Reconciling psychology with economics: Obesity, behavioral biology, and rational overeating

Determinants of Physical Activity and Dietary Habits among Adults in Ghana: A Cross-Sectional Study

A critical understanding of the interrelationship between two behavioral decisions—participating in physical activity, and eating healthily—is lacking in Ghana. This study aimed to determine which factors affect each of the two behavioral decisions, jointly and separately, among adults aged 18 years or older in three metropolises (Kumasi, Accra, and Tamale) of Ghana. The data from the Ghana Obesity Survey 2021 were used. A bivariate probit model was fitted to estimate nonlinear models that indicate an individual’s joint decision to participate in physical activity and consume a healthy diet. A positive correlation (r = 0.085; p < 0.05) was found between these two decisions, indicating a relationship between these two behavioral decisions. The common correlates between these decisions were self-reported good health status, high income, and attitudes toward being overweight. Men were more likely to be physically active but less likely to eat well. Both religion and culture determined participation in physical activity, but not the consumption of a healthy diet. Marital status determined diet, but not physical activity. The new knowledge gained from this analysis around the nature and the extent of the interconnectedness between physical activity and diet is critical to devising targeted interventions for obesity prevention in Ghana.

Diseño y análisis de propiedades psicométricas del Inventario de Estilos de Pensamiento en Respuesta al Cáncer (IEPRaC)

Una de las variables que ha sido definida como mediadora para la respuesta emocional ante el cáncer es el estilo de pensamiento. En contextos patológicos (por ejemplo, rumiación en depresión), y también en contextos normativos, se ha sugerido que el estilo de pensamiento puede predecir el ajuste ante un estresor. Existen instrumentos para evaluar de manera independiente los estilos de pensamiento (rumiación, evitación experiencial), pero ninguno está adaptado para población oncológica y ninguno incluye los tres estilos de pensamiento (rumiación, evitación y compromiso cognitivo). Objetivo: diseñar y estudiar las propiedades psicométricas de un instrumento que mida estilos de pensamiento en respuesta al diagnóstico oncológico. Método: Estudio instrumental, dividido en dos fases: la primera, elaboración de reactivos y jueceo de expertos y la segunda, análisis de propiedades psicométricas. Resultados: La versión final cuenta 15 ítems. La estructura interna resultó de tres factores, obtenidos a partir de un Análisis Factorial Exploratorio y corroborada mediante un Análisis Factorial Confirmatorio. Los valores de alfa de cronbach de las escalas resultaron adecuadas: la de Rumiación resultó de 0,87, la de Compromiso cognitivo de , 0,82 y de 0,72 la de evitación. Todos los ítems cuentan con evidencias de validez de contenido y propiedades psicométricas satisfactorias. La escala de Compromiso cognitivo fue la que obtuvo la puntuación media mayor y la de Rumiación mostró la menor. Conclusión: El Inventario de Estilos de Pensamiento en Respuesta al Cáncer (IEPRaC) cuenta con adecuadas propiedades psicométricas para ser utilizado en población oncológica mexicana.

The shattered "Iron Rice Bowl": Intergenerational effects of Chinese State-Owned Enterprise reform

Reform of the Chinese State-Owned Enterprise (SOE) sector in the late 1990s triggered massive layoffs (34 million employees) and marked the end of the "Iron Rice Bowl" guarantee of employment security for the remaining 67 million workers. An expanding international literature has documented the adverse health impacts of economic insecurity on adults, but has typically neglected children. This paper uses the natural experiment of SOE reform to explore the causal relationship between increased parental economic insecurity and children's BMI Z-score. Using province-year-level layoff rates and income loss from the layoffs, we estimate a generalised difference-in-differences model with child fixed effects and year fixed effects. For a medium-build 10-year-old boy, a median treatment effect implies a gain of 1.8 kg and a 2.2-percentage-point increase in the overweight rate due to the reform. Anxiety about potential losses causes weight gain for boys whose SOE parents kept their jobs. Unconditional quantile regressions suggest that boys who are heavier are more likely to gain weight. Girls are not significantly affected. Intergenerational effects therefore increase the estimated public health costs of greater economic insecurity.

