Obesity and how it's being addressed?

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monkeyMD

monkeyMD

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A random question...but...

Are doctors doing anything about this?
What is your opinion regarding the obesity epidemic?
Aren't many doctors overweight?
Are people doing any research on this in Med Schools?
Any input?
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If you eat too much you get fat.

What else do you want doctors to say? The onus is on the fat person to make healthy lifestyle choices as recommended by his/her doctor.
 
It actually starts by people taking measures on their own, such as exercising, healthy eating, and better lifestyle choices.
 
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Obesity is related to personal responsibility (this is obviously not directed towards people who have real medical issues).

It doesn't matter what your doctor says/prescribes you, if you're going to eat that chocolate cake all by yourself, you're probably going to be a fat slob.
 
The obesity epidemic goes much farther than what you eat and how much you exercise. There are a number of complex factors including age, ethnicity/culture, genetics, SES, region, access to healthy options, other health conditions and medications, etc.
 
For most people, it's simply a matter of personal decisions. If you want to lose weight, simply eat less and exercise more.

However, I'm more concerned about younger kids who don't understand the concept of healthy choices. If a young kid eats french fries every day, he (or she) will be programmed to think it's normal and not unhealthy. In that case, it's up to the parents to make the right choices for him/her.
 
Whatyousay said:
Obesity is related to personal responsibility (this is obviously not directed towards people who have real medical issues).

It doesn't matter what your doctor says/prescribes you, if you're going to eat that chocolate cake all by yourself, you're probably going to be a fat slob.
Click to expand...

While eating a whole cake and other overeating habits = weight gain;

eating a whole cake =/= slob, lazy, etc. be careful not to stereotype.
 
Patient (non) compliance/adherence is difficult to deal with for the aforementioned reasons. It doesn't always mean someone is a lazy slob as the above poster mentions. There definitely are lazy slobs but, in my experience, they don't seem to be the majority.
 
senorsquishie said:
While eating a whole cake and other overeating habits = weight gain;

eating a whole cake =/= slob, lazy, etc. be careful not to stereotype.
Click to expand...

But without stereotypes, how can we generalize?
 
It's being dressed with ranch, barbecue sauce, mayo, and a variety of spices. Mmmmm...:corny:
 
Unfortunately most people who have had the luxury of being skinny/normal their entire lives think that it is easy to say "eat less move more." I was overweight my entire life and finally committed and was able to drop 40lbs and have a better lifestyle. Sometimes you really need a personalized regimen to really lose a lot of weight. The cookie cutter diet plans you get at your doctors office doesn't cut it. Some people really need a structured plan in accordance to their psychology and goals. Hopefully this gets addressed in the future.
 
BJJ said:
Unfortunately most people who have had the luxury of being skinny/normal their entire lives think that it is easy to say "eat less move more." I was overweight my entire life and finally committed and was able to drop 40lbs and have a better lifestyle. Sometimes you really need a personalized regimen to really lose a lot of weight. The cookie cutter diet plans you get at your doctors office doesn't cut it. Some people really need a structured plan in accordance to their psychology and goals. Hopefully this gets addressed in the future.
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I think you make a great point about psychology. If it were as simple as eat less move more it would be easy, but psychology and hormones can be difficult to manage.
 
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rxlea said:
The obesity epidemic goes much farther than what you eat and how much you exercise. There are a number of complex factors including age, ethnicity/culture, genetics, SES, region, access to healthy options, other health conditions and medications, etc.
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Great response.👍
 
Its being addressed with touchy feely lectures/small group discussions that everyone feels are a waste of time in light of the upcoming _________ test.
 
Back when I was a super fatass, my physician never once told me to stop stuffing my fat face so much whenever I needed a physical.
 
BJJ said:
Unfortunately most people who have had the luxury of being skinny/normal their entire lives think that it is easy to say "eat less move more." I was overweight my entire life and finally committed and was able to drop 40lbs and have a better lifestyle. Sometimes you really need a personalized regimen to really lose a lot of weight. The cookie cutter diet plans you get at your doctors office doesn't cut it. Some people really need a structured plan in accordance to their psychology and goals. Hopefully this gets addressed in the future.
Click to expand...

I agree with this. I was overweight all of my adult life, went to yearly doc visits, and was obese the last three years. None of my physicians ever gave me more than a two minute spiel on calories and carbs, and this is over at least eight years of annual visits and after developing weight induced GERD. Sure, give me that PPI and antacid... just make sure you completely fail to tell me how losing weight will cure the disease.

