Obesity–Housing Nexus: An Integrative Conceptualization of the Impact of Housing and Built Environment on Obesity

Abstract

Obesity has emerged as one of the most significant public health challenges of the 21st century, with its prevalence increasing at an alarming rate globally. While individual factors such as diet and physical inactivity are well-known contributors, the built environment, particularly housing, plays a critical yet understudied role in shaping obesity-related behaviors. This study examines the multilayered relationship between housing and obesity, focusing on built and neighborhood environment, affordability, and the social environment. Poor housing quality, such as overcrowding and inadequate ventilation, can potentially lead to chronic stress and sedentary behaviors, while housing design influences physical activity through characteristics such as design features and outdoor spaces. Housing location affects access to amenities such as parks and healthy food options, with disparities in access contributing to obesity in low-income areas. Similarly, neighborhood walkability, influenced by infrastructure and land use, encourages active transportation and recreation. Housing affordability also impacts dietary choices and access to recreational facilities, particularly for low-income families. Moreover, the social environment within housing communities can foster or hinder healthy behaviors through social networks and community engagement. This study emphasizes the need for health-conscious urban planning and policies that address these housing-related factors to combat obesity and promote healthier lifestyles. By integrating these Obesity–Housing Nexus, policymakers can create environments that support physical activity, healthy eating, as well as overall health and well-being.

1. Introduction

Obesity has emerged as one of the most significant public health challenges of the 21st century, with its prevalence increasing at an alarming rate across both developed and developing nations. Global obesity rates have nearly tripled since 1975, with over 650 million adults classified as having obesity in 2016 [1,2]. This epidemic is not confined to high-income countries, and low- and middle-income countries are also experiencing a rapid rise in obesity rates, driven by urbanization, dietary changes, and increasingly sedentary lifestyles [3,4,5]. Obesity is associated with a range of serious health complications, including cardiovascular diseases, type 2 diabetes, fatty liver disease, hypertension, orthopedic conditions and certain cancers, placing a significant burden on healthcare systems worldwide [6,7,8,9,10,11].

While individual factors such as genetics, diet, and physical inactivity are primary contributors to obesity, there is growing recognition that the built environment, particularly housing, plays a critical role in shaping these behaviors [12,13,14,15]. The built environment encompasses the human-made spaces where people live, work, and play, including housing, transportation systems, and public spaces [16]. Research has shown that the design of these environments can either encourage or discourage healthy behaviors, making it a key determinant of obesity [13,14]. The built environment has a profound influence on health outcomes, particularly in the context of obesity. For instance, neighborhoods with limited access to parks, sidewalks, or recreational facilities may discourage physical activity, while poorly designed housing may contribute to sedentary lifestyles [15]. Housing, as a central component of the built environment, plays a particularly significant role in shaping daily behaviors and health outcomes [17]. The quality, design, and location of housing can influence physical activity levels, dietary habits, and mental well-being, all of which are linked to obesity [15].

Historically, urban planning and housing policies have often prioritized economic and aesthetic considerations over health outcomes. However, the growing recognition of the link between the built environment and public health has led to a shift in focus, with increasing emphasis on creating environments that promote healthy lifestyles [13]. This study reviews the existing literature on the relationship between housing and obesity, examining how housing design, quality, and neighborhood characteristics influence health outcomes. By analyzing the interplay between these factors, this study aims to highlight the rationale of integrating health-conscious design principles into housing and urban planning to combat obesity and promote healthier lifestyles. The objective is to provide an evidence base that supports the integration of health-conscious design principles into housing policies and urban planning, ultimately contributing to the prevention of obesity and obesity-related health outcomes.

2. Definition and Conceptualization of “Obesity–Housing Nexus”

The term “Obesity–Housing Nexus” describes the interplay between the built environment, specifically housing characteristics within the built environment, and obesity-related health outcomes. The term highlights how housing design, quality, and neighborhood infrastructure influence lifestyle behaviors such as physical activity, dietary choices and mental well-being, which are key determinants of obesity. This concept underscores the shift from solely individual-based risk factors to a broader environmental perspective, recognizing that housing is not merely a place of residence but a critical determinant of public health. In this paper, we define the “Obesity–Housing Nexus” as a dynamic and multidimensional relationship whereby housing-related factors, such as quality, design, affordability, location, and social environment, act as upstream social determinants that shape energy balance, stress levels, physical activity, and dietary behavior, thus influencing obesity risk.

