Most researchers agree that a combination of excessive calorie consumption and a sedentary lifestyle are the primary causes of obesity.[46] In a minority of cases, increased food consumption can be attributed to genetic, medical, or psychiatric illness. Generally however the rising prevalence of obesity is attributed to the availability of an easily accessible and palatable diet,[47] car culture and mechanized manufacturing.[48][49] A 2006 review identifies ten other possible contributors to the recent increase of obesity: (1) insufficient sleep, (2) endocrine disruptors������¢���¯���¿���½���¯���¿���½food substances that interfere with lipid metabolism, (3) decreased variability in ambient temperature, (4) decreased rates of smoking as smoking suppresses appetite, (5) increased use of medication that leads to weight gain, (6) increased distribution of ethnic and age groups that tend to be heavier, (7) pregnancy at a later age, (8) intrauterine and intergenerational effects, (9) positive natural selection of people with a higher BMI, (10) assortative mating, heavier people tending to form relationships with each other.[50]
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Despite the widespread availability of nutritional information in schools, doctors' offices, on the internet and on product packaging,[51] it is evident that overeating remains a substantial problem. In the period of 1971������¢���¯���¿���½���¯���¿���½2000, obesity rates in the United States increased from 14.5% to 30.9%.[52] During the same time period, an increase occurred in the average amount of calories consumed. For women, the average increase was 335 calories per day (1542 calories in 1971 and 1877 calories in 2004), while for men the average increase was 168 calories per day (2450 calories in 1971 and 2618 calories in 2004). Most of these extra calories came from an increase in carbohydrate consumption rather than an increase in fat consumption.[53] The primary sources of these extra carbohydrates are sweetened beverages, which now accounts for almost 25 percent of daily calories in young adults.[54] Dietary trends have changed with reliance on energy-dense fast-food meals tripling between 1977 and 1995, and calorie intake from fast food quadrupling over the same period.[55] In the early 1980s, the administration of Ronald Reagan lifted regulations limiting the advertising of sweets and fast food to children, and advertisement of these products directed towards children has increased.[56] Agricultural policy and techniques in the United States and Europe have led to lower food prices. In the United States, subsidization of corn, soy, wheat, and rice through the U.S. farm bill has made the main sources of processed food relatively cheap compared to fruits and vegetables.[57]
There is little evidence to support the commonly expressed view that some obese people eat little yet gain weight due to a slow metabolism. What has been found, however, is that some obese people underreport how much food they consume compared to those of normal weight.[18]
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