Sex Differences in Health: Evidence and Explanations 371Etiology. There are genetic predispositions
to obesity, but societal and behavioral factors
also are involved. Because the increase in obe-
sity has been so dramatic and has affected the
entire population of people, some explanations
must focus on societal changes. Among these
are the increased availability of food, the in-
crease in food consumption, and the decrease
in physical activity (Flegal & Troiano, 2000).
During the 1970s, 1980s, and 1990s, people
started consuming more food away from home
and a greater proportion of calories started
coming from salty snacks, soft drinks, and
pizza (Nielsen, Siega-Riz, & Popkin, 2002).
The increase in obesity among children
has been attributed to poor diet and lack of
physical activity—both of which are influ-
enced by heavy television viewing. Studies
have found links of television and computer
usage to obesity. In a study of 9- to 14-year-
olds, television watching and video and
computer game usage were associated with in-
creases in BMI over a one-year period (Berkey
et al., 2000). A 28-year longitudinal study of
children showed that television viewing as a
child predicted increased BMI and lower lev-
els of fitness as adults (Landhuis et al., 2008).
Why are women more likely than men
to be obese? First, as described next, women
engage in a lower level of physical activity
than men. Second, there are life events as-
sociated with obesity in women: Women
are most likely to gain weight when they get
married, when they have a child, and during
menopause (Wing & Klem, 1997).Exercise
Physical activity has been related to lower
rates of mortality and morbidity (Centers for
Disease Control and Prevention, 2010d), and
lack of physical activity is clearly linked to the
increase in obesity. Specifically, physical ac-
tivity is associated with reduced heart disease,instilled in childhood are difficult to change.
In addition, obesity is accompanied by meta-
bolic changes in children that are difficult
to reverse (Centers for Disease Control and
Prevention, 2000). One result of the increase
in obesity among children—especially mi-
nority children—is the increase in Type
2 diabetes—formerly a disease thought to
characterize older people (Dabelea, 2007).
Type 2 diabetes is an endocrine disorder in
which the body is not as capable of using in-
sulin to metabolize food. Children who are
obese often have risk factors for cardiovas-
cular diseases, such as high blood pressure,
high cholesterol, and diabetes (Centers for
Disease Control and Prevention, 2011).
Obesity is more common among those
with a lower SES (Zhang & Wang, 2004), partly
because low SES is associated with poorer di-
ets and less exercise. However, obesity is not
clearly related to SES among all ethnic groups.
Obesity is related to higher SES among White
men, White women, and Black women; lower
SES among Black and Hispanic men; and un-
related to SES among Hispanic women.
Views of obesity differ across gender
and race. Overweight and obese men are less
likely than women to perceive their weight
to be a health problem (Gregory et al., 2008).
Minority groups may have a less negative
view of being overweight because weight
symbolized wealth historically. White women
are more dissatisfied with their bodies than
Black and Hispanic women (Grabe & Hyde,
2006). Among adolescents and adults, Black,
Hispanic, and White girls say that they wish
that they were thinner but this desire occurs
at a lower BMI for White girls than Black and
Hispanic girls (Banitt et al., 2008; Fitzgibbon,
Blackman, & Avellone, 2000). Among college
students, Black women say that being thin is
less important to them than White women—
especially when race is central to their iden-
tity (Fujioka et al., 2009).M10_HELG0185_04_SE_C10.indd 371 6/21/11 8:54 AM