To clarify this relationship, we propose a conceptual framework (as outlined in Figure 1) that integrates housing domains with key obesogenic pathways, drawing from well-established ecological models of health behavior [18]. The term “Obesity–Housing Nexus” conceptualizes housing as a structural force that shapes patterns of daily living, framing obesity not only as a biomedical issue but as one deeply embedded in the spatial and material conditions of home and neighborhood. Given the global obesity crisis, understanding this relationship is essential for developing urban and housing policies that promote healthier living environments.

3. Methods

This study employed a narrative literature review to synthesize and interpret current evidence on the relationship between built environment and obesity-related health outcomes, herein conceptualized as the “Obesity–Housing Nexus”. A narrative review was chosen over a systematic or scoping review to allow conceptual flexibility, given the interdisciplinary nature of the topic and the need to engage with the literature across public health, environmental psychology, urban planning, and housing studies [19].

A comprehensive literature search was conducted across three major databases: PubMed, Scopus, and Google Scholar, between March and May 2025. The search strategy involved combinations of keywords such as “obesity”, “housing”, “built environment”, “urban planning”, “physical activity”, “diet”, “neighborhood”, and “public health”, linked using Boolean operators (e.g., AND, OR). Reference lists of key articles were also scanned to identify additional relevant studies using a snowballing approach. Only English-language, peer-reviewed publications were included. To be eligible, studies had to focus on examining the relationship between housing or built environment characteristics and obesity-related outcomes. Both empirical studies (quantitative, qualitative, or mixed methods) and literature reviews were included if they offered relevant findings. Studies were excluded if they addressed obesity from a purely biomedical or pharmacological perspective without reference to housing or built environment or lacked sufficient methodological clarity. All included studies were read in full, through iterative reading and comparison, and findings were thematically synthesized. Emerging conceptual domains were grouped under six broad themes: housing quality and obesity; housing design and physical activity; housing location and access to amenities; neighborhood walkability and obesity; housing affordability and obesity; and social environment and obesity. These domains are presented in the results.

While this approach does not aim for exhaustive coverage, it enables an integrative understanding of the built environment’s influence on obesity. The narrative synthesis informed the conceptual framing of the Obesity–Housing Nexus and its implications for policy and public health. Limitations of this approach include the potential for selection bias and subjective interpretation, although the thematic analysis aimed to mitigate this through transparency and iterative cross-checking.

4. The Gap in the Relative Importance of Individual Versus Environmental Factors

Research shows neighborhood design, housing, and amenities influence obesity, but gaps remain in understanding the interplay of individual and environmental factors, highlighting opportunities for future studies and policy development [20]. While individual behaviors such as dietary choices, physical activity levels, and genetic predispositions are well-established contributors, the extent to which environmental factors influence these behaviors remains contested [20,21]. There is a well-established understanding in the model that prioritizes individual agency and personal responsibility, advocating for interventions focused on education and behavior change [22,23]. The least explored concept to supplement the model is environmental factors, such as housing design, neighborhood walkability, and access to healthy food options, which play a significant role in shaping behaviors and health outcomes [22,23]. This gap is further complicated by the interplay between individual and environmental factors. For instance, individuals living in neighborhoods with poor walkability and limited access to recreational facilities may face barriers to physical activity, regardless of their personal motivation [24,25,26]. Similarly, residents of food deserts may struggle to maintain healthy diets due to a lack of affordable, nutritious food options [27,28]. Despite these interactions, few studies have systematically examined how individual and environmental factors interact to influence obesity, leaving a critical gap in understanding the underlying mechanisms [29,30].

