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Obesity Causes - Genetic or Environmental
Genes or Lifestyle as a Factor in Obesity Disease
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Obesity - Genetic or Environmental - Nature or Nurture?

As we approach the full sequence of the human genome the question of 'nature versus nurture' has never been more topical.

Obesity & Genes
Today we recognise a number of single gene defects, primarily in the leptin and melanocortin systems, associated with profound obesity. Yet in the overwhelming majority of cases of human obesity it has proved difficult to isolate individual genes, which consistently segregate with the obese phenotype across various populations. For the most part the genetics of body weight represent the balance between genes causing susceptibility to and protection from obesity.

Obesity & Social Systems
At the other extreme we must accept that some cases of obesity are strongly determined by social and cultural systems. The fatness of Sumo wrestlers is not a genetic accident, but the result of targeted eating and exercise habits. In our own society the increase in weight or fatness in adult life, which frequently accompanies declines in physical activity, provides further evidence of a behavioural component to body weight.

Obesity & Children
However, few cases are clear-cut examples of 'nature or nurture' as a cause of obesity. Evidence is beginning to emerge of children, disciplined by over-controlling parents, who are unable to take responsibility for their own food consumption and who appear particularly prone to excess weight gain. It may be argued that this represents either a consequence of familial eating behaviours or an underlying genetic factor transmitted from parent to child.

Weight Gain - Genetic or Environmental?
This and many more examples provide strong evidence that most cases of obesity result from interactions between genetic factors and environmental influences. We are beginning to acknowledge that a strong hunger drive or a preference for high fat foods may be innate rather than learnt phenomenon, conveying an increased risk of hyperphagia and weight gain. However we are perhaps still reluctant to consider that the willingness or capacity to exercise may have a genetic basis. The recent increase in the prevalence of obesity represents the impact of the 21st century environment on our underlying susceptibility to weight gain, not a fundamental change in the genome.

Obesity is not a single disease. It is a heterogeneous group of diseases of diverse origin, each of which is manifest as an obese phenotype. As we understand more fully the relative contribution of 'nature and nurture' it will be possible to develop more precisely targeted interventions to prevent and treat obesity.

Source: Susan Jebb, MRC Human Nutrition Research, Cambridge.

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