It took doing the research myself, identifying my bad habits, and coming up with my own plan to lose those 60 lbs and go from obese to a BMI under 25. While personal responsibility definitely plays a role, I feel physician involvement needs to be stepped up. There are so many steps along the way my doc could have helped guide me. The whole point of the annual visit is to help make sure we're living a healthy lifestyle... preventative medicine if you will.

As for the OP's questions...

Are doctors doing anything about this?

-I'm not sure

What is your opinion regarding the obesity epidemic?

-It is a complex issue with many factors but public health education is key. I'm of the personal belief that we should be teaching our kids in school healthy eating habits. Alas, school lunches are often based around providing the most calories for your buck. This is slowly changing in the richer neighborhoods but not the poorer ones.

Aren't many doctors overweight?

-Yes, and I can't speak for anyone else, but my pediatrician was very overweight and it made taking his advice (albeit it wasn't much advice) seriously. One reason I dropped the weight was I feel doctors should strive to set a limited example for their patients.

Are people doing any research on this in Med Schools?

- Tons. I had a colleague who charted obesity rates in poor neighborhoods as a function of how close the nearest fast food restaurant was, in two different South American countries. That was a really cool project and as you could guess, more fast food = more obesity. I'm not a fan of legislating against liberty but tidbits like that are interesting to note.
 
monkeyMD said:
A random question...but...

Are doctors doing anything about this?
What is your opinion regarding the obesity epidemic?
Aren't many doctors overweight?
Are people doing any research on this in Med Schools?
Any input?
Click to expand...

It seems more and more younger docs tend to be in very solid shape, but if a doc is overweight, he certainly loses all credibility when giving dietary advice to patients. But in general, nutrition is an inherently controversial field, and most doctors are clueless about it. As one example, American Heart Association has for decades (and still does) recommended low-fat, low-protein, and high in complex carbs/grains which they say should be the base of any diet. Yet, more recent studies at Harvard/Duke/New England Journal have also researched high protein, high fat, low-carb diets and found subjects in those groups lost the most weight, raised HDL/lowered cholesterol and lowered blood pressure the most over a 2 year period.

So I think the research is hardly conclusive and there is still tons to be learned about the best diets and what is causing our obesity epidemic. IMO, one of the biggest contributer to obesity is gov't policy of subsidizing the corn industry...products like High Fructose Corn Syrup make all the cheapest foods the most unhealthy and carb-rich.
 
One resident starts off by asking the patient how they feel about their weight and take it from there. Ask open-ended questions and let them decide what to work on in order to reach their goals. The conversation was similar in nature to what I do as a HIV tester/counselor.

Telling them they're fat and to eat less really doesn't do much except annoy the patient.
 
IKNORITE just diaf y dontcha
 
A fat doctor telling a person to lose weight is really hypocritical. Don't see how really overweight people feel like they should be an MD
 
patel2 said:
It seems more and more younger docs tend to be in very solid shape, but if a doc is overweight, he certainly loses all credibility when giving dietary advice to patients. But in general, nutrition is an inherently controversial field, and most doctors are clueless about it. As one example, American Heart Association has for decades (and still does) recommended low-fat, low-protein, and high in complex carbs/grains which they say should be the base of any diet. Yet, more recent studies at Harvard/Duke/New England Journal have also researched high protein, high fat, low-carb diets and found subjects in those groups lost the most weight, raised HDL/lowered cholesterol and lowered blood pressure the most over a 2 year period.

So I think the research is hardly conclusive and there is still tons to be learned about the best diets and what is causing our obesity epidemic. IMO, one of the biggest contributer to obesity is gov't policy of subsidizing the corn industry...products like High Fructose Corn Syrup make all the cheapest foods the most unhealthy and carb-rich.
Click to expand...

Do they still have those commercials about how high fructose corn syrup is the same as regular sugar? Total lie, as we know.
 
Habits, behavioral psychology, market manipulation, government interventions, neurochemistry, eating behaviors, exercise behaviors, psychological make-up all play a role.

Here are some books to consider on the topic:

Dr. Kushner's Personality Type Diet by Robert F. Kushner (MD expert from Northwestern U.)