Evidence on interventions targeting the built environment, including improved walkability, access to green spaces, and availability of healthy food, to reduce obesity is promising but remains mixed [28,31]. The introduction of policy-level interventions has led to increased physical activity and reduced obesity rates in some cases, but some studies have found limited or no significant impact [32]. Discrepancies in the success of walkability interventions may result from differences in design and implementation, as well as factors like population density, cultural attitudes, and access to infrastructure such as public transportation [31]. Similarly, the impact of green space interventions may depend on the quality, size, and accessibility of the spaces, as well as their integration into residents’ daily lives [33]. The long-term impacts and sustainability of built environment interventions remain under-researched, as most studies focus on short-term changes in physical activity or diet rather than lasting effects on obesity and health outcomes [34]. This is particularly important given obesity’s chronic nature, as sustained behavior change and the long-term impact of interventions, which depend on maintenance, safety, and community engagement, are often overlooked [1,13,35,36]. Interventions aimed at improving access to healthy food face challenges such as affordability, cultural preferences, and fast-food competition, while issues of equity and inclusivity remain underexplored despite the disproportionate obesity burden on low-income and marginalized populations [37,38,39]. Low-income neighborhoods often have limited access to green spaces, recreational facilities, and healthy food options, creating significant barriers to physical activity and healthy eating [28,40]. However, interventions aimed at addressing these disparities are often underfunded or poorly targeted, limiting their impact on vulnerable populations [41]. Moreover, the voices and perspectives of marginalized communities are frequently absent from the planning and implementation of interventions, leading to solutions that may not fully address their needs or preferences [42]. The creation of a new park in a low-income neighborhood may fail to achieve its intended health benefits if residents perceive it as unsafe or inaccessible [36,43].

While the relationship between housing and obesity has been widely studied, the specific mechanisms through which housing influences obesity remain poorly understood [16,44]. Poor-quality housing has been linked to stress, mental health issues, and sedentary behaviors, but the pathways connecting these factors to obesity are not well-defined. Similarly, the role of housing design in promoting or discouraging physical activity, such as the availability of stairs, outdoor spaces, or recreational facilities, has received limited attention [31,34]. Moreover, the impact of housing location on obesity, such as proximity to green spaces, public transportation, and healthy food options, has often been studied in isolation, with little consideration of how these factors interact to influence health outcomes [17,27,45]. A well-designed home in a poorly planned neighborhood may still contribute to obesity if residents lack access to safe and convenient opportunities for physical activity [17]. Addressing these gaps requires a more nuanced understanding of the complex interplay between housing design, neighborhood characteristics, and individual behaviors. While significant progress has been made in understanding the relationship between the built environment and obesity, critical gaps remain. The gap in knowledge should, to some extent, focus on clarifying the interplay between individual and environmental factors, evaluating the effectiveness and sustainability of interventions, addressing equity and inclusivity, and elucidating the mechanisms linking housing and obesity [20,46]. The interplay between individual and environmental factors in obesity remains inadequately understood, with gaps in the long-term evaluation of built environment interventions, equity-oriented strategies, and the mechanisms through which housing contributes to obesity risk. These limitations underscore the need for integrated research approaches that consider context, sustainability, and the lived experiences of diverse populations. The next section builds upon this analysis by examining key housing-related domains that shape obesity risk and conceptualizing the Obesity–Housing Nexus.

5. Obesity–Housing Nexus

The relationship between housing and obesity is multifaceted, involving various dimensions of housing quality, design, location, and neighborhood characteristics [47,48]. This can be broadly divided into six key domains that potentially help in understanding the mechanisms through which housing influences obesity, adding to the complex nexus. The six domains are summarized in

Table 1. Summary of housing domains and their mechanisms influencing obesity risk factors.

Housing Domains	Mechanisms Influencing Obesity	Key Risk Factors
Housing Quality	Poor insulation, dampness, pests, crowding lead to stress, disrupted sleep, and reduced physical activity	Chronic stress, poor sleep, mental health problems, sedentary lifestyle
Housing Design	Lack of outdoor space, poorly lit or cramped interiors limit physical activity	Low physical activity, sedentary behavior
Housing Location	Location affects access to parks, healthy food, and exposure to pollution	Food deserts, activity deserts, air/noise pollution
Neighborhood Walkability	Pedestrian infrastructure, mixed-use design influences active transport and recreation	Reliance on cars, lack of daily walking
Housing Affordability	High costs limit spending on healthy food and exercise; financial stress drives emotional eating	Unhealthy diets, emotional eating, lack of recreation
Social Environment	Strong social networks encourage activity and healthy eating; disorganized areas discourage participation	Isolation, low trust, crime exposure, reduced motivation

.

