A welcome addition to the largely economic focus of the
book would have been discussion of different cultural attitudes
towards healthy or desirable body weights. This would have been
especially suitable in those portions of the book that discuss how
the obesity epidemic is spreading and being responded to in
various countries of the world. Less forgivable given the
economic focus of the book is the brevity of the discussion on
povel1y and how it relates to the difficulty of acquiring a
nutritious diet. It is rather blithely stated that obesity is more
common among the poor and that food is more expensive in poor
neighbourhoods. This is oversimplification at best: a
comprehensi ve review of the links between obesity and
socioeconomic status (Sobal and Strunkard 1989) found such a
relationship only among women; more recent work has
suggested that links between SES and obesity are strongly
influenced by ethnicity, gender, and the country in which the
research was done (e.g., McTigue et a!. 2002; Wang 2001). As
for food prices, large- scale studies often fail to find that prices
vary significantly with neighbourhood affluence-of those that
do, many find that prices are lower in poor neighbourhoods.
Smaller scale studies checking the price of greater numbers of
foods have more often reported higher prices in poorer
neighbourhoods, but many of these are often done by advocacy
organizations, and some studies, including at least one cited by
Battle and Horgen, did not perform statistical tests.
These criticisms should not overwhelm what is an
admirably comprehensive (from a biomedical/public health point
of view) treatment of the obesity epidemic as it stands in
America and elsewhere in the world. Especially useful will be
the identification of US policies to be avoided. Canadians, who
are not far behind the US in losing the battle of the bulge, would
do well to make use of this information, and to collect reliable,
national-level anthropometric survey data. Exact overweight and
obesity prevalence figures are unavai lable at present. The
National Longitudinal Study of Children and Youth and National