Twins, Anne and Malou Luchtenberg

Genes and Reasons for Obesity

New evidence of genes for obesity reminds us that a thin line separates reason from rationalization. Last week in Science, investigators led by Joseph Majzoub, chief of endocrinology at Boston Children’s Hospital, published their discovery of a gene mutation that may help explain how different people consuming precisely the same food can gain very different amounts of weight — or none at all.

The investigators showed that deleting a gene in mice called melanocortin receptor accessory protein 2 (MRAP2) caused those mice to gain weight at an early age despite eating and exercising the same as normal-weight mice who did not have the same mutation. They also found this same mutation in four children with severe obesity, but not in a sample of children without obesity who served as controls.

Said Majzoub:

The history of obesity for many many years has been one of blaming people for lack of self control. If some of it is due to a slow metabolism, that would completely change the perspectives of parents and patients. It really would change the way we think of the disease.

This is where the thin line between reason and rationalization comes into view. The headline in the New York Times proclaimed: “Overweight? Maybe You Really Can Blame Your Genes.”

Trying to understand the factors that contribute to obesity is a perfectly reasonable approach, vastly superior to blaming and shaming people with the disease. Setting aside all that baggage is an absolutely necessary step in moving toward a strategy for dealing with the disease. But reason quickly turns into rationalization if we accept obesity as a destiny for which nothing can be done.

For clinical obesity professionals, working with patients who feel a profound sense of futility about their condition is a daily challenge. There’s nothing fair about a chronic disease — no one deserves to suffer its effects. Accepting this fact, a patient still has to decide what to do about it. And skilled clinicians must be ready to help without judging.

Click here to read more about the study in the New York Times, and click here to access the study itself.

Twins, Anne and Malou Luchtenberg, photograph © Qsimple / flickr

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