The Upstream Determinants of Adult Obesity

Over-consumption of high-energy foods and a lack of physical activity are the main behavioural risk factors for people to develop obesity. These behaviours are influenced by a range of individual-level factors which are nested within contexts that contain influencing characteristics further upstream. In this paper, we define these upstream determinants. We also provide a historical background, summarise the current evidence base regarding these determinants across various types of environments and put them in perspective.

• Publication year

  2017

• Venue

  Obesity Facts

• Publication date

  2017-06-01

• Fields of study

  Sociology, Medicine, Environmental Science

• Identifiers
  DOI 10.1159/000471489PMID 28564658PMCID PMC5644962
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• The way ahead: where next for research into obesogenic environments?

  2016cited by this paper
• Height, body mass index, and socioeconomic status: mendelian randomisation study in UK Biobank

  2016cited by this paper
• Neighbourhood social capital: measurement issues and associations with health outcomes

  2016cited by this paper
• Social environment : definitions , measures and associations with weight status – a systematic review

  2016cited by this paper
• The political determinants of health—10 years on

  2015cited by this paper
• The role of social networks in the development of overweight and obesity among adults: a scoping review

  2015cited by this paper
• Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking.

  2015cited by this paper
• Obesogenic environments: a systematic review of the association between the physical environment and adult weight status, the SPOTLIGHT project

  2014cited by this paper
• The Upstream Doctors

  2013cited by this paper
• Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta-analysis

  2013cited by this paper
• Pro v Con Debate: Role of sugar sweetened beverages in obesity Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases

  2013cited by this paper
• Built environment, physical activity, and obesity: what have we learned from reviewing the literature?

  2012cited by this paper
• A systematic review of built environment factors related to physical activity and obesity risk: implications for smart growth urban planning

  2011cited by this paper
• The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment and a research agenda

  2011cited by this paper
• Neighborhoods, obesity, and diabetes--a randomized social experiment.

  2011cited by this paper
• The global obesity pandemic: shaped by global drivers and local environments.

  2011cited by this paper
• When do we know enough to recommend action on the social determinants of health?

  2011cited by this paper
• The built environment and obesity: a systematic review of the epidemiologic evidence.

  2010cited by this paper
• Environmental determinants of overweight and obesity : extended international literature review

  2009cited by this paper
• Thinking in Circles About Obesity: Applying Systems Thinking to Weight Management

  2009cited by this paper
• Targeting health disparities: a model linking upstream determinants to downstream interventions.

  2008cited by this paper
• Short Sleep Duration and Weight Gain: A Systematic Review

  2008cited by this paper
• The spread of obesity in a large social network over 32 years.

  2007cited by this paper
• SUPPLEMENTARY ONLINE MATERIAL FOR: THE SPREAD OF OBESITY IN A LARGE SOCIAL NETWORK OVER 32 YEARS

  2007cited by this paper
• Cross-national comparison of environmental and policy correlates of obesity in Europe.

  2007cited by this paper
• The built environment and obesity.

  2007cited by this paper
• Obesity and the built environment.

  2005cited by this paper
• The economics of obesity: dietary energy density and energy cost.

  2005cited by this paper
• Socioeconomic status and obesity in adult populations of developing countries: a review.

  2004cited by this paper
• Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women.

  2003cited by this paper
• Why Have Americans Become More Obese

  2003cited by this paper
• Social Inequalities in Health: Disentangling the Underlying Mechanisms

  2001cited by this paper
• Social Inequalities in Health

  2001cited by this paper
• The Contribution of Social and Behavioral Research to an Understanding of the Distribution of Disease: A Multilevel Approach

  2000cited by this paper
• Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity.

  1999cited by this paper
• Neighborhood environments and coronary heart disease: a multilevel analysis.

  1997cited by this paper
• Obesity in Europe.

  1995cited by this paper
• THE STRATEGY OF PREVENTIVE MEDICINE

  1992cited by this paper
• Socioeconomic status and obesity: a review of the literature.

  1989cited by this paper
• Sick individuals and sick populations.

