The Economist has an interesting article on obesity. You may know that in earlier centuries the rich tended to be more obese, whereas today the correlation has flipped in many developed countries. What you may not know is that this new correlation is almost entirely driven by women:
That poor people are more likely to be overweight has often been explained by arguments that obesity, in the rich world, is a feature of poverty. Poor people may struggle to afford healthy foods. They may reach for processed or fast foods because they lack the time to prepare meals at home or have less time to exercise because low-wage jobs often involve working long shifts and can be less flexible than those performed by the “laptop class”. Or because low income is often a function of limited education, perhaps, so goes the thinking, that lack of education extends to a lack of knowledge about how to maintain a healthy weight.
The problem with all of these explanations is that the correlation between income and weight at the population level in advanced countries is driven almost entirely by women. In America and Italy the relationship between income and weight or obesity is flat for men and downward-sloping for women. In South Korea the correlation is positive for men but this is more than offset by the sharply negative correlation in women. In France the relationship slopes gently downwards for men, but the slope is much steeper for women.
The Economist discusses factors such as bias in the workplace, but I’d like to offer another explanation. Let’s suppose that thinness is at least mildly correlated with some other factor that leads to success. (BTW, I’ve known highly successful overweight women, so I’m not suggesting that the correlation is anywhere near 100%.)
If thinness is correlated with some sort of X-factor linked to productivity, then why don’t we observe the same relationship for men? The Economist suggests that women have a more powerful incentive to be thin, due to the fact that overweight women are viewed more negatively than overweight men:
All women eventually recognise the importance placed upon their bodies. It is as though girls are walking through a forest unaware and are then shown the trees. They can wonder how the trees got there, how long they have been growing and how deep their roots really go. But there is little they can do about them and it is almost impossible to imagine the world any other way. And the fiction that clever and ambitious women, who can measure their worth in the labour market on the basis of their intelligence or education, need pay no attention to their figure, is difficult to maintain upon examination of the evidence on how their weight interacts with their wages or income. The relationship differs in poor countries where rich people are generally heavier than poor ones.
Bryan Caplan has argued that colleges don’t necessarily make students all that much more productive, and that the wage premium from education largely reflects signaling. A degree from Harvard doesn’t signal that you learned a lot at Harvard, it signals that you are the sort of person that can achieve a Harvard education. Similarly, being thin might signal that a woman succeeded in the difficult task of holding down their weight in a world where physical labor is increasingly rare and we are surrounded by tasty food options. Because men are less likely to be victims of fat shaming, wealthy men are less focused on holding down their weight.
PS. This post is purely descriptive, I’m not suggesting that this state of affairs is desirable.
PPS. The photo at the top of this post shows Alfred Hitchcock and Tippi Hedren, which can be viewed as an example of Hollywood’s double standard regarding weight. Younger readers might recall Hedren’s daughter Melanie Griffith. Much younger readers might recall Griffith’s daughter Dakota Johnson.
PPPS. Slightly off topic, this tweet caught my eye:
[The blank states in 1987 are missing data. Notice how far New York and Kentucky have diverged just since 2003.]
If find this perplexing. I was 32 years old in 1987, and I don’t recall life being much different than today. America was full of fast food even back then. My weight hasn’t changed at all since 1987, and yet I don’t have an unusual amount of self control–I’m just an ordinary person. Lucky genetics? Very likely. But the genetics of the overall population hasn’t changed much since 1987. Like you, I’ve read lots of explanations, but none of them seem all that plausible. Warm states like Hawaii, California and Florida are a bit on the low side, but much of the south is more obese than the north. I suppose that any time series/cross sectional explanation will require multiple factors–some combination of climate, income, education, gender bias, sedentary jobs, decline in smoking, processed foods, cultural attitudes, etc.
PPPPS. This tweet is also interesting:
READER COMMENTS
Chase
Feb 15 2023 at 8:59am
I think another simpler explanation for this divergence is the 1,800-2,000 calorie daily requirement for women vs 2,800-3,000 for men. If the resources available to each poor person allows for 2,500 calories of consumption which is possibly low in fiber and therefore not filling for each calorie, then women will gain weight while men will actually lose it.
Garrett
Feb 15 2023 at 9:05am
That 42 oz average soda size is hard to believe
Scott Sumner
Feb 15 2023 at 10:13am
My reaction too. Perhaps including free refills?
