Smoking incidence.

Not only is good food expensive, it's also difficult to obtain.

A couple years ago I read a fascinating article in the newspaper about "grocery dry zones" and how these dry zones are a major factor in obesity.

Large box stores need a lot of space so these stores are built on the outskirts of towns, places where a car is needed to get to. In urban areas, such locations tend to be off public transportation routes leaving those without a car unable to get to the store in a timely manner. In rural areas, the locations tend to be further out also so, again, a car is necessary to get to places which sell food for cheap. And since box stores are putting the mom and pops out of business, local access is getting more and more scarce.

Not only if the location of the super center a component of obesity, so is the inability to exercise. One needs the time to exercise. It takes an hour or two to run, work out, etc. If one is working one to two jobs the time and energy to get to the gym and sweat to the oldies just isn't there.

It used to be humans showed their wealth by being fat. After all, if you were fat then you had access to food others did not. Now, however, we show our wealth by being skinny because it shows you have the time and energy to exercise. Kinda reminds me of the video you had of the couple who worked flex schedules to be with their kids. They too seemed to exercise a lot.

Is it really poverty? You live in of the richest countries in the world, shouldn't that make the percentage of obese people in Bolivia way higher?

Just a thought

I thought Texas was the fattest state? Anyway the cost of living affects diet habits. Like in California, you know why there's less fat people? It's not cuz we're all trying to look Hollywood sexy out here. It's cuz housing is so friggin' expensive that you cannot afford to eat out all the time like folks in other parts of the country do, such as Texas. When I visited my buddy in Houston, he said that's all people do is eat out. No one there cooks.

Also, maybe having the routine of family cooking at home probably prevents a lot of poor diet habits. Unless your parents are making some really bad food every night. That wasn't the case for me growing up. I'm not a big fan of domestic gender roles, but I do think my mom and sisters' cooking kept me off "obesity."

Good food isn't necessarily more expensive. However, it's takes time and skill to prepare (cook). Needless to say, the poor may not have time, energy or inclination, for that matter, to cook after a grinding day at work. From what I see around, many people don't have the necessary skills to cook, nor do they have any desire to learn. It all comes to down to inability or lack of desire to exert energy on changing a certain behavior. Another possible culprit - ready made processed food is flooded with flavor enhancers. It's very hard to teach oneself to like the taste of real food after years, possibly a lifetime, of flavor enhanced ersatz food.
I would also say it's poverty-low education in combination with geographical location related. Say, poor villagers in India are still slim.
BMI index doesn't account for differences in muscle vs. fat weight. It's just one of the parameters that need to be used in combination with other kinds of data to make any far reaching conclusions about somebody's weight status.

I find it disheartening that Context readers still hold outdated viewpoints of obesity.

From the 5 viewpoints above: Exercise will make you thin. You will be thin by eating at home more. You have to have the "inclination" to cook, so fat people are lazy. Oh, and we eat junk food all the time.

If, perhaps, you read the blogs associated with the BMI project, you would learn that there is no way to make someone permanantly slim. The comments above about diet and exercise are important in the name of health, however, they do not make a large and drastic change in weight.

http://kateharding.net/but-dont-you-realize-fat-is-unhealthy/

@FGS: You said to look at "the 5 viewpoints above", but you only discussed four. What about smoking incidence? Do you think smoking and obesity are unrelated, statistically?

For the record, I find the BMI to be quite full of holes, but still pretty darn good as a public health measure, given how limited the scope of any public health measure must be.

Colorado regularly ranks at or near the top for states where people spend time outdoors and people are likely to engage in exercise activities such as hiking, bicycling, and running. Our major urban areas include many many miles of public hiking and biking trails, as well as transit systems that allow commuters to bike/ride and walk/ride instead of driving. Both individual and community choices add up to living spaces that encourage and reinforce the benefits of physical activity. And, yes, I know that being physically fit can result in some abnormal BMI scores, but not on a scale that would explain the proportions found in this and other major studies. BMI has its flaws as a health analysis tool, but it is one among several indicators that can be useful in comparing health among populations.

