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Datar A, Mahler A, Nicosia N. Association of Exposure to Communities With High Obesity With Body Type Norms and Obesity Risk Among Teenagers. JAMA Netw Open. 2020;3(3):e200846. doi:10.1001/jamanetworkopen.2020.0846
There is substantial evidence of clustering of obesity within geographic and social networks.1 Designing effective policies requires understanding whether this clustering is owing to shared environments, homophily, or social contagion. However, conclusive evidence is limited by the lack of quasi-experimental or natural experiment studies.
In a 2018 study,2 we analyzed data from a natural experiment, the Military Teenagers Environments, Exercise, and Nutrition Study (M-TEENS), in which US Army families were exposed to communities with varying rates of obesity as a result of their assignments to specific installations. We found that teenagers assigned to counties with higher obesity rates were more likely to have overweight or obesity. The study design ruled out homophily as an explanation, and we found no evidence that shared environments explained these results. We suggested that our findings may be consistent with social contagion with the goal of exploring this issue in future work. In the current cross-sectional study, we used newly collected M-TEENS data to examine whether teenagers’ exposure to communities with high obesity was associated with their ideal body type and obesity risk.
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