Wealth and weight revisited

A Bayesian model averaging approach to the Obesity Kuznets Curve

84countries
2000–2020study period
1,195main BMA observations

Katerine Restrepo Gómez · He Du · Carlos Mendez

The European Journal of Health Economics · Published October 8, 2026

October 11, 2026

Does becoming richer eventually mean less obesity?

The tension · One turning point may be too simple

A single rise and fall is a hypothesis to test

The familiar Obesity Kuznets Curve predicts:

Income rises → obesity rises → obesity falls

But what if the answer changes with the controls we choose?

The paper tests both the curve’s shape and the choice of model.

The panel links adult obesity to national development

Measurement What enters the analysis
Obesity Age-standardized prevalence, adults 18+
Income GDP per person, constant 2015 US dollars
Coverage 84 countries, 2000–2020
Main BMA sample 1,195 country-year observations

These are national aggregates, not individual weight records.

Let the evidence weigh competing models

The investigation · From model uncertainty to a curve

Fixed effects separate country differences from time changes

Country effects

Absorb persistent differences between countries.

Year effects

Absorb shocks shared in a given year.

Neither removes unobserved factors that change differently across countries.

Model averaging avoids betting on one control set

Conceptual workflow: compare candidate models, weight them by posterior support, then average their estimates. No numerical weights are assumed.

Compare models, weight their evidence, average their estimates.

Country and year effects stay in every model.

Inclusion probability measures support across models

\[\operatorname{PIP}(X_k)=\sum_{M_j\,\text{containing}\,X_k}P(M_j\mid D)\]

Add the posterior probabilities of models that retain a predictor.

PIP near 1: the predictor is retained across almost all posterior model weight.

High inclusion support is not proof of a causal effect.

Three income terms allow two changes in direction

\[f(x)=\beta_1x+\beta_2x^2+\beta_3x^3,\qquad x=\ln(\mathrm{GDPpc})\]

This is the income component, with other predictors held fixed.

One linear term fixes the slope. A quadratic can bend once. A cubic can bend twice.

Read all three coefficients together.

Both priors retain the same income pattern

Income term Fixed prior (UIP) Robust prior
Log GDP per person −189.358 −187.464
Squared log GDP 21.620 21.405
Cubed log GDP −0.804 −0.796

Posterior means · Table 2 · PIP = 1.00 for every term under both priors

The income relationship survives this change in prior specification.

The estimated income component falls, rises, then falls

Both Table 2 posterior-mean curves form an inverted N. GDP per person is on a logarithmic axis; the outcome is a percentage-point difference relative to income of 10,000 constant 2015 US dollars.

Posterior-mean income components, centered at GDP per person of USD 10,000.

Original reconstruction · Tables 2 and 7 · Means only; no uncertainty band

The two priors produce almost overlapping curves.

The cubic has two real turning points in each main model

\[D=\beta_2^2-3\beta_1\beta_3>0\]

Specification Reported discriminant
Two-way fixed effects + controls 4.97
BMA · fixed prior 10.69
BMA · robust prior 10.51

Table 3 · This is a shape check on point estimates, not a confidence interval.

The controlled panel model turns within the income range

The controlled TWFE model's reported turning points, 2,445.66 and 24,983.24 constant 2015 US dollars, lie inside the observed income range.

Reported turning points for controlled TWFE; Table 4, column 5.

Table 4, column 5 · Point estimates, not policy thresholds

The two bends are not extrapolations beyond the sample’s income range.

Pooled pictures and panel estimates answer different questions

Pooled OLS · Figure 1 BMA / controlled TWFE
Combines differences across countries Uses within-country time variation
No country fixed effects Country and year effects included
N-shaped all-economy fit Inverted-N income component

The pooled all-economy graph is not the evidence for the main inverted-N claim.

Robust correlates extend beyond national income

Selected Table 2 predictor Posterior-mean sign PIP, both priors
Forest area Negative 1.00
Renewable energy share Negative 1.00
Population density Negative 1.00
Arable land per person Positive 1.00

Different units prevent ranking effect sizes from these signs.

Five-year lags preserve the signs on all three income terms

Income term Lagged UIP mean Lagged robust mean
Log GDP per person −233.992 −231.340
Squared log GDP 27.135 26.840
Cubed log GDP −1.037 −1.026

Table 11 · 802 observations · PIP = 1.00 for all six entries

This check changes the timing and sample; it does not establish causality.

Stable model results still leave important uncertainty

  • Curve uncertainty: no joint posterior here for a valid band.
  • Coverage: sparse, less reliable evidence at very low incomes.
  • Aggregation: national patterns need not describe individuals.

Robustness within this framework is narrower than universal certainty.

Model averaging cannot remove every source of bias

Objection. Could omitted changes drive both income and obesity?

Response. Yes. Averaging addresses model selection, not causal identification.

Treat the curve as evidence about associations, not a growth prescription.

Look beyond a single income threshold

The resolution · Multiple stages, conditional associations

Economic growth alone does not guarantee lower obesity

The finding: a decline–rise–decline income component survives two priors.

The implication: examine the food, urban and environmental context at each stage.

The next step: test mechanisms with finer data and credible causal designs.

A model-based turning point is not a universal target for policy.

The published tables make every claim inspectable

Published paper · open access

Full paper PDF · tables and appendix

Website summary & infographic

Download the Quarto source

The full study dataset is available from the corresponding author on reasonable request.

Wealth and obesity are linked through several stages, not one universal turning point.