The Way to Eat: A Six-Step Path to Lifelong Weight Control
David. L. Katz and Maura Harrigan Gonzalez (Yale affiliated physician and dietitian)

Food Politics: How the Food Industry Influences Nutrition, and Health, by Marion Nestle (nutrition expert from NYU)

Mindless Eating: Why We Eat More Than We Think. Brian Wansink (professor of consumer behavior at Cornell)

The End of Overeating: Taking Control of the Insatiable American Appetite by David Kessler (former dean of Yale Med, former chief of FDA)
 
Kevin Baker said:
I agree with this. I was overweight all of my adult life, went to yearly doc visits, and was obese the last three years. None of my physicians ever gave me more than a two minute spiel on calories and carbs, and this is over at least eight years of annual visits and after developing weight induced GERD. Sure, give me that PPI and antacid... just make sure you completely fail to tell me how losing weight will cure the disease.

It took doing the research myself, identifying my bad habits, and coming up with my own plan to lose those 60 lbs and go from obese to a BMI under 25. While personal responsibility definitely plays a role, I feel physician involvement needs to be stepped up. There are so many steps along the way my doc could have helped guide me. The whole point of the annual visit is to help make sure we're living a healthy lifestyle... preventative medicine if you will.
Click to expand...

My understanding is that doctors are given only one short semester/course on nutrition/health [there first or second year - never really applied. Please correct me if I am wrong though]. They are truly not qualified in my opinion about addressing obesity, weight loss options, and nutrition. The person you should go to to learn about weight loss is a dietitian/nutritionists - which I am sure many doctors would advise if they know their patient is interested in weight loss. While I agree preventative care is very important and encouraging your patient lives health is important, doctors just aren't equipped with all the newest findings and all the different diet choices to really help their patients loss weight, explain nutrition/food choices and/or motivate them to continue on their new healthy lifestyle.

In sum, if someone wants to loss weight - advise them to go to a nutritionists. If someone wants to start exercising more regularly, advise them to get a physical from their doc first.
 
Avoidthetiger said:
My understanding is that doctors are given only one short semester/course on nutrition/health [there first or second year - never really applied. Please correct me if I am wrong though]. They are truly not qualified in my opinion about addressing obesity, weight loss options, and nutrition. The person you should go to to learn about weight loss is a dietitian/nutritionists - which I am sure many doctors would advise if they know their patient is interested in weight loss. While I agree preventative care is very important and encouraging your patient lives health is important, doctors just aren't equipped with all the newest findings and all the different diet choices to really help their patients loss weight, explain nutrition/food choices and/or motivate them to continue on their new healthy lifestyle. So why is there such a deficit in the nutrition education in today's physicians?

In sum, if someone wants to loss weight - advise them to go to a nutritionists. If someone wants to start exercising more regularly, advise them to get a physical from their doc first.
Click to expand...

So are you saying that the role of the doctor is not necessarily to address obesity in the patient population directly, but to advise them to go to nutritionists/dieticians? I have also read somewhere that many doctors are afraid to address the "overweight" patient, because they believe that body weight is a "personal issue." What do you think about that?

As partially mentioned above, the obesity epidemic in the younger generations is "more serious" because of the potential effects it could have on our society down the line...doesn't this mean that pediatricians should play a more active role? Since children often do not go to nutritionists/dieticians? Is the only way to address this through schools?

Also regarding obesity research...are there significant physicians/physician scientists who are contributing significantly to this field (in addition to the ones who wrote the books mentioned above) that have significant papers? Or is it a field that is not well explored?
 
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rxlea said:
Do they still have those commercials about how high fructose corn syrup is the same as regular sugar? Total lie, as we know.
Click to expand...

I saw one the other day, so yes, they do. Unfortunately they don't do a fact check before allowing things on tv. Otherwise, where would Fox News be? 😀
 
Avoidthetiger said:
They are truly not qualified in my opinion about addressing obesity, weight loss options, and nutrition. The person you should go to to learn about weight loss is a dietitian/nutritionists - which I am sure many doctors would advise if they know their patient is interested in weight loss. While I agree preventative care is very important and encouraging your patient lives health is important, doctors just aren't equipped with all the newest findings and all the different diet choices to really help their patients loss weight, explain nutrition/food choices and/or motivate them to continue on their new healthy lifestyle.

In sum, if someone wants to loss weight - advise them to go to a nutritionists. If someone wants to start exercising more regularly, advise them to get a physical from their doc first.
Click to expand...