Anorexia: A perverse effect of attempting to control the starvation response

Starvation arouses evolved protective mechanisms including binge eating and increased metabolic efficiency and fat storage. When aroused by dieting, the experiences of out-of-control eating, increased appetite, and increased fat storage arouse greater fears of obesity, spurring renewed attempts to restrict intake severely. The resulting positive feedback cycle escalates into bulimia for many, and anorexia in a few.

Economic policy and the double burden of malnutrition: cross-national longitudinal analysis of minimum wage and women's underweight and obesity

OBJECTIVE

To examine changes in minimum wage associated with changes in women's weight status.

DESIGN

Longitudinal study of legislated minimum wage levels (per month, purchasing power parity-adjusted, 2011 constant US dollar values) linked to anthropometric and sociodemographic data from multiple Demographic and Health Surveys (2000-2014). Separate multilevel models estimated associations of a $10 increase in monthly minimum wage with the rate of change in underweight and obesity, conditioning on individual and country confounders. Post-estimation analysis computed predicted mean probabilities of being underweight or obese associated with higher levels of minimum wage at study start and end.

SETTING

Twenty-four low-income countries.

SUBJECTS

Adult non-pregnant women (n 150 796).

RESULTS

Higher minimum wages were associated (OR; 95 % CI) with reduced underweight in women (0·986; 0·977, 0·995); a decrease that accelerated over time (P-interaction=0·025). Increasing minimum wage was associated with higher obesity (1·019; 1·008, 1·030), but did not alter the rate of increase in obesity prevalence (P-interaction=0·8). A $10 rise in monthly minimum wage was associated (prevalence difference; 95 % CI) with an average decrease of about 0·14 percentage points (-0·14; -0·23, -0·05) for underweight and an increase of about 0·1 percentage points (0·12; 0·04, 0·20) for obesity.

CONCLUSIONS

The present longitudinal multi-country study showed that a $10 rise in monthly minimum wage significantly accelerated the decline in women's underweight prevalence, but had no association with the pace of growth in obesity prevalence. Thus, modest rises in minimum wage may be beneficial for addressing the protracted underweight problem in poor countries, especially South Asia and parts of Africa.

Household-level financial uncertainty could betheprimary driver of the global obesity epidemic

Evidence has accumulated in support of the notion that changes in household-level financial uncertainty (or “economic insecurity”) may be an important fundamental cause of the global obesity epidemic. The timing and spatial/demographic incidence of the obesity epidemic suggest that economic policies aimed at expanding economic freedom may have inadvertently shifted risk to households, thereby generating a costly public health problem.

A soft pillow for hard times? Economic insecurity, food intake and body weight in Russia

This study investigates causal effects of economic insecurity on subjective anxiety, food intake, and weight outcomes. A review of psychological and nutrition studies highlights the complexity of processes at work on each stage of this causal chain. Econometric analyses trace the effects along the hypothesized pathway using detailed household panel data from the Russia Longitudinal Monitoring Survey from 1994 to 2005. Economic insecurity measures serve as key explanatory variables in regressions and are instrumented by exogenous regional indicators. Results support a causal chain from economic insecurity to weight outcomes for some population subgroups. In contrast to the leading hypothesis that economic insecurity increases body weight, I find strong evidence of a decreasing effect among women. Results suggest further that consumption of foods rich in sugar responds strongly to higher levels of economic insecurity. Heterogeneous impacts of economic insecurity on body weight call for individual-level interventions rather than large-scale action.

Limited Self-control, Obesity, and the Loss of Happiness

Is obesity the consequence of an optimally chosen lifestyle or do people consume too much relative to their long-term preferences? The latter perspective accepts that people might face self-control problems when exposed to the immediate gratification from food. We exploit unique survey data for Switzerland in multinomial logit and ordered probit regressions to study (i) the covariates of obesity including indicators of self-control and (ii) the consequences of obesity on the subjective well-being of people with limited willpower. Our main finding is that obesity decreases the well-being of individuals who report having limited self-control, but not otherwise. © 2015 John Wiley & Sons, Ltd.

