The current economic state worldwide has led to an increase in the number of people living in high-income countries who can be considered over-indebted — owing more money than they can repay. While there are many negative factors associated with indebtedness, a new study by Eva Munster and colleagues of Germany, published online in the journal BMC Public Health, found that over-indebtedness is associated with obesity.
In fact, people who are over-indebted are more than twice as likely to be obese and almost twice as likely to be overweight as their more financially successful counterparts.
The Study
Traditionally, socioeconomic factors such as education and income, as well as other factors like sex, age, depression, and smoking habits, have been found to have a relationship with weight. This new study was unique in that it specifically examined the relationship between weight and indebtedness. A characteristic rarely used to describe socioeconomic status. Over-indebtedness is defined by the study’s authors as a “lack of possible debt redemption in due time due to the relation of income and cost of living after a remarkable cutback in a standard of living.”
To conduct the study, Dr. Munster and her colleagues compared the results of two surveys: a study designed to measure the health of 949 over-indebted individuals and a previous telephone health survey of 8318 individuals representative of the German adult population. Both surveys asked questions about age, sex, income, education, Body Mass Index (BMI – a measure of obesity calculated based on height and weight), smoking, and depression.
The study found a number of interesting relationships with indebtedness. When compared to the general population, the average over-indebted study participant was younger, had less education and income, and had a higher incidence of depression, smoking, overweight (BMI ≥ 25), and obesity (BMI ≥ 30). Both men and women were equally likely to be over-indebted.
Aspects other than indebtedness that was found to be related to an increased likelihood of being overweight or obese include being male, being over 40 years old, and suffering from depression. Smokers and those with higher education and income were found to have a decreased likelihood of being overweight or obese.
Over-indebtedness and Obesity
The study found that indebtedness was associated with an increased likelihood of overweight and obesity, even when examined independently of other factors. This means that people who are over-indebted are more likely to be overweight or obese regardless of factors such as income, education, sex, or age – suggesting that over-indebtedness alone can cause obesity.
Why might this be the case? The study’s authors present several possibilities for the relationship between over-indebtedness and obesity. One potential reason is that over-indebted people may be less able to afford healthy food. It is known that, internationally, food that is energy-dense (meaning high in fat, sugar, and calories) is less expensive and more filling than less energy-dense (and healthier) food. For example, for the amount you would spend on a bag of carrots, you can buy a more filling and higher-calorie snack like a Snickers bar.
Another possible reason is the psychological distress faced by those who are over-indebted. Being unable to afford all one’s debts can be stressful and depressing, things that can lead to increased eating for compensation and enjoyment. A number of studies have shown that the majority of people change feeding behaviors when facing stress.
Around 40% or more increase and 40% or less decrease their caloric intake during stressful periods, while 20% do not change feeding behavior. Stress also induces the secretion of glucocorticoids, which increase motivation for food, and insulin, which promotes food intake and obesity, as mentioned in a recent study by Dr. Dellman MF.
Is this a German phenomenon?
Since this study was conducted on a German population, there has been some discussion in the United States’ medical community about whether the results can be generalized to other countries. It is possible that this relationship between over-indebtedness and BMI is a uniquely German phenomenon, but there are also excellent reasons to believe that the study has relevance to other countries such as the United States.
Dr. Emanuela Taioli, a physician at SUNY Downstate Medical Center in Brooklyn, New York, said of the study: “This result is even more applicable to the U.S., where unhealthy food is currently much cheaper and more affordable than healthy food, and so is water in comparison to sugary drinks. This will have a large impact on the current U.S. obesity problem, now that the proportion of people with debts is increasing.”
On the other hand, Dr. Lewis Kuller of the University of Pittsburgh noted that the findings would be more impressive had the data been collected over time, rather than all at once, asking, “Did the individuals gain weight when they lost [their] income [or] job over indebtedness? Or were they already obese, overweight before their economic problems?”
One thing is certain: this carefully conducted scientific study uncovered a significant association between indebtedness and overweight and obesity. The startling finding – that being over-indebted increases a person’s risk of being overweight by almost 100% and increases their risk of being obese by more than 150% – definitely suggests that over-indebtedness should be considered when looking at risk factors for overweight and obesity.