  1985cited by this paper
• American Journal of Epidemiology Original Contribution Psychosocial Stress and Change in Weight among Us Adults

  year unknowncited by this paper

• Investigating the Moderating Role of Food Security on Group Session Attendance of an HIV/STI Intervention for Black Women Under Community Supervision

  2026cites this paper
• The impact of public policy on socioeconomic equity in physical activity: a systematic review.

  2026cites this paper
• Built environmental characteristics, physical activity, diet, and nutritional status in Accra, Ghana: a cross-sectional study

  2026cites this paper
• Prevalence of childhood overweight and obesity in Slovakia from 2018 to 2022: An epidemiological analysis

  2026cites this paper
• Advancing knowledge, maps and tools to address obesity and related socio-economic disparities in Europe: the OBCT project

  2025cites this paper
• Economic factors associated with county-level mental health – United States, 2019

  2025cites this paper
• The implementation of physical activity policies in the Netherlands: a study applying the Physical Activity Environment Policy Index (PA-EPI)

  2025cites this paper
• The association between relative fat mass (RFM) and lumbar bone density in US adults: Insight from 2011–2018 NHANES

  2025cites this paper
• Neighborhood Retail Food Environment, Diet Quality and Type 2 Diabetes Incidence in 4 Dutch Cohorts

  2025cites this paper
• Cross-cultural differences in weight loss maintenance: a comparison between North America and Europe

  2025cites this paper
• Ethnic inequalities in physico-chemical, physical and social neighborhood exposures: An individual-level data analysis of 13,926,781 adults

  2025cites this paper
• Interplay between genetic risk and built neighborhood conditions as predictor of BMI across the transition into adulthood

  2025cites this paper
• Associations Between Social Risks and Obesity in High-risk Veterans.

  2025cites this paper
• Lifestyle interventions for cardiometabolic health

  2024cites this paper
• Opportunities for General Internal Medicine to Promote Equity in Obesity Care

  2024cites this paper
• Moderators and mediators of the association between the obesogenicity of neighbourhoods and weight status in Dutch adults.

  2024cites this paper
• Associations of neighborhood social cohesion and changes in BMI—The Maastricht Study

  2024cites this paper
• Co-occurrence of obesogenic behaviors and their implications for mental health during the COVID-19 pandemic: a study with university students

  2024cites this paper
• The Influence of Housing Status and Food Insecurity on a Behavioral HIV/STI Prevention Intervention for Black Women under Community Supervision in New York City: A Moderation Analysis

  2024cites this paper
• The association of Obesogenic Environments with Weight Status, Blood Pressure, and Blood Lipids: A Cross-Sectional Pooled Analysis across Five Cohorts.

  2024cites this paper
• Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.

  2024cites this paper
• The Contribution of the Underlying Factors to Socioeconomic Inequalities in Obesity: A Life Course Perspective

  2024cites this paper
• Obesity modulates NK cell activity via LDL and DUSP1 signaling for populations with adverse social determinants

  2024cites this paper
• Metabolic and Molecular Response to High-Fat Diet Differs between Rats with Constitutionally High and Low Serotonin Tone

  2023cites this paper
• Pathways from the Campus-Based Built Environment to Obesity: Evidence from Undergraduates in China

  2023cites this paper
• Neighbourhood fast-food environments and hypertension in Canadian adults.

  2023cites this paper
• County‐level socio‐environmental factors and obesity prevalence in the United States

  2023cites this paper
• Associations between dimensions of the social environment and cardiometabolic risk factors: Systematic review and meta-analysis

  2023cites this paper
• Living with obesity in Ireland: determinants, policy and future perspectives.

  2023cites this paper
• Does Weight Gain Makes Elderly More Vulnerable in Labour Market

  2023cites this paper
• Life-course social disparities in body mass index trajectories across adulthood: cohort study evidence from China health and nutrition survey

  2023cites this paper
• Obesity; Spatial Accessibility and SEIFA Case Study: Greater Melbourne Area (GMA)

  2023cites this paper
• Social Determinants modulate NK cell activity via obesity, LDL, and DUSP1 signaling

  2023cites this paper
• Upstream Determinants of Overweight and Obesity in Europe

  2023influential citation
• Temporal trends in obesity defined by the relative fat mass (RFM) index among adults in the United States from 1999 to 2020: a population-based study

  2023cites this paper
• Predictors of successful return to parkrun for first-time adult participants in Scotland

  2023cites this paper
• Associations between the neighbourhood food environment and cardiovascular disease: A systematic review.

