Neighborhood safety may be key to losing weight

Feeling safe where you live may be the key to losing weight, the European Congress on Obesity (ECO) in Dublin, Ireland (May 17-20) will hear.

Preliminary Dutch research showed that feeling safer in their neighborhood was associated with greater weight loss when participating in lifestyle interventions.

The term “neighborhood safety” covered four dimensions: not feeling afraid of crime or harassment while walking through the neighborhood, feeling safe while walking or cycling due to heavy traffic, adequate lighting of the streets during the evening and night and the absence of young people loitering. Region.

In contrast, no significant association was found between access to groceries or sports facilities and weight loss.

Lower socioeconomic status, often measured using neighborhood characteristics or zip codes, is a known risk factor for obesity. Lifestyle interventions, such as diet and exercise programmes, can play an important role in addressing obesity. However, little is known about the influence of neighborhood characteristics on the success of such interventions.

To learn more, Boëlle Brouwer, of University Medical Center Rotterdam, Rotterdam, Netherlands, studied the relationship between neighborhood characteristics and changes in waist circumference and weight in subjects participating in a 1.5-year combined multidisciplinary lifestyle intervention.

The study included 122 obese subjects (74.6 percent women, mean BMI = 39 kg/m).²) who participated in the intervention, which included dietary advice along with exercise and cognitive behavioral therapy, between October 2011 and April 2022.

Before starting the program, participants were asked to complete a questionnaire evaluating neighborhood characteristics focusing on five factors: neighborhood safety (four items – see above), neighborhood attractiveness (four items – presence of trees along the road, presence of a nearby park, clean and tidy appearance of the neighborhood and general attractiveness of the area as a desirable place to live), social cohesion (three components—feeling of unity when in the neighborhood, people in the neighborhood have positive social interactions with each other and people in the neighborhood are willing to help each other), and access to groceries (one component—the ability to Daily grocery shopping in the neighborhood) and access to sports facilities (one item – having sports facilities nearby).

Height, weight, and waist circumference were measured before the start of the program, after 10 weeks, and after 1.5 years.

The study found that individuals who scored higher on a measure of neighborhood safety (with a possible overall score ranging from 1 to 5, 5 indicating the highest sense of security), experienced greater decreases in both weight and waist circumference.

Higher results in vivo safety were associated with increased weight loss after 10 weeks. Specifically, a 1-point increase in the neighborhood safety score was associated with an initial weight loss of 1.3%.

Similarly, a greater sense of safety in one’s neighborhood was linked to greater weight loss and a greater reduction in waist circumference at the end of the program (after 1.5 years). A 1-point increase in the long-term neighborhood safety score was associated with an average 3.2% decrease in weight and a 2.6% average decrease in waist circumference (the latter indicating a positive change in body composition toward less abdominal fat accumulation).

Remarkably, these results were independent of sex, age, and educational level. There are several possible reasons why neighborhood safety is important. People may be less willing to go out if they feel insecure, which leads to less physical activity. Another explanation could be that feelings of insecurity increase stress levels, which can contribute to unhealthy eating behavior and weight gain. We also cannot rule out that neighborhood safety is associated with other factors, such as poverty, that may be important to the association we found.”

Boyle Brewer, University Medical Center Rotterdam, Rotterdam

The study also indicated that increasing the social cohesion score by one point (ranging from 1 to 5 with 5 indicating the highest sense of social cohesion), tended to give an average decrease of 1.3 percent in waist circumference over the first 10 weeks. Again, this was independent of gender, age, and educational level.

“Overall, it is known that social cohesion can provide social support and motivation for participants,” says Ms. Brewer. “Feeling connected and supported by people in your surroundings can increase adherence to healthy behaviors and improve overall outcomes of lifestyle interventions.”

No significant associations were found between social cohesion, weight, and waist circumference.

No significant associations were found between access to groceries or sports facilities and changes in weight or waist circumference.

However, there were indications of a possible link between neighborhood attractiveness and long-term weight loss and changes in waist circumference, when adjusting for sex, age, and education level.

Ms Brewer says: “Our findings suggest that if you feel insecure where you live, this may reduce your chances of successful weight loss in response to common lifestyle interventions.

“We need more research to determine how neighborhood safety may affect weight and waist circumference and whether feelings of safety are related to other factors such as housing, stress or poverty.”

Study co-author Professor Elisabeth van Rossum, also from the University Medical Center Rotterdam, adds: “We often focus on individuals in the context of lifestyle intervention for people with obesity. In this study we found indications that the social and physical environment may play a role in obesity. The success of the intervention, although we need more research to see if this is causally linked.

“If it turns out that these environmental and social factors are indeed drivers of the success of a directed lifestyle intervention, then we need to study the extent to which this also applies to individuals trying to lose weight on their own.”