Thursday, December 8, 2022

Weight Loss: Harnessing the Power of Genetic Testing

By: Dr. Natasha Vani, B.Sc, M.Sc, ND, Director of Exercise and Nutrition at Newtopia.

Weight Loss: Most people know that excess weight is a major risk factor for many serious health conditions — including heart disease, stroke, type 2 diabetes, and some forms of cancer — but obesity rates have continued to rise for decades.

Today, more than 40% of U.S. adults are obese, and another 30% are overweight.[1] Also, having a BMI (Body Mass Index) over 30 is also an indicator of obesity. The higher the BMI, the greater the risk of developing additional health problems.

Why is it so hard to lose weight and keep it off? Part of the answer involves genetics. While there is no one gene that predicts obesity, there are hundreds linked to our choices about nutrition and exercise, which contribute to weight gain. Research suggests that for some individuals, genes account for just 25% of the predisposition to be overweight, while for others the genetic influence is as high as 70% to 80%.[2]

This may explain why some people can eat whatever they want and stay slim while others measure every morsel and still struggle to lose weight. It may also explain why obesity tends to run in families. Although the basic principle of calories in / calories out still applies, genetics can influence how efficiently the body burns those calories and what types of foods an individual craves.

Genetic testing for greater personalization

New technologies that allow genetics to be taken into account in designing weight-loss or health and well-being programs enable more customized interventions and maximum impact.

Newtopia, a tech-enabled habit change provider, incorporates testing for several key gene variants into its hyper-personalized employee disease prevention experiences. Based on the test results, trained coaches create customized tactics that help individuals reduce the impact or harness the benefits of their unique genes. Through ongoing virtual meetings, these coaches support the participants, track their progress and make adjustments as necessary throughout the program. These regular meetings also help hold the participants accountable, which is critical to long-term success.

At the beginning of the program, participants receive an easy-to-use saliva test kit — they simply swab the inside of each cheek and return the swabs in a postage-paid envelope. When the lab results are ready, their personal coach schedules two “genetic reveal” sessions to explain the results and discuss the lifestyle implications.

Participation in the genetic testing component of the program is voluntary, but Newtopia addresses potential privacy concerns by ensuring that all genetic information is securely stored, in compliance with the Genetic Information Nondiscrimination Act, and only the participant and their accountability coach see the information — never the employer or insurance provider.

Coaches also ease fear by emphasizing that the results are not in any way prescriptive — having certain gene variants does not mean a person will inevitably gain weight, for example. Genetic knowledge simply takes some of the guesswork out of designing a targeted program. Coaches can use genetics to understand a personal bar code of action, helping the coach determine what approaches will be most effective. Participants will still see results without the genetic testing, but access to this information makes it likely that improvements will come more easily and more quickly.

The key genes

While hundreds of genes can influence weight — both directly and by affecting the decisions people make about physical activity and nutrition — three are particularly relevant to food choices: MC4R, FTO, and DRD2.

  • MC4R (aka “the appetite gene”) regulates how quickly a person feels satiated after eating. A variant of this gene is linked to obesity because a person who does not feel full will continue to eat — often to the point of being uncomfortable afterward when the brain catches up to the stomach.

To offset the impact of this variant, the coach would work with the individual to identify portion-control strategies and ways to eat more slowly and mindfully. They might also recommend drinking more water to increase the feeling of satiation.

  • An FTO (aka “the fat gene”) variant is associated with an increased risk of obesity[3] because it is linked to a difficulty in breaking down and using carbohydrates, which tend to be stored as fat instead.

If an individual has the FTO variant, the coach might recommend eating less sugar and simple carbohydrates, and more healthy fats and proteins. Eating smaller meals throughout the day can also help. In terms of physical activity, the coach might suggest exercising at a higher intensity.

  • DRD2 (aka “the cravings gene”) encodes the D2 dopamine receptor, which plays a role in regulating motivation and reward.[4] Studies have identified the presence of a DRD2 variant in individuals who preferred carbohydrates,[5] which suggests that eating carbs leads to an increase in dopamine, bringing a greater feeling of gratification. Another study found that the interaction of DRD2 with genes that influence addiction, such as the leptin receptor gene (LEPR) and the mu-opioid receptor gene (OPRM1), markedly influences the development of clinically severe obesity.[6] An individual with a DRD2 variant may be susceptible to eating to stimulate the brain’s pleasure centers (say, when stressed), rather than eating only when hungry.

To offset the impact of this gene, the coach might help the individual identify other mechanisms to manage stress, such as meditation or walking, and help them choose foods with less salt and sugar to reduce cravings for highly processed foods over time.

Putting it all together

Obesity is extremely complex, and weight gain is influenced by a wide range of factors. Losing weight is hard, for many reasons. But moving beyond fad diets and one-size-fits-all programs to embrace a personalized approach — one that takes an individual’s unique genetic influencers into account — can support the development of lifestyle habits that lead to more successful weight loss and long-term health improvements.







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