Obesity, defined as a body mass index of 30 or greater for adults and 95th percentile or more for age and sex among youths, affects almost 40% of adults and 19% of youths in the United States and has increased substantially over the past 40 years.1 Easy availability of inexpensive, energy-dense, palatable foods; higher costs of, and insufficient access to, more healthful foods; reduced need for physical activity; and plentiful opportunities to engage in rewarding sedentary behaviors create an ideal environment for obesity to emerge. The significant differences in obesity prevalence among genetically similar Pima American Indians living in Arizona (>60%) and in Mexico (<20%)—groups with marked differences in access to food and obligate physical activity2—provide a clear example of how important environment can be for obesity.
Yanovski SZ, Yanovski JA. Toward Precision Approaches for the Prevention and Treatment of Obesity. JAMA. 2018;319(3):223–224. doi:10.1001/jama.2017.20051
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