This may be the most obvious explanation for an intriguing finding by Jessica Jones-Smith and colleagues published in JAMA, showing that opening or expansion of American Indian-owned casinos were associated with a significantly decreased risk of childhood obesity in those communities.
The basis for this hypothesis was the simple fact that for some American Indian tribes in the US, casinos provide a significant source of income for the people living in those communities.
The researchers looked at repeated cross-sectional anthropometric measurements from fitness testing of American Indian children (aged 7-18 years) from 117 school districts that encompassed tribal lands in California between 2001 and 2012, of which 57 gained or expanded a casino, 24 had a preexisting casino but did not expand, and 36 never had a casino. Using changes in the number of slot machines per capita as a measure of economic expansion (each slot machine was associated with an increase of around $550 in per capita annual income), the researchers found that every additional slot machine per capita reduced the probability of childhood overweight and obesity by about 0.2 percentage points.
Obviously, as the authors acknowledge, factors other than simple economics may have played a role in this relationship. Thus, as always with these type of studies,  assuming a direct causal relationship between adding slot machines and reducing childhood obesity obesity may be too simplistic.
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