentary lifestyles have all contributed to the rise in obesity. Understanding how our perception of weight has changed over time, including the factors contributing to obesity trends, can help to inform how our lifestyles and environments impact weight.

References

1. https://www.nhlbi.nih.gov/health/overweight-and-obesity
2. https://www.cdc.gov/obesity/data/adult.html
3. https://www.sciencedirect.com/science/article/pii/S1548559506001066
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196377/
5. https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/food-environment-and-obesity/

Author

David J. Bauder, PA-C David Bauder, PA-C, is a certified physician assistant and the assistant medical director at Weight Loss and Vitality in Manassas and Alexandria, Virginia, Washington, DC; and Gaithersburg, MD. He enjoys helping patients optimize their physical and mental health to improve their overall well-being. He earned his physician assistant degree from the University of Texas Health Science Center at San Antonio. Afterward, he gained admission into the reputable graduate program for physician assistant studies at the University of Nebraska Health Science Center in Omaha. David has over 26 years of experience working as a physician assistant. He’s practiced in podiatry, family medicine, emergency medicine, general surgery, urgent care, and functional medicine.