‘Battling my Biology’: Psychological Effects of Genetic Testing for Risk of Weight Gain

Abstract

The availability of genetic tests for multifactorial conditions such as obesity raises concerns that higher-risk results could lead to fatalistic reactions or lower-risk results to complacency. No study has investigated the effects of genetic test feedback for the risk of obesity in non-clinical samples. The present study explored psychological and behavioral reactions to genetic test feedback for a weight related gene (FTO) in a volunteer sample (n = 18) using semi-structured interviews. Respondents perceived the gene test result as scientifically objective; removing some of the emotion attached to the issue of weight control. Those who were struggling with weight control reported relief of self-blame. There was no evidence for either complacency or fatalism; all 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. Genetic test feedback for risk of weight gain may offer psychological benefits beyond its objectively limited clinical utility. As the role of genetic counselors is likely to expand, awareness of reasons for genetic testing for common, complex conditions and reactions to the test result is important.

This is a preview of subscription content, access via your institution.

References

  1. Bennett, L., Thirlaway, K., & Murray, A. J. (2008). The stigmatising implications of presenting schizophrenia as a genetic disease. Journal of Genetic Counseling, 17, 550–559.

    Google Scholar 

  2. Brownell, K. D., Kersh, R., Ludwig, D. S., Post, R. C., Puhl, R. M., Schwartz, M. B., et al. (2010). Personal responsibility and obesity: a constructive approach to a controversial issue. Health Affairs, 29(3), 379–387.

    PubMed  Article  Google Scholar 

  3. Campbell, M., Fitzpatrick, R., Haines, A., Kinmonth, A. L., Sandercock, P., Spiegelhalter, D., et al. (2000). Framework for design and evaluation of complex interventions to improve health. British Medical Journal, 321, 694–696.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  4. Collins, F. (2010). Has the revolution arrived? Nature, 464, 674–675.

    CAS  PubMed  Article  Google Scholar 

  5. Condit, C. M., Gronnvoll, M., Landau, J., Shen, L., Wright, L., & Harris, T. M. (2009). Believing in both genetic determinism and behavioral action: a materialist framework and implications. Public Understanding of Science, 18, 730–746.

    Article  Google Scholar 

  6. Conradt, M., Dierk, J. M., Schlumberger, P., Albohn, C., Rauh, E., Hinney, A., et al. (2009). A consultation with genetic information about obesity decreases self-blame about eating and leads to realistic weight loss goals in obese individuals. Journal of Psychosomatic Research, 66, 287–295.

    PubMed  Article  Google Scholar 

  7. Frayling, T. M., Timpson, N. J., Weedon, M. N., Zeggini, E., Freathy, R. M., Lindgren, C. M., et al. (2007). A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science, 316, 889–894.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  8. Frosch, D. L., Mello, P., & Lerman, C. (2005). Behavioral consequences of testing for obesity risk. Cancer Epidemiology, Biomarkers & Prevention, 14, 1485–1489.

    Article  Google Scholar 

  9. Grosse, S. D., McBride, C. M., Evans, J. P., & Khoury, M. J. (2009). Personal utility and genomic information: look before you leap. Genetics in Medicine, 11, 575–576.

    PubMed Central  PubMed  Article  Google Scholar 

  10. Guh, D., Zhang, W., Bansback, N., Amarsi, Z., Birmingham, C. L., & Anis, A. (2009). The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health, 9(1), 88.

    PubMed Central  PubMed  Article  Google Scholar 

  11. Harris, A., Kelly, S. E., & Wyatt, S. (2012). Counseling customers: emerging roles for genetic counselors in the direct-to-consumer genetic testing market. Journal of Genetic Counseling. doi:10.1007/s10897-012-9548-0.

    PubMed Central  Google Scholar 

  12. Harvey-Berino, J., Gold, E. C., West, D. S., Shuldiner, A. R., Walston, J., Starling, R. D., et al. (2001). Does genetic testing for obesity influence confidence in the ability to lose weight? A pilot investigation. Journal of the American Dietetic Association, 101, 1351–1353.

    CAS  PubMed  Article  Google Scholar 

  13. Leventhal, H. B., et al. (1997). Illness representations: theoretical foundations. In K. H. Petrie & J. A. Weinman (Eds.), Perception of health and illness (pp. 19–46). Amsterdam: Harwood Academic Publishers.

