Baseline energy expenditure may be changing, but weight loss/gain is 80-90% diet. Sure, rural folks aren't moving much, but let's address that they may live off

Baseline energy expenditure may be changing, but weight loss/gain is 80-90% diet. Sure, rural folks aren't moving much, but let's address that they may live off fast food, drink too much alcohol/sugar, eat too many processed carbohydrates, and generally don't have access to healthy vegetarian-heavy cuisine and the education that many city-dwellers use improve their health. Case in point: I drove on a road trip through the southern USA recently. In rural areas, you had highways with truck stops and gas stations with tons and tons of very tempting fried, sugary, tasty treats. I saw barely anyone eating a vegetable-based dish that wasn't fried. Salads? Forget about it...There's a reason it's called The Stroke Belt, and why Southerners are known to eat poorly. Look at even Jim Gaffigan's routine on Southerners, he aptly characterizes their ridiculous diets, poking fun at biscuits and gravy, for instance. So, while exercise is important, really just look at the foods on offer in rural areas. It'll be less healthy by default.