Wealthy Closing Obesity Gap

The poor are most likely to be fat, but the more affluent are closing the gap. Obesity is growing fastest among Americans who make more than $60,000 a year, researchers report.

"This is a very surprising finding," said Dr. Jennifer Robinson of the University of Iowa, whose study was presented at a meeting of the American Heart Association.

But it "underlines the whole complexity" of the obesity epidemic, she said.

The study indicates that, "When it comes to obesity, money doesn't matter," Dr. Nieca Goldberg, a cardiologist with the American Heart Association, told co-anchor Harry Smith on The Early Show Tuesday.

"For a long time," Goldberg explained, "

"We're seeing that numbers are evening up a lot. In fact, the greatest rise in obesity was among people earning over $60,000 a year.

"And you have to think, 'Why is that happening?' And actually, if you can think about what happens when you're earning more money, you're working longer hours, spending a longer time commuting, and at a computer, and also you're eating out and ordering take-out food more."

Robinson and graduate student Nidhi Maheshwari, who presented the findings, culled decades of data from the National Health and Nutrition Examination Surveys, one of the government's prime health databases, to compare obesity with family income.

In the early 1970s, 22.5 percent of people with incomes below $25,000 were obese. By 2002, 32.5 percent of the poor were, they found.

Just 9.7 percent of people with incomes above $60,000 were obese in the 1970s, a figure that jumped to 26.8 percent in 2002.

For purposes of comparison, all the income figures were adjusted to reflect year 2000 dollars.

The study shows the obesity rate continuing to rise among lower-income people as well, Goldberg notes: "The nation is increasing in their waist line. But there are ways we can start to stop that, particularly if you work long hours. …We have to make better food choices, particularly if you're going to eat out, because you're time pressed, you need to read the menu. Order things that are broiled and steamed, have sauces on the side, dressings on the side. Eat more fruits and vegetables. I know this sounds like common sense, but we really have to pay more attention to ourselves."

Yet today, the obesity remedies most often recommended for Americans in general — eat fresh salads, go ride a bike — are impossible for many low-income families, said Dr. Adam Drewnowski of the University of Washington, an expert on the problem.

Exercise can be hard in inner cities, where the streets may be too dangerous after working hours. Many grocery stores in low-income neighborhoods don't stock expensive fresh produce. And people who work two or three jobs have little time to make home-cooked meals.

The poor still are the most likely to be fat, said Drewnowski. Moreover, since the '70s, rates of extreme obesity, being 90 to 100 pounds or more overweight, have ballooned among lower-income groups, something the study doesn't address, he said.

Further complicating attempts to compare income and obesity are cultural factors. Certain racial and ethnic groups positively equate a man's girth with wealth. It's a sign of success, Drewnowski said.

"I would caution against any attempts to interpret these data to say social differences have disappeared," he said. "It just shows that obesity is a general problem and it's now affecting pretty much everybody. ... But it would be very shortsighted to stop paying attention to the people who are most vulnerable."

Robinson agreed: "I don't want to take focus away from the serious racial and ethnic disparities in health."

But, she said, it's likely that different factors play a role in spurring obesity among the middle class than in the poor. "We need to have a lot more research ... to tailor our interventions to specific populations."

Goldberg reminded Smith that, "Obesity…increases your risk of diabetes, heart disease, high blood pressure, and also for young people, there are a lot of psycho-social issues, like self-esteem, isolation, so that it really affects our lives, and we need to stop it."