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“It’s still your choice. This gene will not make you overweight if you do not overeat.” Colin N.A. Palmer, PhD, University of Dundee, Scotland

OBESITY GENE: Inclination, Not Destiny

We continue to learn about the role of heredity in weight control. More than 100 genes have been implicated in the determination of body weight. Most of them affect eating behavior. “The day is not too far off when we will, by scoring…perhaps 15 to 20 such genes, be able to predict individual risk of type 2 diabetes, obesity, and other diseases,” Rudolph L. Leibel, MD, wrote in a New England Journal of Medicine editorial concerning a new study from Scotland.

He added this hopeful proviso: “The important role that environment plays in enabling or resisting such susceptibility is clear evidence that such risk can be modified.” Genes do have an impact, but rarely are they overpowering; we almost always have a say in the outcome. The more we learn the more control we are likely to have. Knowledge is power. The study, which was reported in the NEJM on December 11, 2008, is an excellent example of the interplay between inclination and choice. We may be inclined to act in a certain way, but we can chose to take a wiser path.

The gene involved is known as FTO. According to the researchers, it has the “most robust association with common obesity” yet discovered. The link to obesity had been established, but the mechanism, how it worked, was unknown. Dr. Colin Palmer and his colleagues wanted to know whether the FTO gene influences eating behavior or perhaps how the body senses and burns calories. Simply put, does the gene affect appetite or metabolism? Appetite, of course, would be easier to control. 

The researchers began by examining 2726 Scottish children 4 to 10 years of age for specific FTO gene variations, and for height and weight. Nearly two-thirds of the children had at least one copy of the FTO gene variant, about the same proportion found in a previous study. FTO was again found to be strongly associated with increased body weight.

After confirming the connection between the gene and body mass, they selected 97 of the children for more detailed study, including body fat, energy expenditure, and eating behavior. FTO frequency was the same in the 97 children as in the total group.

The children with the FTO gene were found to have somewhat larger waist and hip measurements and significantly more body fat.

The children were given three meals at school to evaluate their eating behavior. The meals were made up of foods varying in energy density, from low to high density: Fruit and vegetables, bread, ham, cheese, potato chips, and chocolate candy.  

An ounce of chocolate candy, of course, contains more calories than an ounce of apple.

The amount eaten was determined by weighing each food item before and after the meal. Activity level for each child was also assessed.

The researchers found that children with the FTO gene showed no significant difference in metabolic rate, physical activity, or the weight of food eaten.

“The only thing we could find was the fact that [those with the FTO gene] were eating much richer foods,” said Dr. Palmer.

“The major effect [of FTO] appears to be on energy intake and a preference for food of high calorie density,” Dr. Leibel, an obesity researcher at Columbia University in New York, wrote in the editorial.   

On average, those with the FTO gene ate 100 extra calories per meal, which Palmer said “can put on weight” over time. That would be 300 extra calories a day, assuming they ate breakfast, lunch and dinner. Add snacks and it could be considerably more.

Your Choice

The researchers concluded that the FTO gene “appears to confer a risk of obesity through increased energy intake.” Importantly, however, they also concluded that “moderate restriction of energy intake” could control the risk.

Interestingly, the FTO children were more active and expended more energy than the other children. Leibel suggested that the overeating could be driven by a need for calories. An inborn preference for fatty foods would, of course, have been an advantage in ancient times when food was often scarce.

Genes that once helped us survive in hard times now encourage unhealthy weight gain.

Palmer, the Scottish researcher, struck the right chord. “This gene will not make you overweight if you do not overeat,” he said. “It’s still your choice.”

If you believe you may have the FTO gene—apparently most of us do; I would bet that I have it—choose mainly foods that fill you up without making you fat. That’s actually a very satisfying way to eat. You can include some chocolate or other high-density foods. Just do it sparingly.

That approach has worked for me for decades. It will work for you as well.

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