Despite providing access to wholesome fruits and vegetables in food deserts — places where affordable and healthy food is difficult to find — obesity rates continued to stay steady, new study shows.

It’s growing increasingly harder to classify obesity strictly as a personal problem. The Centers for Disease Control and Prevention show that 35.7 percent of the U.S. is obese — a total that, in 2008, put a $147 billion-strain on the health care system. Part of the problem is making healthier food more affordable than the starchy, sugar-heavy foods currently available to low-income budgets. Unfortunately, according to the recent study, initiatives to solve this problem have so far proven unsuccessful.

One of these initiatives is the $400 million Healthy Food Financing Initiative, promoted by the White House Task Force on Childhood Obesity, which informs programs such as Michelle Obama’s "Lets Move!" childhood obesity campaign. The goal of these government-run programs is to bring a wider range of food to impoverished areas, or regions where access to such food is unreasonably far away.

To conduct their study, researchers at the London School of Hygiene & Tropical Medicine and Penn State University analyzed the impact of one Philadelphia supermarket that opened as part of the Pennsylvania Fresh Food Financing Initiative — a program responsible for 88 new or expanded food retail outlets in the area.

The team tracked approximately 650 residents for four years. They looked at what proportion of people used the market exclusively, at least one time, and to what extent people’s health and weight management improved. Unfortunately, by the study’s end only 27 percent of people had adopted the supermarket as their primary food source. And just 51 percent used it at all. The supermarket had no significant impact on improving residents’ obesity or fruit and vegetable intake.

"Though these interventions are plausible and well-meaning,” Dr. Steven Cummins, lead author, said in a statement, “this study suggests that they are only effective in taking us part of the way in changing dietary behavior — in order to realize their full potential we need to better understand how to translate changes in perception to changes in behaviors."

What’s The Problem?

The perceptual changes Cummins mentions may be core to the initiative’s success. Despite its recent classification as a disease, obesity isn’t a single-faceted problem. It’s a combination of factors, which are at once social, biological, and, in Cummins’ study’s case, environmental. People may be predisposed to have lower basal metabolic rates — a determining factor of how quickly the body processes food — but they may also grow up in a household where nutrition was assigned little value, thus reinforcing bad habits.

A large part of this environmental influence stems from the primary source: supermarkets. People that either can’t access or can’t afford fresh fruits and vegetables find alternative food sources to keep their hunger pangs at bay. Enter processed foods. Canned goods and non-perishable enriched grains may be nutritionally poor, but are long-lasting and filling — something Cummins sees as a crippling problem.

"U.S. policymakers have implemented policies and interventions that encourage the location of supermarkets and grocery stores to improve diet and reduce diet-related diseases such as obesity and diabetes,” he said. “However we don't know whether these kinds of policies are effective in improving diet.”

In this, Cummins and his colleagues hope the current study can help motivate further research to learn how to motivate healthier choices within a food desert, whether it’s more supermarkets tailored to residents of the area or complementary initiatives that focus on price promotions, marketing, and branding to encourage people to put down the pastries and pick up a pomegranate instead.

Source: Cummins S, Flint E, Matthews S. New Neighborhood Grocery Store Increased Awareness Of Food Access But Did Not Alter Dietary Habits Or Obesity. Health Affairs. 2014.