Minimum Wage and Overweight and Obesity in Adult Women: A Multilevel Analysis of Low and Middle Income Countries

OBJECTIVES

To describe the relationship between minimum wage and overweight and obesity across countries at different levels of development.

METHODS

A cross-sectional analysis of 27 countries with data on the legislated minimum wage level linked to socio-demographic and anthropometry data of non-pregnant 190,892 adult women (24-49 y) from the Demographic and Health Survey. We used multilevel logistic regression models to condition on country- and individual-level potential confounders, and post-estimation of average marginal effects to calculate the adjusted prevalence difference.

RESULTS

We found the association between minimum wage and overweight/obesity was independent of individual-level SES and confounders, and showed a reversed pattern by country development stage. The adjusted overweight/obesity prevalence difference in low-income countries was an average increase of about 0.1 percentage points (PD 0.075 [0.065, 0.084]), and an average decrease of 0.01 percentage points in middle-income countries (PD -0.014 [-0.019, -0.009]). The adjusted obesity prevalence difference in low-income countries was an average increase of 0.03 percentage points (PD 0.032 [0.021, 0.042]) and an average decrease of 0.03 percentage points in middle-income countries (PD -0.032 [-0.036, -0.027]).

CONCLUSION

This is among the first studies to examine the potential impact of improved wages on an important precursor of non-communicable diseases globally. Among countries with a modest level of economic development, higher minimum wage was associated with lower levels of obesity.

Effects of household composition and income security on body weight in working-age men

OBJECTIVE

Many recent studies have provided evidence suggesting that increases in body weight may spread via social networks. The mechanism(s) by which this might occur have become the subject of much speculation, but to date little direct evidence has been available. Building on evidence from economics, anthropology, and behavioral biology, within-household peers might influence body weight via implicit provision of income security was hypothesized.

DESIGN AND METHODS

Using a sample of 2,541 working-age men from the National Longitudinal Survey of Youth (1979), the effect of cohabitation on weight gain over a 6-year period was estimated. The potential confound caused by the joint determination of economic insecurity and cohabitation status with instrumental variables that exploit variation in local and state-level macroeconomic conditions and the presence of children in the home was addressed.

RESULTS

The marginal effect of cohabitation with adults on body weight is negative. Moreover, the magnitude of the effect is more than six times greater when the cohabitant is engaged in paid employment.

CONCLUSIONS

Income insecurity may play an important role in peer-to-peer transmission of weight gain.

Weight-loss dieting behavior: an economic analysis

In light of the widespread phenomena of diet failure and excessive dieting, this paper presents a theoretical economic analysis of the decision-making process of weight-loss dieting. The paper incorporates behavioral elements involved in the process of dieting: effort exerted in dieting, influence of social norms concerning body weight, time-inconsistent present biased preferences, and a distinction between naiveté and sophistication. The model explains cyclic dieting and provides interesting insights on the extent of weight-loss dieting. The extent of dieting is an increasing function of initial body weight and a decreasing function of the effort exerted in dieting and the strength of social norms concerning ideal weight. Income and diet strictness have an ambiguous effect. In addition, greater dieting efforts are not necessarily balanced against a slowdown in body metabolism or a higher initial body weight.

Obesity under affluence varies by welfare regimes: the effect of fast food, insecurity, and inequality

Among affluent countries, those with market-liberal welfare regimes (which are also English-speaking) tend to have the highest prevalence of obesity. The impact of cheap, accessible high-energy food is often invoked in explanation. An alternative approach is that overeating is a response to stress, and that competition, uncertainty, and inequality make market-liberal societies more stressful. This ecological regression meta-study pools 96 body-weight surveys from 11 countries c. 1994-2004. The fast-food 'shock' impact is found to work most strongly in market-liberal countries. Economic insecurity, measured in several different ways, was almost twice as powerful, while the impact of inequality was weak, and went in the opposite direction.