External forces beyond the home, media, school, and community play an important, if somewhat unclear, role in perpetuating the childhood obesity epidemic. (25) According to the Surgeon General, “more research is clearly necessary to fully understand the specific etiology of this crisis” (2).
Poverty and discrimination: Poverty and racial disparities inflame the already serious problem of childhood obesity.
Not surprisingly, lower income families have much more limited choice in eating and exercising than their wealthier counterparts. (26) In fact, high-income markets have much greater sales of fruits and vegetables and lower sales of high-fat, high-sugar foods than low-income markets. (21)
Poorer city residents must also deal with the remnants of the crack cocaine epidemic and “War on Drugs”; amidst violence, drug addiction, the disproportionate incarceration of minority men, and the collapse of inner-city neighborhoods, the vices of fast food and television seem harmless. (25)
Meanwhile, pop culture has used humor to cover up the severity of the obesity epidemic. (25) Rather than sparking nationwide concern and a concerted public health response, the obesity epidemic initially inspired TV shows and movies like Big Momma's House and The Nutty Professor , which depicted obesity not as a serious health concern, but a joking source of entertainment. (25) The end result is uninformed parents who misjudge their children's weight status and misunderstand the health implications of excess weight. (48)
Stress and depression: Stress and depression are rampant in our society. Today, children surrounded by commercialism and materialism suffer from poor body-image, developmental and emotional problems, overweight and obesity, and other eating disorders. (32)
In 1999, almost 21% of U.S. children aged 9-17 had a diagnosable mental or addictive disorder – but fewer than 1 in 5 actually receive medical treatment. (47)
The connection between depression and obesity remains unclear, but studies have shown that women with severe mental illness are at increased risk for obesity as well as cardiovascular, endocrine, and infectious diseases. (49) Chronic obesity (lasting from childhood into adulthood) is associated with psychiatric disorders such as oppositional defiant disorder and depression. (50)
Predictors of childhood overweight and adulthood obesity include parental neglect, poverty, and childhood stress and depression. (30,52)
Pills, pills, pills: Many people have taken up a sort of biological view of life and personal responsibility, attributing behaviors to genes and chemical imbalances, and relying on drugs for instant gratification and quick-and-easy healing. In the context of the obesity epidemic, such searches for a quick-fix produce hinder prevention and treatment efforts, because these efforts require personal and societal commitments to behavioral change – not mass prescription of fat-burning diet pills or increased consumption of “diet products.” (26)