You don't need the newest findings. Incorporating exercise in some fashion, drinking more water / less juice, trying to incorporate some vegetables/fruits are great places to start.

I guess a great question is when would a doctor feel that seeing a nutritionist would be best?
 
n3xa said:
You don't need the newest findings. Incorporating exercise in some fashion, drinking more water / less juice, trying to incorporate some vegetables/fruits are great places to start.

I guess a great question is when would a doctor feel that seeing a nutritionist would be best?
Click to expand...

I once had a student who worked with families of small children to identify the pithy messages that would be well accepted if delivered by the pediatrician at well child visits for toddlers. There were about a dozen things that docs wanted to bring up but the idea was that it might be best to focus on just one or two directives. The question was, which would be culturally appropriate and well received? (not to insult parents' intelligence or imply that they did x or y) I seem to recall that "limit the child to 4 ounces of juice per day and offer water if the child is thirsty" was one such message.

Nutritionists are most often called upon in the outpatient setting for obesity that may be treated with surgery (some insurance required 6 mos of nutrition counseling before the pt can be scheduled for surgery), renal dialysis, diabetes, and eating disorders.
 
The FOOD SYSTEMS in place are a result of political and economic trends.

If we had food systems that were decentralized with a sustainable base production of vegetables and fruit, perhaps there would be less obesity.

The medical industry could clarify what the healthiest diet really is. I think the food pyramid is not quite accurate. Why do regular, not endurance athletes, need to eat so many grains? Humans didn't even have grains back in the day, we survived on meat and already growing plants.

I think the main thing that needs to be emphasized is a decrease in needless sugar intake. This is mostly directed at myself now.
 
LizzyM said:
I once had a student who worked with families of small children to identify the pithy messages that would be well accepted if delivered by the pediatrician at well child visits for toddlers. There were about a dozen things that docs wanted to bring up but the idea was that it might be best to focus on just one or two directives. The question was, which would be culturally appropriate and well received? (not to insult parents' intelligence or imply that they did x or y) I seem to recall that "limit the child to 4 ounces of juice per day and offer water if the child is thirsty" was one such message.
Click to expand...


True enough. When I shadowed the FM resident, I sort of held my breath and prepared for the worst when I realized the conversation was headed towards the patient's weight. The resident was a gorgeous woman who probably has never seen a fat day in her life. To my surprise, it was well-received. Whether or not the patients were acting nice to save face is another story, but I didn't pick up on it.

I have to constantly watch what I eat and I struggled with my weight growing up, so I paid real close attention to how these conversations went. I complimented her afterwards and told her I wished there were more people that addressed the weight issue like her. The most I ever got from my doctors were, "You're fat. Lose weight."
 
Avoidthetiger said:
My understanding is that doctors are given only one short semester/course on nutrition/health [there first or second year - never really applied. Please correct me if I am wrong though]. They are truly not qualified in my opinion about addressing obesity, weight loss options, and nutrition. The person you should go to to learn about weight loss is a dietitian/nutritionists - which I am sure many doctors would advise if they know their patient is interested in weight loss. While I agree preventative care is very important and encouraging your patient lives health is important, doctors just aren't equipped with all the newest findings and all the different diet choices to really help their patients loss weight, explain nutrition/food choices and/or motivate them to continue on their new healthy lifestyle.

In sum, if someone wants to loss weight - advise them to go to a nutritionists. If someone wants to start exercising more regularly, advise them to get a physical from their doc first.
Click to expand...

I completely agree that in general, docs are completely underqualified to give expert nutritional advice. But I'd say the same about them giving expert illicit drug advice, tobacco and alcohol advice, pregnancy risk advice, STD advice, etc. Yet from what I gather, most family docs ask about drug use, tobacco use, sex, etc from a young age. And then give the patient advice based on their response.

Sure, the average family doc may not know the most uptodate pros and cons of various illicit drugs, second hand smoke, alternative tobacco delivery mechanisms, teenage or young adult drinking, condomless sex, etc. But if the patient, especially a younger patient, presents as a user (yes, even something as safe as pot), a smoker, a binge drinker, or as someone who practices high risk sex, I expect their physician to initiate a conversation on the applicable topics. And in my experience, and others I've talked to, they do... except for pot. It seems, imo, body weight is viewed largely as a personal issue and minimally as a health issue. I think the world would be a better place if docs initiated this often tough conversation about weight, rather than simply be there when the patient wants to change.
 
