Dear DOCTOR Owen:

I recently moved into a well-to-do community outside of a major metropolitan area and I notice that everyone here looks like a “Stepford” wife. They are all thin, exercise like crazy, and dress “to the nines.” Nobody is fat! I feel very “out of place.”

Out of Place

Dear “Out of Place”:

You have stumbled on one of the greatest dilemmas in obesity research: Is obesity genetic or environmental (cultural)? The answer is. . it is both! Study after study clearly shows a strong socioeconomic relationship between obesity and wealth and social status.

In addition to obesity, lower socioeconomic groups also suffer from statistically higher incidences of cigarette addiction, drug and alcohol addiction, and more self-destructive practices than higher socioeconomic groups. The reasons are fascinating and far too complex for this column.

An article in the International Journal of Obesity, Vol. 21, No. 8, by researchers at the National Public Health Institute of Finland, reviews these health risks relative to education and socioeconomic factors. They find higher smoking and greater weight among the lower-income groups, which flies in the face of research suggesting that smokers are less obese than non-smokers. Many young adults in both the higher and lower echelons of society—especially women—smoke because they believe that it keeps them thin.

I’ll bet, though, that it is not “kosher” to smoke in the well-heeled “yuppie” community. As baby-boomers age and as our society becomes more well educated and more affluent, I think that you will see more people focused on staying thin and active.

It is unfortunate that the people most vulnerable to the negative risks in our Western culture— socioeconomically—also self-contribute to their own health problems.

Perhaps people who are struggling with survival in life put a low priority on living longer. After all, if they are deprived in one area of their lives, it is only human nature to minimize deprivation in other areas. For example, I imagine that I would be less inclined to “work out” in the gym if I had just finished exerting myself as a manual laborer in the hot sun all day long. Why would I want to live longer so that I could work longer in the hot sun? That is a problematic thought.

If people deprive themselves of one pleasure (food), I believe that they should replace that deprivation with another reward. Since there are only have five senses (sight, smell, touch, taste, and sound), there are only three alternatives to lose weight: sight, touch, and sound. (The senses of taste and smell require placing food in or near the mouth; therefore, consume less caloric, yet very satisfying, food items.) In addition, I suggest that you become creative—in areas outside the realm of food—with your senses of sight, touch, and sound! If you do not think this is worth the extra effort to keep you living longer and with more quality, ask your loved ones for their opinions. I’ll bet they will encourage you to do everything possible to have a full, enjoyable life.