Andrew_FL
Feb 15 2023 at 10:33am
A McDonalds’ large soda is nominally 30 ounces. In reality, unless you serve yourself that’s gonna be filled with a lot of ice. 42 ounces is implausible, unless they’re averaging together gas station beverages with restaurants. Even a Super Big Gulp from 7-Eleven is only 40 ounces, a Double Gulp 50, which is actually a reduction from when it was originally introduced at 64 ounces in the 80s-the official rationale being it was too big for car cupholders.
JayT
Feb 24 2023 at 4:19pm
Even with free refills, something like 75% of McDonald’s orders are take out, and there aren’t going to be refills on those orders. I’m pretty sure this chart is just wrong. The average American drinks 13oz of soda a day. If the average restaurant soda was 42oz that would mean basically no one was drinking soda at home, which is obviously false.
Jeremy
Feb 15 2023 at 10:16am
Does that map account for the definition of obesity changing over the years? The medical establishment keeps changing the BMI needed to be considered obese.
BC
Feb 15 2023 at 4:49pm
I didn’t realize this, but the definition of obese did change at least once, in 1998:
http://www.cnn.com/HEALTH/9806/17/weight.guidelines/
According to the article, the change increased the number of “fat” Americans by 25M. Unclear whether “fat” meant obese or merely overweight. US adult population at the time was about 200M, 276M total. So, the fat population increased by about 10 percentage points just due to redefinition. That’s a change from medium or light blue in 1987 to dark blue or yellow in 2003.
Not sure what happened between 2003 and 2021. Broadband and wireless internet made people more sedentary, e.g., handling errands online rather than in person? Alternatively, according to Wikipedia [https://en.wikipedia.org/wiki/Body_positivity], body positivity changed from “providing people of all sizes a place where they could comfortably come together and exercise” in the 1990s to “embracing all body types, loving one’s body even with any flaws, and feeling confident about one’s own body” in the 2010s. Of course, that change might have just reflected, rather than contributed to, the increase in obesity rates.
Scott Sumner
Feb 16 2023 at 6:29am
I certainly don’t need a scientific study to tell me there’s much more obesity than when I was young—it’s obvious. But good point about the changing definitions; perhaps the reported increases are overstated.
Brett
Feb 15 2023 at 11:13am
I was wondering if maybe it was greater childhood obesity, since obese kids tend to become obese adults. But it looks like childhood obesity just matched the overall tripling of obesity in America.
That makes me suspect it’s a measurement issue, or they changed the standard. As far as I can tell, there was no big shift in food preparation that might have caused this in the 1980s (Low-Fat Diets became popular before this).
Henry
Feb 15 2023 at 11:46am
Obesity is an issue that current medical science has few answers for. There are 1000 different diets and as many speculative reasons, but long term reversal of weight gain remains rare. I live near a high school and see a lot of fat kids, far more than when I was in high school (the 1960s). We need more investigation into this issue and novel ideas. Our current ideas are not working
Knut P. Heen
Feb 15 2023 at 12:04pm
The participants in the Tour de France consume 8000 kcal or more per day, and they are often underweight (BMI<18.5). This information lead me to make an experiment a few years back. I started hiking for 10 hours a week without doing anything to my diet. I lost a lot of weight. I measured the weight loss to 1400 kcal per hour hiking in the beginning (2 kg per week, 2 kg human fat is about 14000 kcal). The weight loss dropped gradually as I approached normal weight. Moreover, as I lost weight, I also lost appetite. I tried to stay on the same diet, but I could not. I was very surprised by that. It turns out that the causality is that extra weight increases your appetite because you need the extra energy to carry the extra weight around. Carry a backpack of 50 kg around for a day and see what is does to your appetite. No wonder restaurant meals have increased in size. Experiments produce knowledge, correlations produce confusion.
I am convinced that the changes in the job market is the real reason behind the obesity problem. There is a difference between sitting for 8 hours a day and doing physical work for 8 hours a day. Cutting back on food consumption does not work well because food is not pure energy. Potato, for instance, is an important vitamin C source too.
Seppo
Feb 16 2023 at 5:37pm
It is not just the jobs – it is the commute as well. Share of people driving to work has increased greatly.