My doctor doesn't really talk much about my diet and things, matter of fact, he doesn't run blood tests, or anything I see my friends getting done. I guess I should also keep in mind that my friends are overweight, and I am not, I'm at a healthy weight etc. The only thing he said to me about my weight is that when I weighed my most which still wasn't overweight at all, he just said "Oh exercise, run, jog, blah blah blah." that conversation lasted like 5 seconds, because again I wasn't overweight but he still really failed to give out any advice about keeping fit.

Even if your not overweight, you should still exercise.
Obesity also comes from technological advancements. If you're really obese and lazy (which I have some friends who are like this, and then I have friends who are fat, but eat a good diet and exercise a little bit) you don't even have to get you lazy butt out of the bed, hop in the car, and go to the grocery store. You can order it online. Along with clothes, you can order it online, etc.
Can be delivered.
People also may not be able to afford quality good food, so they might be stuck with Mickey Ds, like the people in Honduras (I think), some people look well, and even overweight but they are suffering from malnutrition and are dying because the only thing they can afford is junk food and soda.
So there are also different case scenerios, but in America, I think there aren't that many people that poor, at least you can still steal things from the grocery store to get your food, they can't even do that.
 
doctors arent paid to counsel about nutrition so any time u spend doing so is on ur own. Also what you end up telling them is common sense like being obese is bad. Go exercise. eat healthier. Its not exactly a hidden secret. Everybody knows that eating Micky D's everyday is bad for them. Its really a self control issue.

Exercising is free and doesnt cost any money. Healthy food is actually quite cheap if you know how to buy it. It just doesn't taste good so nobody does.

I regularly buy this stuff from the local grocery in the bronx (aka obesity central + really poor so its not just made up numbers)


Breakfast- quaker oats one month supply costs about 4$ (around 15cents a day) + 1 piece of fruit (50cents)

Lunch- Whole grain bread + turkey + 1 slice of cheese. Costs about 1.50$ per sandwich

Dinner - Steam Frozen vegetables, grilled/baked chicken with some brown rice (2$) + 1 more fruit (50 cents).


Costs less than 6$ a day and is really healthy. And yet you see the oatmeal collecting dust at the top while the chips fly off the shelf. Really its all about personal choice. Its only harder to eat healthy when you are REALLY REALLY poor which is legit, (meaning not the people toting iphone4's while using food stamps), but then again those people tend not to be obese if they are that desperate.

Most problems with our modern healthcare are caused by ourselves and we search for answers like why? when really it is up to each person to make sure they stay healthy, but it is much easier to blame genetics, food choices, etc which I feel is total b.s. unless you're Pima indian or maybe polynesian. Most people were fit 100 years ago, we didn't all suddenly develop fat genes.
 
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circulus vitios said:
Back when I was a super fatass, my physician never once told me to stop stuffing my fat face so much whenever I needed a physical.
Click to expand...
There has been a lot of research on this - drs often don't bring up the issue of weight with a patient because they are afraid the patient will be offended or they don't feel qualified to discuss weight loss issues.

CoolWhipp said:
I'm fat.
Click to expand...
Yeah, me too.

iceman132 said:
A fat doctor telling a person to lose weight is really hypocritical. Don't see how really overweight people feel like they should be an MD
Click to expand...
I don't disagree that personal responsibility is a part of obesity but it is more complicated than just laziness. Look up insulin resistance, for example. Obesity is a medical issue and physicians are not exempt from having their own medical issues. For every normal weight/thin patient that feels I shouldn't be their dr there will be two other overweight/obese patients that feel comfortable with me and know I will try to help them without judging them (2/3 of people in the US are currently overweight or obese).

That being said, I certainly am making every effort to lose weight (seeing a dietician and exercising 45-90 minutes 7 days/week). We do have a responsibility to practice what we preach and try to be a role model.
 
I started going to gym from today !
 
Out of curiosity, how are you going to keep up a 70 min/day exercising routine and intensely healthy eating habits during surgery rotation? Also, I want every one of you to print out your response to this and put it in an envelope. Label it with today's date, your current weight, and age. Compare it in 10 years with your current weight. You may find your words taste very different in your 30's.
 
BrainOnFire said:
Out of curiosity, how are you going to keep up a 70 min/day exercising routine and intensely healthy eating habits during surgery rotation? Also, I want every one of you to print out your response to this and put it in an envelope. Label it with today's date, your current weight, and age. Compare it in 10 years with your current weight. You may find your words taste very different in your 30's.
Click to expand...

