Can Gene Tests Benefit People With Obesity?
Thursday, July 18, 2013
Although we are far from having predictive genetic tests for obesity that are useful in clinical practice, a common argument against the possible use of such tests (even if we did have them) is that they may lead to fatalism and complacency.
I was therefore interested in a study by Susanne Meisel and Jane Wardle, from University College London, UK, published in the Journal of Genetic Counseling.
This study explored psychological and behavioral reactions to genetic test feedback for the FTO gene (which explains a small proportion of people’s excess weight) in a sample of 18 volunteers.
The primary finding was that individuals with excess weight perceived a ‘positive’ result as removing some of the emotion attached to the issue of weight control and relief of self-blame.
Or as some of the participants responded:
“…it would just help understand yourself really. Kind of…it makes me feel better that I have AT, if I had TT I think I’d be a bit upset, because it would be like, oh my gosh I’ve got…it’s all me, it’s me…but as it’s AT, at least it’s got something to do with my genes and it’s not just me being a pig”
“[…] because when it’s kind of scientifically objective you are able to see whether that’s just your genetic condition and it helps to deal with it the best way possible… to be able to address these things and not to make it into some sort of taboo that can’t be talked about”
There was no evidence for either complacency or fatalism, rather respondents emphasized the importance of lifestyle choices in long-term weight management, although they recognized the role of both genes and environment.
Regardless of the test result, respondents evaluated the testing positively and found it motivating and informative.
Overall, the authors conclude that,
“Although the predictive value of most genetic tests for “common” conditions such as weight gain is currently very modest, there may be benefits beyond “objective” clinical utility for individuals seeking advice, which could be explored in the genetic counseling session.”
Thus, there may be some merit to genetic testing for obesity (when such tests become available), even if just to relieve some of the considerable self blame so common to people struggling with excess weight.
I wonder what my readers have to say on this topic. Would you take a genetic test for obesity if it were offered by your doctor (even if this would not change treatment)?
@DrSharma
Edmonton, AB
Meisel SF, & Wardle J (2013). ‘Battling my Biology’: Psychological Effects of Genetic Testing for Risk of Weight Gain. Journal of genetic counseling PMID: 23832708
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Thursday, July 18, 2013
As a country, we actually have a large informal study of how roughly 5 million people respond when diagnosed with a disease that results from genetic predisposition, has no cure, and is primarily treated with a single medication and extremely active lifestyle management.
That disease is Type 1 diabetes.
There’s quite a bit of anecdotal evidence that many people w/ Type 1, far from being fatalistic or complacent, are actually extremely conscious of their lifestyle choices and the connection to short-term and long-term health outcomes.
For example, a surprisingly large # of Type 1s are extremely active exercisers – marathons, triathlons, century cycling and the like. And my personal opinion – again, anecdotal – is that Type 1s may well be MORE active as a group than the general population.
Many self-restrict foods that spike blood sugar, carb-count and exchange-count at a level of detail that would shock most non-diabetics.
And virtually all of this is self-managed and self-directed, with most guidance coming from fellow diabetics, and little practical input from docs and even CDEs.
Thursday, July 18, 2013
I think genetic testing is valuable, partly because it WOULD relieve some of the shame and guilt that obese people are made to feel, but it also offers proof to refute the bigots who blame obesity totally on the victims’ personal habits and lifestyle. Whenever obesity is discussed, you ALWAYS get people who immediately generalize sloth and gluttony as the only causes of obesity, and then start pontification on why these people should take personal responsibility and lose weight. And by the way, if someone wanted to know their status on the FTO gene, it’s one of the SNPs tested by 23andme, whose testing is not all that expensive. I am not associated with this company in any way — I’m just offering information.
Thursday, July 18, 2013
I had a genetic panel completed several years ago. This was through a company called Navigenics, (which was sold recently and no longer offers the service.) The testing covered a wide range of health conditions, as well as four markers related to obesity. When I received the results, and learned that I had ALL FOUR of the obesity markers they targeted, my response was a feeling of vindication for years of dedication to lifestyle change (and significant weight loss,) but “failure” at achieving a “normal” weight. I was also able to give myself a “break” in terms of harsh self-judgment, and increase self-compassion. My professional work as a psychologist (that helps people with many issues including weight,) was also impacted, as the insights gained helped me appreciate that biology is a powerful factor in human behavior that is easily overlooked—especially in our cultural climate which espouses self-control as a simple solution to behavior change.
Thursday, July 18, 2013
I think the testing would be a good thing when available. It may link to other conditions and advance the cause of science by unforeseen associations; the psychological benefits of knowing are important; obese people are not prone to complacency or fatalism but always “rage, rage against the . . .” expanding of the waist line; in crafting an evidence-based response to your own obesity, it is important to know what you are dealing with (knowledge, as always, is power). Obese people need to be stopped being treated like kids by the medical establishment, so of course finding and sharing all that can be known is vital.
Friday, July 19, 2013
I was one of the volunteers in this study – I came out as AT – this result did not surprise me as I was well aware that I had a tendency to be heavier. It did not in any way change my thoughts on how I managed my weight.
Friday, July 19, 2013
I think this could be useful as long as there is some sort of severity or risk indicator along with it. Example – with the 4 genetic markers one poster mentioned 4-4 would have the highest risk category and 1-4 would have a lower risk category. Of course there might be other contributions to this evaluation as well related to ones health.
As with any testing though you have to weigh out the benefit of it as related to our ever changing insurance system (in the US). I would hate for insurance companies to start adjusting premiums based on this information. This is already something we have to consider when it comes to life insurance. I know people who have very high premiums because a blood clotting disorder was found through genetic testing and they had to disclose that information to the underwriter.
So yes the information would be nice but only if it’s not used against you in some way.
Friday, July 19, 2013
Genetic testing for screening or therapeutic monitoring is useless and just a way to screw money out of vulnerable frightened people. Its a crime.