Knut P. Heen
Feb 17 2023 at 5:27am
In Europe, I would guess it is cheaper and more accessible public transport which is the “problem”. I see people get on and off just for a few stops. Elevators are also pretty tempting.
Daniel Carroll
Feb 15 2023 at 12:32pm
As a non-expert observer, I suspect the difference between men and women’s correlations between weight and income is entirely explainable by cultural factors – skinny women tend to get better jobs, more promotions, and wealthier mates. There is probably some reverse causation as well – poverty tends to lead to depression and other forms of unhappiness, leading to less consideration of body size. In men, this leads to drugs, alcohol, and suicide.
In my purely anecdotal experience, I was shocked at how much sugar plays into my own weight loss/gain. As a lifelong runner (4-6 miles 3-5 times per week at a rapid clip), I have been rarely obese, but often overweight. Then I realized I was fructose intolerant – a condition I probably always had at a mild level, but got worse as I aged. So I pulled sugar out of my diet, and my body weight dropped 10% to a level I’ve not seen in 30 years. Probably another 5-10%, since I had eliminated sugary drinks 20 years ago and lost weight then (but I was doing other stuff then, so I didn’t make the connection). This despite that I increased my chip and carb consumption to compensate. I’ve been on diets before, including low carb diets, but never lost more than 3% of my body weight. I then added small amounts of sugar back, and my weight jumped 5 lbs (3%).
Sugar is everywhere, in increasing amounts over the last 30 years. It’s hard to avoid.
Mark Brophy
Feb 16 2023 at 12:10pm
It is isn’t that’s causing people to gain weight, it’s vegetable oils.
JFA
Feb 15 2023 at 1:26pm
Here’s an interesting write-up on less wrong tat covers some obesity data: https://www.lesswrong.com/posts/NRrbJJWnaSorrqvtZ/on-not-getting-contaminated-by-the-wrong-obesity-ideas.
The section about the steady weight gain throughout the 20th century was an interesting perspective.
Jose Pablo
Feb 15 2023 at 2:09pm
Let’s suppose that thinness is at least mildly correlated with some other factor that leads to success
“Some other factor” looks like a careful wording …
What are your candidates for these “some other factors”? Nature or nurture?
Scott Sumner
Feb 16 2023 at 6:32am
As in almost everything, I suspect a mix of the two. (Just as obesity itself is a mix of the two.)
artifex
Feb 15 2023 at 4:57pm
John Speakman has a thread that mentions the hypothesis of assortative mating for obesity causing an increase in its prevalence through recessive genes. Assortative mating would have increased due to people pairing and having children later in life, when there is more ability to tell who will be obese later. It would be a small contribution to obesity rates.
Jim Glass
Feb 15 2023 at 6:04pm
#1) Law of supply and demand? The cost of food has fallen 40% as a share of disposable income over the last 50 years.
#2) Women have disproportionately benefited from labor saving innovations, and so are burning fewer calories? For instance…
The Mayo Study…
I know there’s much more and more recent data on this, but this is a start.
the relationship between income and weight or obesity is flat for men and downward-sloping for women … being thin might signal that a woman succeeded in the difficult task of holding down their weight in a world where physical labor is increasingly rare
Possibly. Though also note that working women burn more calories than stay-at-homes, have enjoyed much less of the ‘calorie burn reduction’. So one would expect them to be thinner, and of course they have more income and are the richer, so causation can go that way too. But the two ideas are not mutually exclusive, they can live together.
Mactoul
Feb 16 2023 at 4:38am
Obesity is hormonal diversion of food calories into excessive storage.
Calorie in is finely matched to calorie-out in healthy people. It needs only a daily mismatch of 24 kcal for an annual weight gain of 1 kg and heathy people past growing age don’t consistently gain that much yearly.
So, it is not more calorie IN and it is not less calorie OUT. Why does an obese person feel hungry? He is storing sufficient energy but he isn’t able to access that stored energy. The hormonal state doesn’t allow access to stored energy. And that’s the crux of the problem. A disordered hormonal state.
JFA
Feb 16 2023 at 8:42am
I have never met an obese person who didn’t eat calories in excess of what was expended. There has not been some exogenous hormonal change in the population. People eat a bunch of crap and then sit around the TV. Physical activity has decreased and calories eaten have increased essentially the entire 20th and 21st century (see my link above). Are some people born with hormonal issues? Absolutely. Do people develop hormonal issues because they acquire massive excess adipose tissue? Almost certainly. If you want to lay blame on hormones, I think you’ll have a hard time explaining the geographic variation. There’s no need to add epicycles to a theory when the evidence still fits the most likely theory: calories in, calories out.