I'm sure I won't be able to always eat a perfect diet and exercise every day. But I will still have to try to do the best I can and get in as many days a week of exercise as my situation allows.

BTW, I am 39 years old. What's supposed to change in our 30's? 😉
 
rxlea said:
The obesity epidemic goes much farther than what you eat and how much you exercise. There are a number of complex factors including age, ethnicity/culture, genetics, SES, region, access to healthy options, other health conditions and medications, etc.
Click to expand...


Exactly. Well said.
 
It's so easy to point out food that people should be eating and blame personal preferences for being overweight. And hey, a lot of times it is. But, you also have to look at it from multiple viewpionts. From a public health standpoint, you need to consider the availability of these foods. In the surrounding area of my college, there is an extremely high incidence of obesity. Why? Because of the food deserts-areas in which they only food available is packaged and there is a small amount of produce available. Many of these people work two or three jobs, are single parents, and don't have access to a car. On top of that, their nearby grocery stores only sell boxed and convenient foods. If stores have produce, its mostly rotten and in bad quality. What are people supposed to do? Either spend 10 dollars getting healthy food for a day or packaged food that could feed their family for a week? I don't think we can truly help patients if we don't understand these underlying factors and help improve them first.
 
I am so glad someone mentioned food deserts. This is a huge issue is many low income areas. Recently, the farmers' markets in my area started accepting food stamps, which I think is wonderful; especially since there are numerous of these markets throughout the city within walking distance of many of the neighborhoods most in need. It not only benefits people of a low SES, but the local economy as well.
 
Here's my take on this:
The recent (within like 100 years) changes in how we grow, preserve, prepare, and manipulate food have been far more drastic than any other changes in our diet during humanity's entire evolutionary history. We are inventing all these perverted, synthetic concotions that we call "food" which our bodies have never dealt with before; and we're just eating it up (pun intended). It's kinda gross, but those two tacos or a double-cheeseburger for 99 cents; and hot pockets (c) that are ready to be devoured after 2:30 in a microwave....it's cheap, fast, convenient, and deliciously hard to pass up. But our bodies have never dealt with this kind of crap before and it's kinda surprising that we can actually cope with it. Mix that with poor lifestyle choices, and you have a recipe for disease.

But also income, education, lifestyle, culture, politics, and genetics definitely play a role as well.
 
Pisiform said:
I started going to gym from today !
Click to expand...
Congrats!

Useful information though, is that really diet and exercise don't equal weight loss. Diet alone is the most useful weight loss tool. Exercise has been shown to only be effective in improving cardiovascular health and muscle strength. When it comes to people wanting to loss weight, when you exercise, you actually are more hungry - so you tend to eat more (not to mention the 300-600 calorie shakes/smoothies that you often see at the gym don't help). Individuals tend to actually gain or maintain weight when they start exercising regularly, if they don't carefully monitor their calorie intake. Article

So if you feel compelled to offer advice to a future patient regarding usually extreme weight loss (patient is obese) - advise them to focus on just diet alone first. Then get into exercise over time.

Kevin Baker and above people who wish to have doctors talk about weight loss to their patients. It might be smart for physicians to address that you have some weight to loss (maybe make sure they are eating enough vegetables, remind them to drink water/avoid sodas, are they taking a multivitamin ect ect), but honestly, I feel like the motivation for a patient to loss weight has to come from within. Otherwise, they are never going to be successful.
 
rxlea said:
I am so glad someone mentioned food deserts. This is a huge issue is many low income areas. Recently, the farmers' markets in my area started accepting food stamps, which I think is wonderful; especially since there are numerous of these markets throughout the city within walking distance of many of the neighborhoods most in need. It not only benefits people of a low SES, but the local economy as well.
Click to expand...

🙂 Agreed. Accepting food stamps and opening up markets is a great step. There were a few studies that analyzed the effectiveness of placing farmer's markets in low socioeconomic areas. It was hypothesized that individuals would not increasing their consumption of produce as it was assumed they would only like to eat processed and packaged food. However, the farmers markets started booming. It's not that these individuals WON'T eat produce, it's that its not available. When it does become available, residents actually do purchase them. On top of that, you need to increase education in these areas so that people know about what is available to them and how to go around eating a good diet. Not everyone has access to the internet or nutritionists which they can quickly reference.
 
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