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APHA Scientific Session and Event Listing

Recorded presentation

Sara Bleich, Ph.D. Program in Health Policy, Harvard University, 104 Mount Auburn Street, 3rd Floor, Cambridge, MA 02138, 617.495.5602, bleich@fas.harvard.edu, David Cutler, PhD, Social Sciences, Harvard University, University Hall 031, Cambridge, MA 02138, Christopher Murray, MD, PhD, Harvard Initiative for Global Health, 104 Mount Auburn Street, 3rd Floor, Cambridge, MA 02139, and Alyce Adams, PhD, Department of Ambulatory Care and Prevention, Harvard University, 133 Brookline Avenue, 6th Floor, Boston, MA 02215.

Introduction: This paper seeks to understand why the developed world is obese by exploring three questions: 1) Is the rise in obesity attributable to increased caloric intake or reduced physical activity?; 2) Why are we eating more? and/or Why are we exercising less?; and 3) Do specific types of calories differentially impact obesity?

Data and Methods: A panel data set of OECD countries was constructed from the Food and Agricultural Organization, OECD Health, and the World Development Indicators. Three methods of energy accounting were used to calculate the relative contribution of energy intake and energy expenditure to rising obesity. Pooled OLS models were used to test the mechanisms driving increased caloric intake as well as the differential impact of caloric type on obesity.

Results: Obesity has increased primarily as a result of higher caloric consumption. From 1990 – 2002, caloric intake accounted for 66% - 100% of the rise in adult obesity. The increase in caloric intake (measured in kcal) is driven by development factors such as: urbanization (ß= 14.2; 95% CI: 11.4 to 16.9), female labor force participation (ß = 14.7; 95% CI: 10.0 to 19.3), and reduced food prices (ß = 3.2; 95% CI: -4.7 to -1.7). It is also driven by food availability; caloric intake is lower where it is difficult to open a new business (ß = -31.9; 95% CI: -64.3 to .43).

Conclusions: The rapid increase of obesity in developed countries is mainly attributable to increased caloric intake driven by food availability and development factors.

Learning Objectives:

• Evaluate the relative contribution of energy intake and energy expenditure to weight gain in developed countries.
• Identify the mechanisms driving increased caloric consumption.
• Discuss policy options for reducing energy intake.

Keywords: Obesity, Economic Analysis

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation