We all know obesity is on the rise across the globe. All countries are quickly developing an obesity crisis if they don’t have one already. Obesity however is not simply a matter of calories in vs. calories out nor is it genetic, cultural or environmental but a combination of factors. Now, as we explored earlier– to cut diabetes risk to the obese, dropping weight is the number one solution and its impact is immediate and profound. That said, other factors need to be studied.

McAllister et al 2012 looked at several different types of data dating back to 1980 or earlier, depending on what was available. This was done in an effort to find the factors that most influence obesity across national borders and from culture to another.

Among the factors analyzed; increased maternal age at first birth, BMI and baby weight, sleep debt, exposure to endocrine disruptors, ambient air temperature, gestational diabetes, pharmacological agents and the intrauterine environment, reproductive fitness and rate of infections.

It was found, that every factor could increase body fatness. In fact, every factor had both animal evidence and epidemiological evidence. Pharmacological agents were the only one that had strong experimental evidence in humans. Correlational data was found for maternal age, sleep debt, endocrine disruptors, pharmacological agents, ambient air temperature and intrauterine environment. This tends to indicate that living with plastics, air conditioning, an educated class of women, high-stress, long-hours and many other aspects of early 21st century life put us all at increased risk of obesity either from our own or from our mother’s behaviors.

Clearly, this demonstrates quite clearly that factors beyond nutrition and exercise play a role (though how much of sleep debt and endocrine disruptors play a role compared to nutrition and exercise is not thoroughly explored). We need to map out as many factors as possible and learn to control what we can. I am still a firm believer that fitness trumps everything but clearly, lining up other factors helps to control the outcome. Given the rapid onset of obesity as a cultural phenomenon, having a multifaceted understanding will help fitness and health care professionals get a handle on it and help get it under control. Hopefully, between lifestyle interventions and medical interventions, the bulk of these cases can be treated.