Access to Fast Food Restaurants and Obesity

We have a plethora of fast food outlets in America and we also have a plethora of people who want to tell everyone how they should conduct their lives.  In the supposed interest of public health, in many jurisdictions tobacco taxes have been raised, soda has been taxed or banned, trans fats have been limited, and on and on.  Might be interesting to know if any of these intrusions into private decision-making and choice are having any beneficial effects.  A study in Health Affairs finds that limiting access to fast food restaurants does not appear to impact obesity rates.   (HA Article)   While some other research has suggested that access to food with different supposed health characteristics may be related to higher or lower rates of obesity, these studies are generally seriously flawed by not controlling for factors related to choices, or inability to choose, where one lives.  In this study, the authors used data collected on veterans about their residential environment over a 7 year period.  In particular they looked at access to fast food, supermarkets and mass merchandisers who also sell food.  Data on over 1.7 million people aged 20 to 64 was analyzed.  Their body-mass index was calculated and the number of certain types of food sources within one mile or three miles was also collected.

Alas, the results are not what the smart people who know how we all should live hoped for.  For mean, access to chain or non-chain supermarkets within a mile had no association with BMI; access to a mass merchandiser within a mile had a very slight correlation with increased BMI; living within a mile of more chain fast-food restaurants also had a slight correlation with higher BMI, but access to non-chain fast-food sources actually was associated with lower BMIs.  The larger geographic access of three miles showed generally the same pattern.  There was no association over time due to changes in access.  For women, the results were similar.  The authors summarized their findings as follows:  “we found almost no evidence that absolute or relative geographic accessibility of (food outlets) affected BMI”.   Now this won’t stop the do-gooders who really don’t care about science or evidence; they are just sure that their ideas and beliefs must be right, no matter what the facts are.  And the whole premise is wrong.  We should want people to live healthy lives, but the way to encourage this is to make sure people bear the consequences of their actions and know that they will bear those consequences, number one, and number two, to provide them with education, information and tools to help them make those healthy choices.