  2023cites this paper
• The built environment and cardiovascular disease: an umbrella review and meta-meta-analysis.

  2023cites this paper
• Relationships between anthropometric and body composition characteristics and age in Polish women over 60 as affected by their socioeconomic and health status and physical activity levels

  2023cites this paper
• Substitution of cooked kidney beans or ground beef in hypercholesterolemic high fat diets reduces plasma and liver lipids in hamsters

  2023cites this paper
• The Value and Process of Inclusion: Using Sensitive, Respectful, and Inclusive Language and Images in NCCN Content.

  2023cites this paper
• Body Image, Body Composition, and Aging in Women: Insights into an Older Adult Problem

  2023cites this paper
• The environment a young person grows up in is associated with their mental health: A nationwide geospatial study using the integrated data infrastructure, New Zealand.

  2023cites this paper
• The Impact of the Social Determinants of Human Health on Companion Animal Welfare

  2023cites this paper
• Health promoting sports clubs: from theoretical model to logic model.

  2023cites this paper
• Characteristics of parkrun That Encourage New Participants to Return

  2023cites this paper
• Longitudinal dietary trajectories from pregnancy to 3 years post delivery in women with obesity: relationships with adiposity

  2023cites this paper
• Participant recruitment, baseline characteristics and at-home-measurements of cardiometabolic risk markers: insights from the Supreme Nudge parallel cluster-randomised controlled supermarket trial

  2023cites this paper
• Comparative study on the importance of physical activity on body composition in adults

  2022cites this paper
• Machine learning approaches to characterize the obesogenic urban exposome.

  2022cites this paper
• Social determinants of health and obesity: Findings from a national study of US adults

  2022cites this paper
• Large-scale diet tracking data reveal disparate associations between food environment and diet

  2022cites this paper
• Using Structural Equation Modeling to Untangle Pathways of Risk Factors Associated with Incident Type 2 Diabetes: the Lifelines Cohort Study

  2022cites this paper
• Population density and obesity in rural China: Mediation effects of car ownership

  2022cites this paper
• Obesity is negatively associated with dental caries among children and adolescents in Huizhou: a cross-sectional study

  2022cites this paper
• The Association Between Perceived Discrimination and BMI Trajectory

  2022cites this paper
• Associations between Adverse Childhood Experiences and Obesity in a Developing Country: A Cross-Sectional Study among Middle-Aged and Older Chinese Adults

  2022cites this paper
• Relation between the food environment and oral health—systematic review

  2022cites this paper
• Densification and health in China: A U-shaped association between population density and obesity

  2022cites this paper
• On Target: Environmental Health Messaging That Hits the Mark

  2022cites this paper
• Life-course social disparities in body mass index trajectories across adulthood: cohort study evidence from China Health and Nutrition Survey

  2022cites this paper
• Associations of four indexes of social determinants of health and two community typologies with new onset type 2 diabetes across a diverse geography in Pennsylvania

  2022cites this paper
• Famine exposure in adolescence is associated with a higher risk of overweight/obesity and abdominal obesity in adulthood: A meta-analysis.

  2022cites this paper
• Does eating behaviour among adolescents and young adults seeking obesity treatment differ depending on sex, body composition, and parental country of birth?

  2022cites this paper
• Globalisation and Rising Obesity in Low-Middle Income Countries

  2022cites this paper
• Community priorities for obesity prevention among low-income adults in Kuala Lumpur: a discrete choice experiment

  2022cites this paper
• Public preferences for policies promoting a healthy diet: a discrete choice experiment

  2022cites this paper
• Neighborhood socioeconomic differences in BMI: The role of fast‐food outlets and physical activity facilities

  2022cites this paper
• Healthy eating: a matter of prioritisation by households or policymakers?

