Both hunger and obesity occur with an increased frequency among poorer populations in the United States.1-6 Because obesity connotes excessive energy intake, and hunger reflects an inadequate food supply, the increased prevalence of obesity and hunger in the same population seems paradoxical. Although a variety of environmental, social, behavioral, or physiologic mechanisms could cause both problems independently, an alternative possibility is that hunger and obesity are causally related. The following case report supports this hypothesis.
A.B. (not her real initials) was a 7-year-old African American girl first brought to the Weight Control Program of the Boston Floating Hospital in December 1992.