The social origins of obesity within and across generations

Abstract

We propose a model for obesity development that traces a considerable part of its origins to the social domain (mainly different forms of prolonged social adversity), both within and across generations, working in tandem with a genetic predisposition.To facilitate overview of social pathways, we place particular focus on three areas that form a cascading sequence: (A) social adversity within the family (parents having a low education, a low social position, poverty and financial insecurity; offspring being exposed to gestational stress, unmet social and emotional needs, abuse, maltreatment and other negative life events, social deprivation and relationship discord);(B) increasing levels of insecurity, negative emotions, chronic stress, and a disruption of energy homeostasis; and (C) weight gain and obesity, eliciting further social stress and weight stigma in both generations. Social adversity, when combined with genetic predisposition, thereby substantially contributes to highly effective transmission of obesity from parents to offspring, as well as to obesity development within current generations. Prevention efforts may benefit from mitigating multiple types of social adversity in individuals, families, and communities, notably poverty and financial strain, and by improving education levels.

Small for gestational age preterm infants and later adiposity and height: A systematic review and meta‐analysis

“…We defined appropriate control for confounding as adjusting for any SDOH [14][15][16] and maternal weight status. 17 Studies that did not adjust for both the SDOH and maternal weight were considered to have residual confounding.…”

“…Infants born SGA, particularly those born preterm, are of particular concern, given the potential for increased risk of adverse outcomes consequent to suboptimal fetal growth. To gain an understanding of the causal relationships between size at birth and excess adiposity in later life, analyses should adjust for baseline confounders/common causes, including the social determinants of health (SDOH) [13][14][15][16] and maternal pre-pregnancy weight status 17 and should not adjust for later weight or other intermediate factors including growth that fall on the causal pathway between prenatal exposures and later metabolic and adiposity outcomes. 4,5 Our objective was to conduct a systematic review and metaanalyses of the available published literature on differences in anthropometric measures (adiposity and height) in later childhood or adulthood among preterm SGA infants compared with those born preterm but non-SGA, with a focus on the statistical methods and adjustments used in the analysis of individual studies.…”

Socioeconomic inequalities in obesity during 2006-2017 in Spain: An outcome-wide epidemiology approach

“…Obesity is a complex and multifactorial problem [40], and although sedentary lifestyle plays an important role in the development of this clinical condition [41], other social determinants have also been described to in uence the apparition and maintenance of this disease [42]. We believe it is important, from a Public Health perspective [43], to try to help social disadvantaged groups with greater risk to obesity [44].…”

Models of body weight and fatness regulation

“…Some lose weight at the same time. Factors driving obesity are largely independent of biology and include social factors, poverty and education [116][117][118] and the built environment [119,120]. It is like we are all just aimlessly drifting around nudged this way and that by a string of environmental factors, with a slow upward trajectory that is the obesity epidemic.…”