5.1. Housing Quality and Obesity

Housing quality is a foundational element of the built environment that significantly influences health outcomes, including obesity. Poor housing quality encompasses a range of issues, such as inadequate ventilation, mold, pest infestations, structural deficiencies, and overcrowding. These conditions not only compromise physical health but also contribute to chronic stress and mental health challenges, which are closely linked to obesity [49,50]. Living in damp or moldy environments can exacerbate respiratory conditions, limit physical activity, and increase stress levels, all of which are risk factors for weight gain [51]. Chronic stress, often a consequence of poor housing conditions, triggers physiological responses that can lead to obesity. Stress activates the hypothalamic–pituitary–adrenal (HPA) axis, resulting in the release of cortisol, a hormone associated with increased appetite and fat storage, particularly in the abdominal region [6,52,53]. Residents of substandard housing may also experience sleep disturbances, poor insulation, or unsafe living conditions [54,55]. These factors, most importantly sleep disturbances, disrupt hormonal regulation, increasing levels of ghrelin (the hunger hormone) and decreasing levels of leptin (the satiety hormone), which can lead to overeating and weight gain [56].

Poor housing quality often limits opportunities for physical activity within the home. For instance, homes lacking safe outdoor spaces, such as yards or balconies, restrict residents’ ability to engage in outdoor activities such as gardening, playing, or exercising. Indoor spaces may also be inadequate for physical activity, particularly in overcrowded or poorly designed homes [57,58,59]. This lack of space can discourage residents from engaging in home-based exercises or active play, contributing to sedentary behaviors [57,58]. Similarly, lack of adequate lighting is another factor significantly impacting overall and psychological health [60]. Living in substandard conditions can lead to psychological distress, social isolation, and depression, which are associated with emotional eating and reduced motivation for physical activity [61,62]. For children, poor housing quality can negatively affect cognitive development and academic performance, further limiting opportunities for physical activity and healthy lifestyle choices [61].

Addressing housing quality through targeted interventions is essential for mitigating these risks. Home repair programs, energy efficiency upgrades, and pest control initiatives can improve living conditions and reduce stress [63]. Additionally, incorporating design elements that promote physical activity, such as safe outdoor spaces and functional indoor layouts, can encourage healthier behaviors [34].

5.2. Housing Design and Physical Activity

The design of housing plays a pivotal role in shaping residents’ physical activity levels, which are directly linked to obesity. Housing design encompasses architectural features, spatial layouts, and the availability of amenities that either encourage or discourage active living. Housing designs that prioritize elevators over walkability or lack accessible outdoor spaces may discourage physical activity [64,65]. Outdoor spaces, such as gardens, balconies, and courtyards, are critical components of housing design that influence physical activity [58]. These spaces provide opportunities for gardening, playing, and exercising, which can contribute to overall energy expenditure. For children, access to outdoor play areas is particularly important for developing motor skills and maintaining a healthy weight [66]. However, many housing developments, particularly in urban areas, lack adequate outdoor spaces due to high land costs and dense construction. This limitation can lead to sedentary behaviors, especially among children and older adults.

The layout of housing units also impacts physical activity levels [58]. Open floor plans and multi-functional spaces can facilitate home-based exercises, such as yoga or aerobics, while cramped or poorly designed layouts may discourage such activities. Additionally, housing designs that incorporate communal spaces, such as gyms, swimming pools, or walking paths, can encourage residents to engage in regular physical activity [58,67]. These amenities not only provide opportunities for exercise but also foster social interactions and community engagement, which are important for maintaining active lifestyles [68].

The role of housing design in promoting physical activity extends beyond individual homes to the broader neighborhood context. Housing developments that are integrated with pedestrian-friendly infrastructure, such as sidewalks and bike lanes, can encourage active transportation [69,70]. Similarly, mixed-use developments that combine residential, commercial, and recreational spaces can reduce reliance on cars and promote walking or cycling for daily activities [69,70]. Urban planners and architects must therefore prioritize health-conscious design principles to combat obesity [70]. This includes incorporating features that encourage physical activity, such as staircases, outdoor spaces, and communal amenities, into housing developments. Additionally, policies that mandate the inclusion of active living elements in building codes and zoning regulations can ensure that new housing projects promote healthier lifestyles. By rethinking housing design, we can create environments that support physical activity and reduce obesity rates.

