More Debt Means More Obesity, Study Says

Aug. 9, 2009— -- Financial belt-tightening could result in a literal belt loosening as hard times force people to adjust their dietary habits, according to a German study of indebtedness and obesity.

The likelihood of being overweight or obese doubled with increasing indebtedness, an association that could not be explained by other socioeconomic or medical factors, according to an article published online in the journal BMC Public Health.

One plausible explanation relates to the potential impact of indebtedness on risk factors for obesity and other chronic diseases.

"These findings are in accordance with international models assuming a link between individual's financial situation and the diversity of access to 'healthy' food," Eva Munster of the University of Mainz and colleagues observed. "An inverse relationship between energy density of food and its costs, combined with the inability to pay, can be a partial reason for the higher risk of overweight or obesity among overindebted subjects."

Some clinicians in the United States expressed doubts about the study and its applicability to the U.S. But others said its statistical rigor made the relationship between debt and waistline an important finding.

One thing there's no doubt about: worldwide economic turmoil has led to a substantial increase in the proportion of overindebted residents in Europe and the U.S. The authors defined overindebtedness as "lack of possible debt redemption in due time due to the relation of income and cost of living after a remarkable cutback in standard of living."

Socioeconomic status has a well-documented association with health, particularly overweight and obesity. However, conventional definitions of socioeconomic status do not account for overindebtedness, the authors continued. As a result, the impact of indebtedness on health remains unknown.

In an effort to clarify relationships, investigators examined results of two population-based surveys in Germany. One from 2003 covered disease risk factors, quality of life, utilization of healthcare and socioeconomic status in the general population, while the other assessed the health status of overindebted individuals. The data involved 8,000 individuals from the health survey and 949 respondents to the debt survey.