Why are so many poor people fat?
Progressives point to limited food choices — food deserts — as one cause. But that idea has been refuted.
Conservatives might cite bad food choices — people get fat because they choose to eat fattening foods.
Yet another idea is that humans are programmed in the womb by what their mothers eat during pregnancy.
South Africa has some of the highest levels of obesity in the world, together with exceptionally high rates of poverty. These two issues are linked in a vicious, attritional cycle.
At first glance it appears counter-intuitive to consider that poverty and obesity could be associated. The fact is that poverty is intimately correlated to several non-communicable diseases. Numerous international studies have shown how obesity and its morbid fellow travellers, hypertension and diabetes, stalk the health of the poorest and most marginalised sectors of society.
As a developing nation, with increasing urbanisation, South Africa provides an exemplary case of the paradox of obesity amongst poverty. So how does this apparent contradiction exist and perpetuate?
When most people consider the effect of poverty, the initial image is of an emaciated, stunted figure, perhaps with a tell-tale red tint in her hair. While this is the most visible impact on children, research shows us that the long-term impacts of poverty are even more profound and menacing.
Poorly nourished infants have been found to be predisposed to obesity in later life. This occurs by interference with the genetic programming of the body, mainly in utero. If a mother does not receive adequate nutrition, the lot of her baby can become forever compromised. This is how the tragedy of poverty is perpetuated, inter-generationally. This occurs directly through malnutrition, as well as through other rather more sinister mechanisms.
There is some evidence for this, as you’ll see in this TED presentation.
Annie Murphy Paul tells of a group of Dutch babies who were in utero during a bleak time in WWII when the Dutch were surviving on 500 calories a day. These babies grew up to become more obese than the general Dutch population.
According to the theory, the babies got the inside the womb message that it was a lean world out there and their bodies were programmed to hang onto every calorie.
Sounds plausible. But why wouldn’t the babies of fat mothers be programmed to be lean?