  2021cites this paper
• Communicating About Weight in Dietetics Practice: Recommendations for Reduction of Weight Bias and Stigma.

  2021cites this paper
• A critique of the English national policy from a social determinants of health perspective using a realist and problem representation approach: the ‘Childhood Obesity: a plan for action’ (2016, 2018, 2019)

  2021cites this paper
• Cardiovascular Impact of Race and Ethnicity in Patients With Diabetes and Obesity: JACC Focus Seminar 2/9.

  2021cites this paper
• Sociodemographic disparities and contextual factors in obesity: updated evidence from a National Survey of Risk Factors for Chronic Diseases

  2021influential citation
• Rethinking sustainability in childhood obesity prevention interventions: learning from South Australia's Obesity Prevention and Lifestyle (OPAL) Programme.

  2021cites this paper
• Anthropometric Profile of Latin American Population: Results From the ELANS Study

  2021cites this paper
• An appeal to our government for nationwide policies in the prevention of cardiovascular disease

  2021cites this paper
• Trajectories of Dietary Patterns and Their Associations with Overweight/Obesity among Chinese Adults: China Health and Nutrition Survey 1991–2018

  2021cites this paper
• Low-wage migrant workers during coronavirus disease 2019: a social determinants analysis

  2021cites this paper
• Developing a Culturally Responsive Lifestyle Intervention for Overweight/Obese U.S. Mexicans

  2021cites this paper
• Predictors of surgical intervention for those seeking bariatric surgery.

  2021cites this paper
• Associations between the built environment and obesity: an umbrella review

  2021cites this paper
• Do Associations Between Vascular Risk and Mild Cognitive Impairment Vary by Race?

  2021cites this paper
• A practical approach to obesity prevention: Healthy home habits

  2021cites this paper
• A cluster-randomised controlled trial of the LifeLab education intervention to improve health literacy in adolescents

  2021cites this paper
• Is the proportion of per capita fat supply associated with the prevalence of overweight and obesity? an ecological analysis

  2021cites this paper
• Accuracy of buffers and self-drawn neighbourhoods in representing adolescent GPS measured activity spaces: An exploratory study.

  2021cites this paper
• The good, the bad, and the environment: developing an area-based measure of access to health-promoting and health-constraining environments in New Zealand

  2021cites this paper
• Meal composition during an ad libitum buffet meal and longitudinal predictions of weight and percent body fat change: The role of hyper-palatable, energy dense, and ultra-processed foods.

  2021cites this paper
• Nature as Ally in Our Chronic Disease Epidemic

  2020influential citation
• Cardiometabolic risk factors for COVID-19 susceptibility and severity: A Mendelian randomization analysis

  2020cites this paper
• Assessment of Age-Induced Changes in Body Fat Percentage and BMI Aided by Bayesian Modelling: A Cross-Sectional Cohort Study in Middle-Aged and Older Adults

  2020cites this paper
• Obesity: A Complex Process Requiring Reframing

  2020cites this paper
• Trends in obesity by socioeconomic status among non-pregnant women aged 15–49 y: a cross-sectional, multi-dimensional equity analysis of demographic and health surveys in 11 sub-Saharan Africa countries, 1994–2015

  2020cites this paper
• Deep phenotyping meets big data: the Geoscience and hEalth Cohort COnsortium (GECCO) data to enable exposome studies in The Netherlands

  2020cites this paper
• H2Oslim®, the water-soluble polysaccharides from Agaricus bisporus, significantly reduces body weight and improves lipid parameters in overweight humans in a randomized double-blind vs placebo study

  2020cites this paper
• “Being fat is not a disease but a sign of good living”: The Political Economy of Overweight and Obesity in Nigeria

  2020cites this paper
• CIA_A_277171 2301..2311

  2020cites this paper
• Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED)

  2020cites this paper
• Do physical activity and sedentary time mediate the association of the perceived environment with BMI? The IPEN adult study.

  2020cites this paper
• Mobile health (m-health) smartphone interventions for overweight or obese adolescents and adults

  2020cites this paper