This section highlights several key aspects of housing and spatial design that influence physical activity and, by extension, obesity. However, it is important to note a limitation within the existing body of literature. Specifically, there is a relative lack of empirical studies that provide detailed examination of spatial and architectural features such as room configuration, internal circulation patterns, access to natural light, ventilation flows, and flexibility of space use. As a result, the discussion of housing design in this review necessarily remains at a general level, focusing on broad features such as outdoor spaces and communal amenities. This limitation reflects the current gaps in the published scientific literature, rather than the scope or intent of this review.

5.3. Housing Location and Access to Amenities

The location of housing within a neighborhood significantly influences residents’ access to amenities that impact obesity, such as parks, recreational facilities, and healthy food options. Proximity to these amenities can encourage physical activity and healthy eating, while their absence can contribute to sedentary lifestyles and poor dietary habits [71,72]. Residents living near parks or green spaces are more likely to engage in regular exercise, such as walking, jogging, or playing sports [36,43]. Similarly, access to supermarkets offering fresh produce can promote healthier diets, while limited access may lead to reliance on calorie-dense, nutrient-poor foods [73]. Access to health services also significantly influences obesity outcomes [74,75,76].

The concept of “food deserts” highlights the importance of housing location in shaping dietary habits. Food deserts are areas with limited access to affordable, nutritious food, often characterized by a high concentration of fast-food outlets and convenience stores [27]. Residents of these areas, particularly low-income families, may struggle to maintain healthy diets due to the lack of fresh fruits, vegetables, and whole grains [77,78]. This disparity in food access is a significant contributor to obesity, as poor dietary habits are a leading risk factor for weight gain [29,77,78]. Similarly, “activity deserts” refer to neighborhoods with limited access to recreational facilities, such as gyms, swimming pools, or sports fields. Residents of these areas may face barriers to physical activity, such as long travel distances or unsafe walking conditions [69]. This lack of access can discourage regular exercise and contribute to sedentary behaviors, particularly among children and older adults [79,80].

Urban planning policies that prioritize the equitable distribution of amenities can address these disparities and reduce risk of obesity. Zoning regulations that incentivize the development of supermarkets in underserved areas can improve access to healthy food options [70,81]. Similarly, investments in recreational facilities and green spaces can encourage physical activity and promote healthier lifestyles [33,82]. Transportation infrastructure also plays a critical role in enhancing access to amenities. Public transportation systems that connect residential areas with parks, grocery stores, and recreational facilities can reduce reliance on cars and promote active transportation [37,83]. The location of housing also influences exposure to environmental hazards, such as air pollution and traffic noise, which can impact obesity [70]. Residents living near busy roads or industrial areas may experience higher levels of air pollution, which has been linked to metabolic disorders and weight gain [54]. Similarly, exposure to traffic noise can disrupt sleep and increase stress levels, both of which are risk factors for obesity [54].

5.4. Neighborhood Walkability and Obesity

Neighborhood walkability, defined as the ease and safety of walking within a community, is a key factor in the Obesity–Housing Nexus. Walkable neighborhoods are characterized by well-maintained sidewalks, pedestrian-friendly infrastructure, mixed land use, and accessible destinations, such as schools, shops, and parks [37,69]. These features encourage residents to engage in active transportation and recreational walking, which can lead to increased physical activity levels and lower obesity rates [31].

The design of streets and sidewalks plays a critical role in promoting walkability. Wide, well-lit sidewalks separated from traffic by buffers, such as trees or bike lanes, create a safe and inviting environment for pedestrians [84]. Conversely, narrow or poorly maintained sidewalks, high traffic volumes, and lack of crosswalks can discourage walking and promote sedentary behaviors [31,69]. Mixed land use, which combines residential, commercial, and recreational spaces within a neighborhood, is another important aspect of walkability [85]. This design reduces the distance between destinations, making it easier for residents to walk or cycle for daily activities, such as grocery shopping or commuting to work [37,69]. In contrast, neighborhoods with segregated land use, where residential areas are far from commercial or recreational spaces, often require car travel, discouraging active transportation. The availability of destinations within walking distance is also critical for promoting walkability. Neighborhoods with parks, playgrounds, and community centers provide opportunities for recreational walking and physical activity [31,43]. Similarly, access to public transportation hubs can encourage residents to walk or cycle to transit stops, reducing reliance on cars [86]. However, many neighborhoods, particularly in low-income areas, have limited access to these amenities, creating barriers to physical activity.

