The Strangest Factor Yet for Rising Obesity?


We’ve posted repeatedly on this blog about the rise in U.S. obesity and its causes. While there may really be only one “cause” — calories are cheap and plentiful, and consuming them is fun — there are surely a number of contributing factors, including a decrease in smoking, the prevalence of restaurants that serve large portions, and so on.

The other day, while reading a children’s book called When I Was Young in the Mountains to my daughter, I came across a passage that made me wonder about another possible contributing factor:

When I was young in the mountains,

Grandmother spread the table with hot

corn bread, pinto beans, and fried okra.

Later, in the middle of the night,

she walked through the grass with me to the

johnny-house and held my hand in the dark.

I promised never to eat more than one serving of okra again.

Is it possible that the availability of good plumbing has contributed to our national weight gain? This may sound ludicrous, but think about it for just a moment. Very few people have to trek through the night to use an outhouse anymore; furthermore, restroom facilities are readily available just about everywhere — which means you don’t have to worry about getting rid of your waste, which frees you up to consume as much as you’d like.

As a kid, I remember taking a long bus ride to New York City for a ballgame. There was no bathroom on the bus. No one on the bus was drinking anything either. (Yes, this was before you could readily buy bottled water; but there were such things as cans of soda.)

A few times in the recent past, I’ve rented a summer house with no garbage pickup. This meant not only paying for how much waste you produce, but also storing your trash until the one day that the dump is open. During these times, our behavior changed radically: not only did we compost all our food waste to cut down on stink, but we thought about everything we bought before we bought it to make sure we wanted to deal with the waste. As a result, we bought a lot less.

I know of no legitimate research connecting plumbing and obesity, though I would be interested in hearing from anyone who does.

The idea does remind me a bit of a book by the economist Werner Troesken called Water, Race, and Disease. It argues that life expectancy for African-Americans rose even at the peak of the Jim Crow era because of unintended consequences of white racism: in their zeal to “protect” white neighborhoods against waste from black neighborhoods, public officials upgraded the sewer and water systems in black neighborhoods.


I'm not convinced, and I'll tell you why:

I live in the country with the awesomest toilets in the known universe: Japan.

You've never seen toilets like these if you haven't been here. It's not uncommon to visit someone, and upon sitting upon the toilet, hear a small fan kick in, feel the surface of the toilet gently warm your buttocks, and maybe even hear soothing Mozart or gentle waterflow sound recording. On your right you'll see a control bar with a myriad of buttons for all kinds of bidet or other nether-area washing options, so many that a dozen trips to the toilet can yield a new experience.

And yet, for all this amazing defecatory convenience, Japanese people are, more often than not, skinny as rails -- many of them almost to an unhealthy degree.


what about my great grandmother on the farm?

Did she get pregnant 15 times to avoid doing the laundry and soaking rags in bleach? problem was, while she didn't have modern (waste) paper products that helped her monthly cycle she produced babies that needed diapers.

most things in life are a wash!

I am sure most of that kind of bathroom business was not done in the outhouse.

Dave Keiser

Here's an idea. Today, I live in a city (Nashville) with poor public transit and I have to drive 7 miles into downtown for my job. It takes me a surprisingly cool 15 minutes to get there (I will not give up my secret way either). I was also a Peace Corps volunteer in Morocco where I survived by foot, bike, bus, taxi, donkey cart, and trains.

What would my commute look like if I transposed my 7 mile Nashville commute into a Moroccan infrastructure or any other culture with different conveniences? Would it be longer, less convenient or the opposite.

One thing is certain, I was a lot skinnier and healthier over there than I am now...maybe it was because I walked and biked everywhere!


I live for 5 months out of each year in a building with an "outhouse", which is to say a rental portajohn. I'm sorry to say that this has no effect on my eating habits nor my weight gain, other than the fact that I have to walk a flight of stairs and 20 feet to get to the thing...minimal exercise really.

What has the largest effect, it seems to me, is money; when I'm doing well, I can afford better food, look at your supermarket and you'll discover that leaner meats and lower fat prepared foods and vegetables all cost more; subsisting on ramen and high fat hamburger and the like really put on the weight, and then there's the fact that when business is poor and my wallet is empty, I seem to snack more and eat larger portions, I guess as a "fatten up in case we starve later" response.

The more successful business is, the less I feel driven to eat, and at the same time, I'm much more busy and have less time to do so.

Economy in the toilet is making me fat, not not having to walk outside to the toilet.



This is such a silly subject.

I've lived in Scandinavia for the last 10 years. Although people here have the same access to all convenience devices (plumbing, microwaves, Wii) they simply aren't fat.

The reason is two-fold: Public transportation/biking is widespread and used at near 100% capacity (this is a consequence of $9/gal gasoline) and junk food (heck, food in general) is expensive (a pint of ice cream at the local supermarket costs over $10 and a BigMac costs $6).

One doesn't need any other clarification...

Brian G

I agree that the correlation between available restrooms and obesity does not imply causality.

Yet, there may be a way to test.

Certain states (such as Florida) have a law that all public venues (stores, restaurants, etc) are required to have public restrooms available.

Other states such as NM have no such law.

Comparing the obesity rates between such states - or at least the trends - may produce interesting results.

(Note: NM actually has had the largest run-up in obesity in the past 10 years, going from the 49th skinniest state to, when last I checked, the 3rd fattest)


What I took from the passage was that maybe we're not eating enough okra.

Eddie G

A picture from's own Maoman, nice! That's actually what caught my attention but this post turned out to be worthwhile. I think that the idea has its merits. It could be hard to do research though since there probably is a strong correlation between the prevalence of food and the prevalence of toilets. I do know though that I did my very best to not have to crap when I was hiking in the mountains of northern Vietnam.