When you feel your pants getting tight, you can either change up your diet just a little bit and increase you physical activity… or you can buy bigger pants. A lot of people choose the latter and you get an obesity “epidemic”. With small, simple choices, the vast majority of people can avoid obesity.
Rajat
Feb 16 2023 at 1:09am
I’m glad you’ve blogged about this. I had a very similar reaction when I read the Economist piece and the different male-female weight correlations with income. I’m convinced the female correlation is driven by signalling. Bryan suggested that higher education signals not just intelligence, but conscientiousness and conformity. Taking the world as it is, an ambitious woman can use thinness to signal her conscientiousness and conformity, both in the workplace and in finding successful mates. I think it’s intended and seen as a sign they have their act together, for better or worse. My observation is that increasingly, young men in high status jobs are also signalling with their bodies, through diet and gym. Looking across city workers in high status professions, I don’t see many overweight or obese guys below 40, unlike elsewhere. I live in a well-off inner city suburb in Melbourne and the contrast between people’s bodies (of all ages) there and those who live 10 or 20km further out of the CBD and in rural areas is enormous.
As for the cause of the huge overall rise in obesity, I’m just as convinced it has everything to do with cultural attitudes. There was plenty of processed food and sugar around in western countries in the 1970s and ’80s and plenty of sedentariness. But there was a real stigma about being overweight – people on TV were in the main not fat and kids teased each other for being fat. Kids played outside a lot and rich desserts were limited. Maybe it started with the TV show ‘Roseanne’, but we started seeing all these obese people on our screens and before you know it, it seemed quite normal. I’m still shocked when we get a snippet of American footage on the evening news and see even young men, 30 year old cops, with inflated bodies. This has obviously happened across many countries and I think it is too late to reverse. Overweightness will over time just become an even stronger reverse indicator of social and economic class.
Scott Sumner
Feb 16 2023 at 6:35am
Good points, but I’m more inclined to think it’s a mix of factors, with cultural attitudes being both cause and effect. Don’t underrate things like the huge decline in smoking.
Jim Glass
Feb 16 2023 at 12:07pm
As for the cause of the huge overall rise in obesity, I’m just as convinced it has everything to do with cultural attitudes … Maybe it started with the TV show ‘Roseanne’, but we started seeing all these obese people on our screens…
The boom in obesity is totally world wide, the most obese world regions being Oceania (Micronesia, Cook Islands, Samoa…) the Middle East (Egypt, Kuwait…) and South America. The western TV likes of Roseanne did not cause this.
There was plenty of processed food and sugar around in western countries in the 1970s and ’80s and plenty of sedentariness.
This handwaves away the hard facts that no, there weren’t nearly as many calories produced 50 years ago, their price was much higher than today, and life was less sedentary then (especially for stay-at-home women, as documented in the Mayo study).
Of course cultural attitudes change. But what causes that? Is it just random? World-wide and simultaneously?
Did the plunges in the prices of the automobile, electronics and effective birth control change cultural attitudes towards travel, entertainment, and sexual behavior?
As for the cause of the stark change in the world-wide cultural attitude towards obesity, how about this: Per capita kilocalorie supply from all foods per day, 1961 to 2019. That’s an average increase around the entire world of >20%.
I gotta say, I’m bemused by how on an economics site the supply-demand equation for calories gets so little consideration.
Rajat
Feb 17 2023 at 10:15pm
I fully accept the reference to Roseanne was flippant, but it was meant as a reference to changing societal attitudes around overweightness in general. But to your point, I don’t think the increased global supply of calories explains overweightness in the US or other rich countries. Supply affects price, and food prices may have fallen in real terms in the last 40 years and real incomes risen, but were Americans in the 1970s and ’80s too poor to purchase the amount of calories their hearts desired? Especially given that many of the fattest people in rich countries today are the poorest? As for the rise in obesity in Oceania, the Middle East and South America, I doubt the obese in those countries (other than the Gulf states perhaps) are as rich today as the average American was in 1980. It’s a puzzle.