Urban design interventions aimed at improving walkability can have a significant impact on obesity rates [70,87]. The creation of pedestrian zones, bike lanes, and traffic-calming measures can make neighborhoods safer and more inviting for walking [70]. Similarly, investments in green spaces and recreational facilities can provide destinations that encourage physical activity [26,88]. These interventions not only promote active lifestyles but also enhance the overall quality of life for residents [31]. Moreover, the social environment of a neighborhood also influences walkability. Communities with strong social networks and a sense of collective efficacy are more likely to support walkability initiatives and maintain safe, clean, and attractive public spaces. Conversely, neighborhoods with high crime rates or social disorganization may discourage walking, even if the physical infrastructure is in place [89].

5.5. Housing Affordability and Obesity

Housing affordability is a potential factor influencing obesity, particularly among low-income populations [90,91]. High housing costs can strain household budgets, leaving limited resources for healthy food options and recreational activities. This financial pressure often forces families to prioritize housing expenses over nutritious food, leading to reliance on cheaper, calorie-dense, and less healthy options [91,92]. Low-income families may purchase processed foods or fast food, which are often more affordable but less nutritious than fresh fruits, vegetables, and whole grains [92].

The financial stress associated with housing affordability can also contribute to mental health issues, such as anxiety and depression, which are linked to unhealthy coping mechanisms, such as emotional eating [16]. Emotional eating, characterized by the consumption of high-calorie, comfort foods in response to stress, can lead to weight gain and obesity [20,29]. Additionally, financial stress may reduce motivation for physical activity, as individuals may prioritize work or other responsibilities over exercise [92]. Housing affordability also influences access to recreational facilities and opportunities for physical activity [77,91]. Low-income families living in unaffordable housing may have limited disposable income to spend on gym memberships, sports equipment, or recreational activities. This financial constraint can discourage regular exercise and contribute to sedentary behaviors. Furthermore, low-income neighborhoods often lack access to affordable recreational facilities, such as parks, community centers, or sports fields, creating additional barriers to physical activity [36,43].

Policies aimed at improving housing affordability can alleviate these pressures and create conditions conducive to healthier living [91]. Housing subsidies, rent control measures, and affordable housing initiatives can reduce the financial burden on low-income families, freeing up resources for healthier food options and recreational activities. Additionally, investments in affordable recreational facilities and community programs can provide opportunities for physical activity in low-income neighborhoods [26]. The location of affordable housing also plays a role in shaping health outcomes [90,91]. Affordable housing developments located in areas with limited access to healthy food options or recreational facilities may inadvertently contribute to obesity [27,28]. Residents of affordable housing in food deserts may struggle to maintain healthy diets due to the lack of fresh produce and reliance on fast food. Similarly, affordable housing in neighborhoods with poor walkability or limited green spaces may discourage physical activity. Urban planning strategies that prioritize the development of affordable housing in areas with access to healthy food options, recreational facilities, and green spaces can address these disparities [40,84]. Mixed-income housing developments that combine affordable and market-rate housing can create diverse, vibrant communities with access to amenities that promote healthier lifestyles [44,68,81].

5.6. Social Environment and Obesity

The social environment within housing communities plays a significant role in shaping obesity-related behaviors [12]. Supportive social networks can encourage healthy behaviors, such as regular exercise and balanced diets, through peer influence and community activities [25]. Residents of neighborhoods with strong social ties may participate in group exercise classes, walking clubs, or community gardens, which promote physical activity and healthy eating [59,93]. Conversely, social isolation and lack of community engagement can lead to sedentary lifestyles and poor dietary habits [25,93].

The social environment also influences mental health, which is closely linked to obesity. Residents of neighborhoods with high levels of social cohesion and collective efficacy are more likely to experience lower stress levels and better mental health outcomes [94,95]. These positive mental health outcomes can reduce the risk of emotional eating and promote healthier lifestyle choices. In contrast, neighborhoods with high levels of social disorganization, such as those with high crime rates or low social trust, may experience higher levels of stress and mental health issues, contributing to obesity [95]. Community-based interventions that foster social connections and promote healthy behaviors can be effective in reducing obesity rates [93]. Community gardens, cooking classes, and walking groups can provide opportunities for residents to engage in physical activity and healthy eating while building social connections [59]. Similarly, neighborhood events, such as health fairs or fitness challenges, can raise awareness about healthy lifestyles and encourage community participation [96,97]. The role of housing design in fostering a supportive social environment cannot be overlooked. Housing developments that incorporate communal spaces, such as courtyards, playgrounds, or community centers, can facilitate social interactions and community engagement [59]. These spaces provide opportunities for residents to connect with one another, share resources, and participate in collective activities that promote healthier lifestyles [93,97]. Additionally, housing designs that prioritize safety and accessibility can create environments that encourage outdoor activities and social interactions.

