People say 'his mother was also overweight, if you don't eat that much and don't exercise, you will have a bigger belly like this, and he was overweight when he was born', is considered one of the causes of obesity. In fact, there is a small part in these legendary myths. WHO obesity; It is defined as the effects of genetic and environmental factors on the individual's fat tissue and energy metabolism. To put it more clearly; Individuals with a genetic predisposition to obesity become obese under the influence of environmental factors (Pekan, 2017).
1.2.1. Effects of Genetic Factors on Obesity: It is known that obesity has a genetic transmission, but except for diseases comorbid with obesity, the majority of obese patients do not become obese due to heredity. Twin studies, family and step-individual studies have been conducted to find out the effects of heredity on obesity. In studies based on BMI, the BMI of identical twins and identical twins or identical twins raised separately showed a 70% similarity, while the same rate decreased to 30% in step-individual studies. In studies conducted with families, a moderate level of heritability was found, unlike twin and step studies. Obesity or overweight status in first-degree relatives is calculated by the method called 'lamda cofficient'. This compares our risk of becoming obese when a biological relative is obese with the risk of other individuals in the community becoming obese. The study on this subject; It showed that the risk ratio obtained from 2349 first-degree relatives of 840 obese individuals was twice as high as that in the general population. The risk increases depending on the severity of obesity in the individual (Şık, 2017). A study conducted in Canada provided arguments supporting this issue. In a study conducted on 15245 individuals, the risk of being obese in those who have an obese relative is 5 times higher than the Canadian population (Gedik, 2003). In summary, people who have obese individuals in their family or relatives have a higher risk of becoming obese than other members of the society.
1.2.2. Effects of Environmental Factors on Obesity:Although genetic factors have an impact on the individual's exposure to the obesity problem, the main determinants are environmental factors. Everyone and everything outside the individual is called 'environment' (Gürel and İnan, 2001). Swin Burg (1999) is the person who put forward the first thesis on the relationship between environment and obesity. A healthy food environment pushes the individual to live a healthy life and causes an increase in the individual's physical activity. The lifestyle, style, thought and even food consumption habits of the environment affect us voluntarily or unintentionally. Environmental factors in obesity; It is shaped by what type of food we choose, how we access that food, the caloric values of that food, and the values that the environment imposes without us being aware of it (Soylu, 2016).
Food Selection: The environment we live in determines our healthy food choices. When support is provided, change is achieved more easily and continuity continues. Cummins and Macintre nutrient environment; It is defined as any kind of food bought from outside and ready to be cooked, packaged products or food consumed from outside (Duman, Kayhan and Sesal, 2009). Factors originating from the individual (the individual's food choice, eating behavior and attitudes, biological and demographic factors), social environment (family, neighbors, friends and relatives), physical environment (school, market, workplace, shopping mall and restaurant) and macro-level environmental factors. (socio-economic situation, culture, marketing of foods and policies in the field of nutrition) are factors that affect the individual's nutritional environment. Whether a child likes vegetables or not or determines the portion of the food he eats is an individual factor, while whether the child's family eats vegetables or not is a social factor. The availability of vegetables in places where the child spends his day, such as home or school, or the family's easy and cheap access to vegetables are physical environment factors. Agricultural policies and quality products in this regard are macro-level environmental factors (Gedik, 2003).
Accessibility: It is now almost impossible to see people carrying food in lunchboxes like in Turkish movies. Today's environment easily offers us instant, hot, delicious, energy-rich and high-calorie foods. Fast food restaurants on every corner, high-calorie drinks that we can drink even while walking, refrigerators and freezers where we can easily stock everything outside make it easier to access and consume food. However, developments in lifestyle and sociocultural structure force the individual to eat outside. It makes you happy. Eating out contains more sugar, fat and cholesterol than eating at home, which is an invitation to obesity (Soylu, 2016). Studies conducted by the US Department of Agriculture (2010) found that the food we consume outside is 134 calories more than at home. Another study showed that people tend to perceive fewer calories in the food they consume than usual (Serter, 2003). Short-term studies on animals show that; When animals were given various foods high in fat as desired, intense energy increase and obesity occurred in the animals. One of the horses, which was placed in two different cages, was placed with 3 cups of sucrose-containing beverage and one cup of water, and the other was placed with 3 cups of water and 1 cup of sucrose-containing beverage. The horse that received a drink containing more sucrose gained excessive weight after thirty days. Even though these animals have the same metabolic system, their energy balance is under the management of environmental factors (Soylu, 2016).