Regarding Scott’s suggestion that maybe the decline in smoking is party responsible is interesting. Looking cross-country data on obesity and smoking, there seems to be a bit of an inverse correlation if you focus on most English-speaking and western European countries, although Netherlands, Sweden and Norway are low in both, and outside the rich world, Chile, Hungary and Turkey are high in both. Also, male and female smoking rates differ a lot in China, Indonesia and Turkey, but I doubt obesity rates do.
Thinking of individual decision-making, while I don’t think fundamental human self-control has declined, expectations, norms and habits have loosened quite a bit. For example, snacking between meals is now incredibly common (it didn’t used to be), as is eating sugary foods on a routine basis and eating while watching TV (or scrolling), and different people within households consuming different menus and at different times. The idea of ‘feeling full’ from a normal-sized meal has been distorted, as people continue eating until they feel full and as often as they don’t feel full, and appetites expand as a result. It takes time and patience to become accustomed to smaller and less sweet and rich meals, especially when others aren’t and don’t, and patience is less of a virtue than it was.
Jim Glass
Feb 18 2023 at 3:24pm
This is an economics blog. Supply of X increases, price falls, what happens to quantity demanded? Also, increasing income typically increases level of demand (for obvious reasons). So as to a consumable X, when supply increases *and* at the same time the level of demand for it also increases, what happens to the quantity consumed?
Okay… So when you see your local grocer this week advertising “Big Sale! 25% Off [whatever]!!” you know this won’t increase sales any, because surely your rich Americans neighbors were already buying all the food “their hearts desired” last week, and how would a bargain discount price get anyone to buy any more than that?
Hint: They bought all their hearts desired at that price.
Or, price does not affect sales. The law of supply & demand is refuted.
The law of supply & demand doesn’t apply until income levels reach that of 1980 USA? Now that’s a puzzle!
World-wide, in all regions simultaneously, there is a major increase in the supply of calories *and* an increase in the demand for them (with rising incomes). And there’s also a big increase in the consumption of them, in all regions simultaneously! Why? How? It’s a mystery…
Rajat
Feb 19 2023 at 6:44am
But there’s no demand for calories as such. There is, loosely-speaking, a demand for food and appetite should be fairly constant over time if not socially and culturally influenced. So when food becomes cheaper, people in rich countries shift their demand to higher-quality food, but after satisfying their appetites, they should not consume more calories no matter how cheap calories becomes. If beef becomes cheaper and people become richer, one might choose eye fillet instead of rump steak, but why would one eat more food overall unless one was going hungry before – which was clearly not the case for >95% of Americans even in 1980.
The same goes for the 25% sales. Yes, they might generate more sales of the brand in question for that week, and may even increase sales of that foodstuff overall, but sales for that brand the next week should be lower and sales of other foodstuffs should fall due to substitution. Ask yourself how many more calories would you consume on a sustained basis even if food were completely free? If all that’s stopping Americans from eating Shake Shack for every meal is a few dollars, their problem is not money, but their relationship with food, weight and their bodies.
Warren Platts
Feb 16 2023 at 4:32am
People have been complaining lately about portion sizes being reduced because of inflation. But it’s probably for the best! 🙂
Knut P. Heen
Feb 16 2023 at 5:33am
Don’t forget that the number of children per woman is correlated with family income. There may be a relationship between the number of pregnancies and weight, and/or the number of children and exercise. Laziness may cause both low income and obesity. Correlations do cause confusion.
Floccina
Feb 16 2023 at 1:04pm
I’d think 2 things:
Success is more likely for those with better self discipline.
Lookism=>Discrimination against obese people. From what I read low income people are more likely to under weight also.
Also I ran into some data that the more black men in the USA earn the more likely they are to be fat.
Monte
Feb 16 2023 at 2:28pm
I agree with Rajat that the problem is primarily attitudinal. Sadly, the body positivity and fat acceptance movements are normalizing obesity. The entertainment industry is glamorizing plus size representation on screen, and the fashion industry is catering to it with vanity sizing – the practice of assigning smaller sizes to articles of manufactured clothing than is really the case in order to encourage sales. And the psychology is powerful. We’re being bombarded with what style pundits call “progressive and complex images of plus-sized people.”
