I think the root cause of the obesity epidemics in the Mid-South USA is linked to the NUTRIENT POLLUTION OF THE OHIO-MISSISSIPPI RIVER BASIN, in particular the run off of agricultural fertilizers (nutrient enrichment). These rivers run across the states most affected by obesity. I recommend to measure environmental exposures - chemical (i.e. phosphorus) and biological toxins (i.e. microsystin, cyanotoxins) and measure their impact in the biology of populations most affected by obesity.