A lot of people that I know want to get into the sort of shape that I am in. I am not really even in that great of shape but in USA, you don't really have to be terribly fit in order to stand out as someone that is in "great" shape. This is not American-bashing, we just generally speaking have some of the worst food-oriented lifestyles in the world. The USA routinely ranks in the top 3 most obese countries in the world and you don't have to spend that much time in this country in order to realize that this is the case.
I live in a big city now and in big cities there tends to be a greater focus on health to some degree. There are fitness clubs all over the place and even though the mass transit is actually pretty good you are still going to do a great deal of walking to get wherever you are going.
I grew up in a small city though where everyone drives to everything that they do. You walk out your door where your car is right there and chances are you are going to be able to park that same car no matter where you are going. In that small city, I don't recall a single instance of ever needing to walk a great distance to get to anything I had to do, and this included going to see concerts in nearby cities. We simply do not have to do any exercise by necessity. The only exercise you are going to get is the stuff you set out to do.
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Now don't get me wrong, there are plenty of fat people in metro areas as well but it just becomes more noticeable when you get into smaller areas. Also, both of these figures are very bad even though the metro ones are lower. The fact that we have an entire country where 30% of all people are obese - and keep in mind that this is worse than overweight - is a pretty terrible statistic to have as a national population.
I have no idea how they compile this information, but according to the NIH (National Institute of Health), the average increased medical cost that an obese person can expect to pay over a non-obese person is around $1500. Given the rather absurd nature of the medical system in the USA anyway, I would imagine that this figure is grossly under-represented. Let's not forget Diabetes, this one can kill you and if you are obese, you have a 70% higher chance of getting this chronic illness. I know a guy that has this and he has had to have several parts of his body cut off of him because of it. If that doesn't scare you, I don't really know what possibly could.
Not long ago I visited a friend of mine that I went to college with. He lives in a rural area that is outside of the DC metropolitan area. I noticed that he was much larger than I was an much larger than I remembered him being, his wife was quite large as well. Well one day they took me to a fundraiser lunch at the local volunteer fire department and it was just SCARY how unhealthy and fat nearly everyone in attendance was. There were people with mobility scooters that couldn't be any more than say 55 years old. Suspenders were all around because after a certain point belts wont keep your pants up anymore. Even the children were little chunks and nobody seemed all that concerned about it. Of course the fundraising lunch was something that is terrible for you and consisted of almost entirely carbohydrates. The only vegetable or fruit that was in the lunch at all was a casserole of sorts and it had more cheese and breadcrumbs in it than it did vegetables. The lack of awareness and lack of health in this one group of people was a bit staggering because how can they not see the writing on the wall?
I might have fallen into that same trap had I stuck around in the small city and even though I moved to a larger one and continue to live in one, it can happen to you there as well. Lack of exercise is bad enough but when you introduce extremely poor diets, this is a recipe for health disaster.
I don't know what can be done to rectify this and in all honesty I don't think it can be. People are too set in their ways and I guess misery loves company. The reason why people in metro areas tend to be more fit is likely because of the group mentality. This is the same reason why rural areas tend to be more fat.
In the meantime, whether you live in a big city or a small one, I think it is important to identify the problems in your own life and do something about them before it becomes too late. It gets harder and harder to lose and maintain weight as you get older, so I hope people out there can realize this problem before they hit, say, 40 years of age.
I am not awesomely fit, but I am not obese either. I don't dedicate my life to fitness but I achieve balance. When I was in my 30's I had truly let myself go and was near 250 lbs. I pulled it back though by making small and manageable changes to my lifestyle... it aint rocket science, and you can do it too