As mentioned by JFA, there are certainly people who struggle with fat due to genetics. But the overwhelming majority of obese cases are a result of lifestyle choices. Weight bias and fat shaming are wrong, of course, but are a separate issue. The danger lies in accepting, or even glorifying, weight gain rather than trying to control it. The focus should remain on educating the public about the health risks associated with obesity – development of multiple chronic diseases.
Monte
Feb 16 2023 at 10:31pm
Circling back, isn’t it reasonable to conclude that obesity-to-income variations are mostly explained by female weight bias in occupational sorting? As pointed out, overweight women are viewed more negatively than overweight men. It’s a bit dated, but this article found in The Atlantic April 2014 issue tends to support that conclusion:
Being 13 pounds overweight meant losing $9k a year in salary by this estimate.
Mactoul
Feb 16 2023 at 7:25pm
You see obese people overeat because they are losing disproportionate amount of food calorie into storage. Those calories are not accessible to them.
They are not gaining weight because they overeat. They overeat because they lose energy to storage.
Jim Glass
Feb 16 2023 at 7:26pm
The photo at the top of this post shows Alfred Hitchcock and Tippi Hedren, which can be viewed as an example of Hollywood’s double standard regarding weight.
I don’t get your point. As I don’t go out to the flickers much these days so wouldn’t know, I checked a list of highest-paid Hollywood actors: Tom Cruise, Will Smith, Brad Pitt, The Rock, Chris Helmsworth, Vin Diesel, Tom Hardy, Jason Momoa, Joaquin Phoenix, Denzel Washington … There isn’t an overweight guy in the lot, and about half are jacked up to the level of steroids or beyond.
If you are instead talking about society’s double standard being reflected in Hollywood in a larger behind-the-camera sense, “society” doesn’t have a double standard, men and women judge each other by two different standards cooked into our respective DNA by eons of natural selection, for better or worse.
To really see this in action I can but refer you to the former head of Paramount, the late great Sumner Redstone and his live-in girlfriends. 🙂
Scott Sumner
Feb 16 2023 at 7:52pm
Everyone, Once again, my primary focus here is not the question of why obesity is increasing over time, rather it is why the relationship of obesity to income varies so much between men and women.
Knut P. Heen
Feb 17 2023 at 5:45am
Low paying jobs for men may still require more physical work than low paying jobs for women. Lifting stuff without a fork-lift for example.
Jim Glass
Feb 17 2023 at 10:46am
At root, the Mayo study: Women have reduced their calorie-burning more than men, and among women stay-at-home (lower-income) women much more than working (higher-income) women, thus the weight gain distribution among them. Housework has become physically much easier over the last 50 years, construction and office work not. It’s all data.
On top of that add signaling and the rest. Women who score high in IQ and conscientiousness are more able to stay lean and attractive for social advantage, to mate higher, help earn more income, etc. Others, not.
Remember how many women in eastern Europe suddenly became strikingly more beautiful very quickly after the fall of communism. Incentives. Many, not most. The distribution really widened.
Brandon Berg
Feb 16 2023 at 9:27pm
Presumably this is based on household income and not personal earnings. Could it be driven mostly or entirely by marriage? I would guess that obese women are less likely to get married, and especially less likely to get married to high-earning men.
Brandon Berg
Feb 16 2023 at 11:26pm
Also, note that “obesity rates tripled” likely somewhat exaggerates the extent of the increase. When you shift a distribution slightly to the right, the portion of the curve falling to the right of a particular threshold may increase dramatically, depending on what part of the original curve the threshold was set to.
I’m not saying that Americans haven’t gotten a lot fatter, but it would be more informative to talk about what’s happened to age-adjusted percentiles of BMI (or better yet, body fat percentage, but that data set probably doesn’t exist). For example, how much fatter have 30-year-olds at the 50th, 75th, 90th, and 95th percentiles gotten? 20-year-olds? 60-year-olds?
Grand Rapids Mike
Feb 19 2023 at 3:38pm
One way to understand why people are fatter today than will say 40 years ago is just to look at the ingredients in the standard containerized (cans, bottles, packaged etc. ) food. Just looking at 2 items 1 Ranch dressing and 2 log cabin syrup the list of items by content in each includes sugar as the 2nd or 3rd item listed. Other foods we eat French fries are potatoes that digest into sugar. So its not just by income its the crap we eat, with all its sugar content.
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