This association between education, socioeconomic level and obesity has not yet been fully explored, and may be false, since rates of obesity are increasing in high and middle income groups as well. Medical issues may lead to weight gain, and must be considered in the differential. Conditions such as hypothyroidism, Cushing's syndrome and polycystic ovarian syndrome are often associated with weight gain. Lack of knowledge surrounding the condition may also contribute to rates of obesity. In a recent study published in American Family Physician (2007), Americans were surveyed asking to report approximate height and weight, which was then used to calculate BMI. Responses showed 20% of Americans were obese and 38% were overweight. Since this study is based on self-report, it is quite possible that there is an even higher degree of obesity, since many people underreport their weight. These figures certainly differ from objective data gained from the Centers for Disease Control and Prevention (CDC) which report that 35% of Americans are overweight and 30% are obese (Katz, et. al, 2007) Katz and colleagues go on to report that it takes a combination of nutritional and physical activity programs rather than simply an emphasis on nutritional changes, supporting the notion that obesity is not simply a matter of excess consumption. Additionally, effectiveness of obesity targeted weight loss programs cannot be based on weight loss alone, since it is important that changes be made in other parameters like types of...

Department of Health and Human Services, 2001). This is especially true when one considers the relative frequency of weight rebound which occurs after short-term weight loss.
In closure, it would appear that the problem of obesity rests not only with an imbalance of intake vs. energy expenditure, but also in a lack of knowledge surrounding healthy life habits. It is not so much how much we eat, but what we eat and how we live which contribute to our risk for obesity.

References

International Obesity Task Force (2007) Global Rates of Obesity, 2006. Accessed on the Internet on 14 October 2007 at http://www.iotf.org/database/GlobalAdultTableJune07.htm

Davidson M, Knafl KA. (2006) Cultural Analysis on the concept of Obesity. Journal of Advanced Nursing. 3, 342-350

No Author Listed. (2007) Poll Shows Americans Underestimate Obesity Problem. American Family Physician. 2; 15-16.

Katz DL, O'Connell M, Yeh MC, Nawaz H, Nijke V, Anderson LM, Cory S, Dietz W. (2007) Public Health Strategies for Preventing and Controlling Overweight and Obesity in School and Worksite Settings MMWR,

US Department of Health and Human Services. The surgeon general's call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001. Available at http://www.surgeongeneral.gov/topics/obesity.