The correlation with poverty is striking. The poorest states are overwhelmingly the most obese, and the richest the least. It does take time and energy to cook good food, and poverty has a compounding effect on this, as the cheapest food in the developed world offers the most "low value" calories, with very little nutrients apart from fat and carbohydrates. The developing world is seeing a shift to cheap calories too, which is decreasing hunger (obviously a good thing) while increasing obesity. One only need look to Mexico to see the effects of this shift. The solution is to make good food available and affordable to all.

See, for comparison: http://factfinder.census.gov/servlet/ThematicMapFramesetServlet?_bm=y&-geo_id=01000US&-tm_name=DEC_2000_SF3_U_M00279&-ds_name=DEC_2000_SF3_U&-_MapEvent=displayBy&-_dBy=040

@ Breck:

With a quick search of Google Scholar, I could find only a few reports that discussed obesity and smoking. The few studies that I did find showed that smokers typically weighed less than non smokers. Can you point me to something that would show that smoking leads to obesity?

As I've often heard while in Alabama, "Thank God for Mississippi!" And West Virginia, too I guess.

I've been to Mississippi, and it's a bleak and depressing place better suited to being a giant lake or (someday relatively soon) a marine estuary. There's plenty of cable TV, barbecue, and Doritos to go around, however.

America's pseudo-food is usually a corn-based substrate on which excitotoxins and a few nutrients are sprayed (enriched!), then it's put into bright flashy packaging and pushed with extensive marketing that cost many times what the "food" did to produce. Look into 'excitotoxins' if the term is unfamiliar; sugar is better for us (or rather 'less toxic') than aspartame, for example, but the intensive marketing of chemfood (As Seen On TV!) trumps reality every time. Diabetics should still avoid aspartame like the plague that it is; if it's gotta be sweet go for stevia.

Speaking of produce, awhile back on CNN a show called "America's Killer Diet" had Dr. Gupta interview a gov. nutritional expert who said in no uncertain terms that there are not enough fruits and vegetables to feed every American according to the USDA's recommendations. So, we are basically already in a new kind of famine, or will be if everyone were to kick the junk food habit.

Responsible personal trainers will tell a new client that there are several distinct body types based on genetics, and not everyone is capable of having a fitness-model body. "Obese" is not one of those body types, however. I saw my sister slowly become obese over the years, and it was entirely due to lifestyle choices I saw her make (and we grew up in California and Colorado!). Mass is not created out of thin air, so to speak. It was a very long process of bad choices and no self-discipline. She's extremely self-conscious about it, yet she won't throw her TV out the window and get up and do something else instead.

Our bodies are built for moving all day, not pressing gas or brake pedals and compressing couch cushions, or being chained to desks for that matter. We're also not well-suited to consuming copious amounts of toxins like aspartame, MSG, partially-hydrogenated oils, etc... Add it all together and I'd say it's a remarkable testament to human resiliency that many of us live as long as we do.

I think everyone is missing the point here. It is about lifestyle, and if you have a healthier lifestyle, you can work more and make more money. I think it is important to note Alaska has a 27.3%. Alaska is far from broke, yet they don't have an economy that is dependent on working year round. I believe that when your community supports more activity, then yes, you can do that. Also, it's HOT in the South. If you worked 12 hours, then came home in 103 degrees, do you think you would want to go out and run to the gym? No, because your body feels like you just came from the gym! I am so glad this report was on a sociology based site. There are more social aspects to obesity than anything else. Just pay a little more attention. The problem with scientific studies is that we form a thesis in our head and all information pointing to that thesis is remembered, while the stuff that kinda is outside of it gets passed away. It's a natural thing to do, but we must be very careful not to. Enjoy your day!

Healthy food is not more expensive. Pound per pound, Twinkies cost more than vegetables. Some of the healthiest, most nutritious foods are the cheapest, such as beans, potatoes, and eggs. If you don't believe this, look at what your grandparents' generation ate. They received good nutrition without buying exotic fresh fruits and processed foods that are labeled as "healthy." These are the "expensive health foods" that people think of when they say that good nutrition is unaffordable. They're ignoring the fact that the raw ingredients for healthy dishes are some of the cheapest foods you can buy.

this map eerily parallels the electoral map...