Thanks for the thought provoking article. But I understand that our modern diets are going the other way with less and less fiber and "plumbing." Dr. Burkitt often called "the fiber man" is well known for his work in the role of fiber, and he went to great lengths to document his work...

Read all about his work and fiber: (warning, not for faint of heart):

Sarah Mullen

From my own experience, I'd say yes, plumbing makes a difference.

I've spent most the past five years on job sites where I often only had access to porta-johns, sometimes close to my trailer, sometimes quite a walk. We've all found that we really think about what we consume, particularly eating or drinking close to bed time. Nobody wants to walk across the desert at night to a dark out-house.

This year I purchased a new trailer with a good working bathroom. Last night I found my self eating ice cream in bed. I doubt I would have indulged in something like that in the days of out-door toilet.

Most of my coworkers still don't have plumbing, and I can't think of a single person who would be considered obese. Admittedly, ours is also a fairly active life style, and access to plumbing probably isn't a deciding factor, but I'm sure it makes a difference.

Russell Hopper

I doubt the premise.

It used to be that obesity was a rich person's affliction. although not seen as such in an earlier time. If you were rich enough to have have the ability to evacuate yourself indoors,by whatever means, you had had more than enough to eat as well.

Poorer people without the means to possess indoor plumbing, didn't have the means to eat meat everyday. The ate veggies, nuts and berries most of the time, hardly foods with a constipating effect.

Edwin Hoogerbeets

I think you're right. I have a 37-foot yacht which my wife and I sail around SF bay on the weekends. A few times a year, we take it for longer trips of 4 or 5 days. The constraints of a boat with its limited storage space, limited fridge, and limited holding tank (which collects the sewage) means that we bring and eat less food for that time period than we do at home. These constraints definitely modify our behaviour!


I just got back from a trip visiting New York City and upstate - a place I'm not entirely familiar with. During my trip, I was conscious of the possibility of not being around a toilet later and thus, ate accordingly. That said, I'm not obese in real life, either.


This is why we are so fat:


A human does not require more daily exercise than this:

- walk to the bus stop

- walk from the bus stop to your office

- walk to get lunch

- walk back to the office

- walk from the office to the bus stop

- walk to the grocery store

- walk home

Or, do it by bike. Make your kids do it, too. Advocate for sensible city planning that make biking and walking safe and practical.

Study the layout of older cities built before cars and giant parking lots. People were thinner. Build and retrofit places where people live to be encourage pedestrian life.

Stop eating (and subsidizing) high fructose corn syrup. Your taste buds and metabolism will return to their natural state.

Ella Hates Frivolous Answers to Important Questions

This has to be THE stupidist column I have read this week.

Why are we obese? Just ask the people still left all over on the earth outside of the United States who are not, collectively, obese. Take a look at Darfur's sanitation system and I dare say you'll agree it's not outdoor toilets that make people skinny, idiots.

We have enough to eat, and we have less physical work to do in order to stay alive. It's the simple algebraic equation " calories in + energy expenditure = net calories burned". It's called human progress, but our metabolism and physiology have not had a chance to adapt evolutionarily to this relatively sudden change in human history, so we do what we are programmed to do when opportunity knocks we get fat.

Eric L

The idea is actually not that far fetched. It reminds me of my grandma, and I wouldn't be surprised if a lot of people experienced the same of their grandparents. She always tells me that she doesn't drink a lot of water, especially during the night time, because she doesn't like having to get up in the middle of the night to go to the bathroom. So amounts of food/beverage intake is affected along the same lines, where people do get concerned about the convenience (or lack thereof depending on age or circumstance) of getting rid of their waste.


Aside from the extra walking involved to and from said outhouse, this is the stupidest theory I've ever heard.

Really, you'd pass up that last nacho because in 12 to 24 hours, you might have to walk 200 feet outside?

First, instant gratification ALWAYS trumps long-term pain (i.e. credit cards, hangovers, etc.).

Second, who even thinks about what they eat in relation to the subsequent excretion?

And finally, having lived in a ger (yurt) in the Gobi desert for months, I can assure you that indoor v. outdoor plumbing has no effect on food consumption.

Don't overthink it Dubner--we eat more and walk less.


I think that the convenience of internal plumbing has radically impacted obesity, but i doubt that it was caused by plumbing alone (obviously). I believe that the advent of cheap calories, i.e. junk food, combined with teh convinience of easy-acess 24/ plumbing has changed our eating habits.

I personally am famous within my family, along with my brother, for midnight pantry raids of anything that tastes good and is easy enough to prepare (ice cream especially). This leads to irregular usage of the bathroom as you are consuming food at different times, in different quantities, of different content to be processed at different rates. I knwo that if i had to make a large trip to an outhouse i would rarely indulge in any snacks that would throw off my "bathroom schedule", hence I would eat less snacks, maybe more at meals, which in theory should be healthier.


I'm from Wisconsin. I can tell you that the toilet seats in the women's roadside rest areas are bigger and wider north of Hwy 10.


Yeah i think this does make a lot of since. i've read some of these comments and people keep saying that plumbing doesn't make people eat more...? well think of this..would you be more or less willing to go to mcdonalds or any other resturaunt if they didn't have a bathroom ready for you...but also look at how "convenient" they've made don't even have to get out of your car anymore!! and i'd just like to point out that that may be a pretty bid reason why the family unit isn't so tight people just take care of themselves but their kids a happy meal and make sure they don't cry...i think theres just not very much human reaction to each other any more walk two blocks to a friends house when you want to hang out...just call text or is just too comfertable...