Policies that promote social equity and inclusivity in housing communities are essential for addressing disparities in obesity, as they help ensure that all residents have equal access to resources and environments that support healthy lifestyles. Low-income and marginalized populations often face barriers to social participation, such as discrimination, language barriers, or lack of resources [39]. These barriers can limit access to social networks and community activities that promote healthy behaviors. Addressing these disparities requires a more inclusive and interdisciplinary approach to urban planning and policymaking, which prioritizes equity and actively engages marginalized communities in the development and implementation of interventions [39,98,99,100].

6. Policy Implications and Future Directions

While personal factors such as diet and physical activity are often emphasized in public health narratives, mounting evidence underscores the significant role of environmental influences on obesity risk. Built environment features such as walkability, access to green spaces, and neighborhood safety have been consistently linked with physical activity levels and dietary behaviors [31,69]. However, inconsistencies across contexts, particularly regarding the impact of food environments, highlight the need for more nuanced, place-based research to inform urban design and planning. Understanding the balance between individual agency and structural constraints is central to effective policymaking [101]. While behavior-change interventions remain important, they are often insufficient when implemented without environmental supports. For instance, encouraging physical activity is less effective in areas without safe sidewalks or public parks. Policy approaches should therefore adopt integrated strategies that combine education and individual empowerment with infrastructural changes such as accessible recreational facilities and zoning policies that limit the density of fast-food outlets. Urban planners can enhance such efforts through “choice architecture”, embedding subtle environmental cues (e.g., visible stairs, shaded walking paths) that encourage healthier behaviors without relying solely on individual motivation [102].

The effectiveness and sustainability of built environment interventions are context-dependent and influenced by long-term investment, community engagement, and local infrastructure. Although initiatives such as the addition of parks, bike lanes, or incentives for grocery stores in underserved areas have demonstrated potential, the long-term impacts on obesity remain mixed. Variability in outcomes may result from differences in urban density, socioeconomic disparities, or maintenance efforts. Successful interventions are often those that are community-informed, culturally appropriate, and supported by ongoing programs, such as fitness classes or community gardens, that maintain engagement over time [103,104,105]. Equity remains a critical dimension of obesity prevention in the built environment. Marginalized populations, particularly those in low-income communities, frequently reside in neighborhoods that lack the structural features necessary to support healthy living [106,107,108]. These communities face higher exposure to food deserts, unsafe streets, and inadequate housing conditions, compounding barriers to achieving and maintaining good health. Addressing these disparities requires policies that prioritize resource allocation to disadvantaged areas, supported by participatory planning processes that ensure community voices shape the design and delivery of interventions. Without such inclusive approaches, built environment strategies risk reinforcing existing inequities rather than mitigating them.

Finally, the mechanisms linking housing and obesity require in-depth investigation, drawing on both population-based quantitative data and the perspectives and experiences of people with lived experience through qualitative approaches [109,110]. Housing quality, design, and location influence health not only through direct environmental exposure but also via indirect pathways, including stress, sleep disruption, and opportunities for movement. Future research should explore these biological and psychosocial mediators, using longitudinal and experimental designs that incorporate objective health measures. Strengthening housing codes, promoting active design, and embedding health equity in urban policy are essential steps toward addressing the obesity crisis through environmental and housing reform.

7. Conclusions

This review highlights the multifaceted relationship between housing and obesity, identifying six key domains through which housing conditions influence obesity risk: housing quality, housing design, housing location, neighborhood walkability, housing affordability, and social environment. These key housing-related domains that shape obesity risk were collectively conceptualized as the Obesity–Housing Nexus. While evidence supports the role of these domains in shaping physical activity, diet, stress, and sleep, critical gaps remain in understanding causal mechanisms, especially the interaction between individual and environmental factors. The study findings also underscore the need for longitudinal, interdisciplinary, and equity-focused research. Future work should also evaluate the long-term effectiveness of built environment interventions and their relevance across diverse populations and settings.