Researchers found that one million of America’s three million homeless people are obese or too close to obesity.
“This study suggests that obesity may be the new malnutrition of the homeless in the United States,” one expert involved in the project said.
By the metric of body mass index, just 1.6 percent were underweight. The researchers say that about one-third fell in what’s considered a normal weight range.
Some 65.7 percent were overweight, of which half — 32.3 percent of the study’s total homeless population — were formally obese.
As one co-author points out: “I thought we’d see a lot more people who were malnourished.”
“People who are homeless are under a lot of stress, and stress causes higher cortisol levels. Higher cortisol levels lead to weight gain,” he explained.
The numbers generally matched obesity rates expected among the general population, a surprising finding among people ostensibly too poor to buy enough food, writes Wired.
“I thought we’d see a lot more people who were malnourished or underweight,” said Jim O’Connell, president of the Boston Health Care for the Homeless Program and co-author of the study.
The fast food and processed food products homeless people eat are already bad for them, said nutritionist Sherry Tanumihardjo of the University of Wisconsin, who has studied the hunger-obesity paradox but was not involved in this research.
The link between stress and weight gain is an ancient physiological adaptation designed to store energy in times of uncertainty. It’s a double-whammy when combined with the natural instinct of a food-insecure person to eat as much as possible in case of opportunity.
However, homeless people in other countries share the same stress responses, but they don’t suffer from obesity. So, it can be easily explained by American food system in which low-nutrient, high-calorie foods are especially inexpensive.
It may not be quite as difficult as sometimes portrayed to eat healthy on a budget, but homeless people certainly don’t have the money. Potato chips and soda are relatively affordable, accessible and filling.
“You can buy calories very cheaply, but it’s hard to buy nutrition cheaply,” said Andrew Rundle, a Columbia University obesity researcher who was also not involved in the study.
“Obesity-related diseases among America’s 3 million homeless are a looming problem”, said O’Connell. Diabetes is typically managed with diet and exercise, neither of which are easily controlled on their lifestyle. One more problem appears as insulin needles are often not permitted inside shelters.
“This is going to be a national issue,” said O’Connell, who described the homeless situation as anticipating trends in the mainstream U.S. population. Project current health trends into the future, and one in three U.S. adults will be diabetic in 2050.
“The homeless will show it to us early,” O’Connell added. “Because they’re living on the edge of survival, they frequently point out to us the weaknesses of our mainstream systems.”
The full research conducted by led by Harvard Medical School student Katherine Koh will be published in an upcoming Journal of Urban Health study.