Food Prices: Increases and decreases in food prices affect the amount of food we will buy. A study conducted on university students showed that when the prices of healthy foods (such as dairy products, soup and salad) were reduced, students consumed more of these foods. Likewise, in different studies conducted with students, it was observed that when fruit and salad prices were halved, sales rates increased compared to before. In addition, announcing to the consumer that the prices of healthy foods have been reduced has increased the consumer's tendency towards healthy foods. In a study conducted in a hospital cafeteria, it was found that when the price of high-sugar drinks was increased, consumption decreased, and even when the price was lowered, individuals' behavior in consuming those drinks decreased. Considering all these studies, the prices of unhealthy foods that increase the obesity rate should be increased and the aim should be to direct the individual to consume healthy food and raise awareness among consumers. Reducing the prices of healthy foods also reduces the obesity rate (Soylu, 2016).
Labeling of menus: Writing the nutritional values and calories of the food and beverages on the menu on the product to be consumed immediately can push the individual to choose healthier menus (Köksal and Özen, 2008). In a study conducted in a large restaurant chain, it was observed that when individuals were told the nutritional values and calorie information of the product they chose, they showed less calorie food selection behavior (Soylu, 2016). Another restaurant chain study was conducted on a population of 106 people between the ages of 11 and 18. Individuals were first given a menu that did not contain nutritional values and calories. Later, a second menu was given with calories and nutritional values written on it, and it was observed that individuals who took the second menu ordered 29% less food. These changes in menus and orders help individuals consume fewer calories, and individuals are more careful in their future food choices. In this regard, if a legal framework is established for the calorie declaration in menus, a factor affecting obesity may be reduced (Gedik, 2013).
The effect of advertisements and Neurobiology: Foods Advertisements regarding these foods affect our preference for those foods. Appetite mechanism and food intake are susceptible to being affected by signals from our environment and body. Aware of this situation, the food industry encourages us to choose that product by using neuromarketing techniques. That's why the food industry works with neuroscientists and psychologists. The target in this regard is children; children who are exposed to these perceptions since childhood also become customers for the same companies when they grow up. The food industry creates positive beliefs by influencing individuals' perceptions of foods that are high in calories and low in energy (Öyekçin and Deveci, 2012). Studies have shown that children; It has been shown that they are more likely to want what they see in advertisements rather than consuming home-made juice. The World Agriculture and Health Organization (2002) stated that consuming and marketing products with high energy value and poor nutrients are risk factors for obesity.
Children and Their Families: The first child the individual knows The stage is family, so the first learnings and first habits are framed in the family. The family taken as a model affects the child's life and choices in adulthood. Research conducted on 1196 families with children in the fourth grade showed that there is a close relationship between the presence of junk food (chips, cola, ready-to-eat products) or healthy foods at home and obesity. Since the individual has an orientation towards the food available at home, the individual either consumes whatever is available at home or orders ready-made food from outside. Children who eat at the same table with their families seven or more times a week have a 0.7 times lower risk of obesity than children who do not eat with their families (Köksal and Özel, 2008). In a study conducted by Saelens et al., the rate of overweight children of overweight families was 35.1%, while this rate was 8.2% for children of non-obese families, and 23.2% of obese families had obese children. According to the results of research conducted in England, the BMIs of individuals who live in places selling unhealthy food around their homes are higher than others. Children who are close to a healthy environment and whose physical activity is supported (markets and restaurants with healthy products, close to bicycle paths and walking parks) face less risk of obesity (Şık, 2017).
Organization of the Environment: It is important where, how and what facilities the house we live in or the place we work in all day long has. What role does our home or workplace, where we spend most of our lives today, play in obesity? The fact that our home and workplace are in a safe, spacious place that makes us feel comfortable, that it is physically helpful (providing opportunities for parks, sidewalks and exercise activities), and that it is comfortable in terms of transportation (proximity to bicycle paths and public transportation) makes our environment attractive. These values are factors that increase the individual's physical activity and quality of life (Sözen, 2006). Studies on the importance of the physical environment in obesity mention 4 criteria on this subject. These criteria; functionality, aesthetics, distance and security. The distance of the environment where the individual lives; stores, parks, shopping malls, healthy products
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