Expert Commentary: Dr. Elliot Goodman, M.D. May 5, 2009

In a fascinating study in the journal Nature Structural and Molecular Biology,  scientists explored the creation of fat through a structure called fatty acid synthasase. While this is pure research with no immediate clinical application it does open a window into how fats are formed from carbohydrates. A deeper understanding of how this happens can ultimately lead to the development of inhibitors that would help block the conversion of carbohydrates into fat. This research always begs a somewhat difficult question. To what extent are people who overweight at fault. Or rather the question is how should a person feel about being overweight. This is an a critical question because how a person feels about their weight can go a long way to how they try to deal with it, either through diet, exercise, or surgery.

So let’s begin to explore that question. Here is a question I am often asked in one form or another.  Is there a genetic basis for obesity? And if there is, am I at fault for being overweight. Current research implies that in some cases there may be a genetic predisposition to obesity. Does that mean that if your parents are overweight, that you will be overweight.

Well that is true and not true. First, it is not necessarily true that one automatically inherits the genes for obesity. Blonde-haired parents can have dark haired children, same for a genetic pre-disposition for obesity. However, just as important as a genetic disposition for obesity is that children usually share the same life style as their parents. Children learn from their parents their attitudes to food consumption, amount of exercise, image of themselves. So determining how much any one patient may or may not have a genetic predisposition obesity versus lifestyle choices will rarely be a straight-forward task.
 
What is important and what I am getting to is a person’s self-assessment. How much do they personally feel at fault. Call it the guilt factor. For this self-assessment has tremendous impact on a patients approach and success at any weight-loss program.

I’ll be talking more about this issue in future blogs, because I think this is often the key to ultimate success in marinating a new and healthy lifestyle.

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