Being fat can make you sick. Being sick can make you poor. And being poor can make you fat. The complex interplay between these factors makes it difficult to plan for public health policymaking. Futhermore,
"Those in greatest need...tend to be both poor and fat. We know, for instance, that the lower your income, the more likely you are to inhabit an 'obesogenic' environment. Food options in poor neighborhoods are severely limited: It's a lot easier to find quarter waters and pork rinds on the corner than fresh fruit and vegetables. Low-income workers may also have less time to cook their own meals, less money to join sports clubs, and less opportunity to exercise outdoors."
Engber writes that programs designed simply to reduce obesity won't work; a more just distribution of a society's resources can help alleviate poverty, ill health and obesity.