Another Cause of Obesity?

As I scanned the home page of my internet service provider one morning, I see the ‘hook,’ “Kids of Stressed, Low Income Moms Prone to Weight Problems.” As a stressed, former low income mom, I took a mental survey of myself, family and peers from the time frame studied. I soon discovered that not only is the headline misleading, but I contend that this country’s epidemic weight problem is due to more factors than income and parental stress level.

The news brief, written by Alan Mozes, reports children between the ages of 2 and 11 years old have a higher risk of being overweight if their female parent is stressed and low income. The brief is based on a study published in Pediatrics magazine September 2008 http://pediatrics.aappublications.org/cgi/citemap?id=pediatrics;122/3/e529. The report states that thirty-seven percent of the 841 children surveyed were overweight. The written survey was given to heads of households with income of 200 percent below the poverty line. The respondents reported a combination of external stress and financial difficulties. The researchers found a correlation between obesity and food security in the household. “Food security” is defined as the ability to feed all its family members three meals a day for an entire month. There was no correlation between food insecurity (the inability to feed all family members three meals a day each month), and obesity (go figure). The report then concludes that since 37% is greater than the 25% national average (they did not give this statistic, I found it in www.CDC.gov/nccdphp/dnpa/obesity/index.htm), the difference is related to maternal stress. The hook worked. I had to read the study.

The results did show a statistically significant difference in the probability of obesity- 43.7% in food secure households. Here’s the problem I had with the study:

1) I didn’t see other factors that may cause weight problems: maternal obesity, inherited disease factors, sedentary lifestyle, parental education level or number of children in each household.
2) If we concede that most parents in poverty are likely to report high levels of stress, I cannot see the correlation to obesity. Except perhaps that this age group is highly dependent on parental food choices for their nutrition.
3) There is no discussion of the increase in eating disorders in America, along with a societal need for comfort measures during stressful times- especially overeating. I’d like to see the prevalence of obesity in middle class or above the poverty level households as well.

How does this relate to bioethics? The taxpayers of the United States elect the officials who make the decisions about how the healthcare dollars for the impoverished are spent. A policy of not giving paid maternity leave, the 47 million citizens without health insurance in this country, and their dependence on Emergency Centers as their health care, are all examples of a reactive, rather than proactive approach to health maintenance in this country. Eventually, billions of Medicare and Medicaid dollars will be spent on the many complications of obesity: heart disease, hypertension, diabetes, bariatric and orthopedic surgeries to name a few. All of these costs will be the result of not combating obesity with education, and if the study is correct, assistance with stress management in parents with young children.