Does where you live affect what you weigh?

Adult obesity rates in the United States have reached epidemic proportions, with one in four people considered obese. Yet, obesity rates vary considerably across states and counties.

In a new study, researchers at the Yale Global Health Leadership Institute (GHLI) explored community-level factors that may be associated with reduced adult obesity rates in counties within states that have a high adult obesity rate. Such geographic variation raises questions about the influence of community and regional factors on obesity, said the researchers.

Individuals who are obese are more likely to develop chronic diseases, and as of 2009, the annual cost of obesity in the United States was approximately $300 billion. With the possibility of more people having less or no insurance, finding other means to help offset individuals medical and health costs will become crucial in coming years, said the researchers.

The study, published on Nov. 18 in Biomed Central, identified six U.S. counties that—based on environmental influences—should have high obesity rates. However, the counties had lower rates of adult obesity, suggesting they used uncommon but successful strategies that enabled better outcomes than other, similar counties.

"Through visits and interviews with community leaders and government officials we identified several recurrent themes and strategies," said Maureen Canavan, a GHLI researcher. "We found that counties with self-led initiatives to promote healthy living saw reduced rates in obesity, and fostered more ability for individuals to sustain healthier lifestyles."

Community initiatives that targeted challenges related to physical activity and healthy eating proved successful in helping residents improve their lifestyles. These communities built internal partnerships that utilized their own resources and connections—including collaborations with local restaurants, grocery stores and recreation facilities—to foster initiatives that could then be sustained by community members on their own.

Although a small sample, findings suggest tapping into the unique strengths of a given community (e.g. natural resources, an active retiree community, or local small businesses) instead of medical or individual disease-specific approaches can be employed to counter the obesity epidemic in the United States, said the researchers.