I'm confused why they would point this out. It's obvious that people who have better insurance are paying more for it than people who have crappy insurance or none at all...so that also means they probably have more money to buy more food. It's simple.


Could it be that people with desk jobs and twinkies also have insurance, and people running around on farms don't?


Sure I'd love a second piece of cake. Oh no it's alright, I'm insured.


have to adjust for the poor, who can afford neither healthcare or weekly food bills (so better to look at non-insured with median incomes)


Is this a case of correlation but not causation? aka people who have health insurance (on average) have more money for food, as well as work a job that generally has less disamenity (aka more sitting, less moving around). While it makes sense that it could cause it, that on the margin if you have health insurance you are less likely to be cautious about eating, I am not sure people think it through like that.


Let me take that back. The authors are some of the best in the field and of course they handle all the issues related to job choice effecting your overall health and just capture effects of insurance on your BMI.


Correlation is not causation.

Joe Smith

Moral hazard strikes again.


What a strange conclusion.

Wouldn't the more obvious connections be that:

1. People who have more money (i.e., are in a position to get better health insurance) eat out more often, and get the attendant calorie boost?

2. People who work for government (great insurance) tend to be lower-income, and eat more-affordable, less-healthy options?


Maybe because in the US, insured people are employed people? Employed people tend to have more money to spend on food and dining out.


Umm, correlation != causation. It seems most likely that the explanation comes from the insured being wealthier and the wealthier buying more food. Right?

On the other hand, I seem to recall once reading that the relationship between money and obesity was negative, so who knows.

Imad Qureshi

That makes sense. People with health insurance are those who are employed in a company that gives reasonable benefits to its employees or have their own businesses and can afford a health insurance. That also means under most cases they can afford what they would like to eat and that includes food with high calories served in restaurants and fast foods. People with no insurance are usually poor and unlikely to afford restaurants and fast foods, hence consuming less calories.


Maybe its because the demographic most likely to opt out of insurance is the young male, aged 18 to 30. People gain weight as they ge.

A. B.

I find this study somewhat puzzling, having been able to compare the difference between the type of food available for people with more vs. less means (at least in a metropolitan area).

I used to live in East Village, NYC. There I had plenty of grocery stores and a Whole Foods store where to buy fresh fruit and all types of healthy (and relatively expensive) food that isn't too caloric.

Then I moved to Washington Heights (top North of Manhattan), and the options completely changed: the local grocery stores only had white bread (not the multigrain that is recommended by nutritionists), artificial juices full of corn syrup, very little options on fruits, and so on.

In the U.S., contrary to Brazil, where I am from, nutritious, non-fattening food, is typically much more expensive than food that is full of empty calories, fat and additives (cakes, cookies, hot dogs, etc.). The people in the neighborhood I moved to definitely looked heavier, and to me it was no wonder considering the type of food they are consuming.



Sure, and this is why Americans with their crappy health care system are so super slim, and Europeans with excellent public health care systems are well known for their obesity...


Just "eating out" would not necessarily cause weight gain-
Assuming having health insurance stems from having better jobs, indicating more education, (higher SES) you are more likely to make better food choices for yourself and your family no matter where you choose to eat. These people are also more likely to afford gym memberships.
Lower income, uninsured people would probably buy less healthy foods, (they are often less expensive) and be more likely to eat fast food places as a choice of "dining out."

I'm with #7. Correllation does not equal causation.


I'm surprised that so many people think that it's an income issue -- that more money leads to greater obesity. Their premise is that the more money you have, the more money you can spend on food, which leads to higher calorie intake.

But that may not be the case. Some studies have shown that obesity is inversely correlated to income. The higher the income, the LOWER the obesity rate.

Some believe it's because higher income is a "symptom" of a higher level of education. That means high income consumers make more-informed choices with respect to food. Others believe it's because higher income people can be more selective with regard to food choice. For instance, fast food may be more accessible and cheaper than a good grocery store.


On the other hand, in developing countries, obesity and income are positively correlated as many commenters suggest.



If it's the health care access that makes them fat (or the lack of having to pay for each use), why aren't social health care countries lazier and fatter than the people in the USA?


@ # 1) Everyone eats food. People with lower incomes are more likely to eat at places that are cheaper (unhealthy, high calorie fast food places), while wealthier people have the luxury of health food (places like whole foods) that are predominantly in higher income neighborhoods. One of the biggest health problems in many low income areas is the lack of access to affordable, healthy food.


Good point, Steve. I wonder if the study took age into account.

As for the people who have insurance have more money and can afford more food or dine out more: I thought the correlation was the other way around. The poor are more likely to be obese because they buy more calorie-rich, unhealthy foods, rather than fruits and veggies.