Why Money Won't Buy Fat

Health and medicine explained.
Dec. 25 1998 3:30 AM

Why Money Won't Buy Fat

In rich countries, the rich get rich and the poor get fat.

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This cultural-differences explanation certainly accounts for why anorexia nervosa is mainly a disease of higher-income girls and young women. Since obese men are less stigmatized, it may also explain why wealthier men are not that much less obese than poorer men.

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Still, if thinness really becomes the ideal in every affluent culture--the way plumpness is in poor societies--it's curious. Is this simply the nature of status--the rich will always find a way to distinguish themselves from the poor? Or does richness breed an instinct for longevity? Whatever the case, I'll know India has finally risen from Third World status when I go back to visit my relatives and the first few words they say are not "Eat, eat, skinny boy."

Atul Gawande, a surgical resident in Boston, is a staff writer on medicine for The New Yorker and author of the new book Complications: A Surgeon's Notes on an Imperfect Science.