    Google Scholar 

  14. Lippa, N. C., & Sanderson, S. C. (2012). Impact of information about obesity genomics on the stigmatization of overweight individuals: an experimental study. Obesity.

  15. Lock, M. (2006). When it runs in the family: putting susceptibility genes in perspective. Public Understanding of Science, 15, 277.

    Article  Google Scholar 

  16. Loos, R. J., & Bouchard, C. (2003). Obesity–is it a genetic disorder? Journal of Internal Medicine, 254, 401–425.

    CAS  PubMed  Article  Google Scholar 

  17. Marteau, T. M., French, D. P., Griffin, S. J., Prevost, A. T., Sutton, S., Watkinson, C., et al. (2010). Effects of communicating DNA-based disease risk estimates on risk-reducing behaviours. Cochrane Database of Systematic Reviews, 10.

  18. Meisel, S. F., Walker, C., & Wardle, J. (2012). Psychological responses to genetic testing for weight gain: a vignette study. Obesity, 20(3), 540–546.

    CAS  PubMed  Article  Google Scholar 

  19. O’Brien, K. S. (2010). Reducing anti-fat prejudice in preservice health students: a randomized trial. Obesity, 18, 2138.

    PubMed  Article  Google Scholar 

  20. O’Rahilly, S., & Farooqi, I. S. (2008). Human obesity as a heritable disorder of the central control of energy balance. International Journal of Obesity (London), 32(Suppl 7), S55–S61.

    Article  Google Scholar 

  21. Persky, S., Kaphingst, K. A., Condit, C. M., & McBride, C. M. (2007). Assessing hypothetical scenario methodology in genetic susceptibility testing analog studies: a quantitative review. Genetics in Medicine, 9, 727–738.

    PubMed  Article  Google Scholar 

  22. Puhl, R. M., & Heuer, C. A. (2012). The stigma of obesity: a review and update. Obesity, 17(5), 941–964.

    Article  Google Scholar 

  23. Ritchie, J. (2003). Qualitative research practice: a guide for social science students and researchers. London: Sage Publications.

    Google Scholar 

  24. Rogers, R. W. (1975). A protection motivation theory of fear appeals and attitude Change. The Journal of Psychology, 91, 93.

    Article  Google Scholar 

  25. Rosenstock, I. M. (1988). Adoption and maintenance of lifestyle modifications. American Journal of Preventive Medicine, 4, 349–352.

    CAS  PubMed  Google Scholar 

  26. Saguy, A. C. (2005). Weighing both sides: morality, mortality, and framing contests over obesity. Journal of Health Politics, Policy and Law, 30, 869.

    PubMed  Article  Google Scholar 

  27. Sanderson, S. C., & Wardle, J. (2005). Will genetic testing for complex diseases increase motivation to quit smoking? Anticipated reactions in a survey of smokers. Health Education & Behavior, 32, 640–653.

    Article  Google Scholar 

  28. Senior, V., Marteau, T. M., & Peters, T. J. (1999). Will genetic testing for predisposition for disease result in fatalism? A qualitative study of parents responses to neonatal screening for familial hypercholesterolaemia. Social Science & Medicine, 48, 1857–1860.

    CAS  Article  Google Scholar 

  29. Shostak, S., Zarhin, D., & Ottman, R. (2011). What’s at stake? Genetic information from the perspective of people with epilepsy and their family members. Social Science & Medicine, 73, 645–654.

    Google Scholar 

  30. Steinbrook, R. (2006). Imposing personal responsibility for health. The New England Journal of Medicine, 355(8), 753–756.

    CAS  PubMed  Article  Google Scholar 

  31. Sturm, A. C., & Manickam, K. (2012). Direct-to-consumer personal genomic testing: a case study and practical recommendations for “genomic counseling”. Journal of Genetic Counseling, 1–11.

  32. Townend, L. (2009). The moralizing of obesity: a new name for an old sin? Critical Social Policy, 29, 171–190.

    Article  Google Scholar 

  33. Wardle, J., Carnell, S., Haworth, C. M., Farooqi, I. S., O’Rahilly, S., & Plomin, R. (2008). Obesity associated genetic variation in FTO is associated with diminished satiety. Journal of Clinical Endocrinology and Metabolism, 93, 3640–3643.

    CAS  PubMed  Article  Google Scholar 

Download references

Acknowledgments

This research was supported by a grant from Cancer Research UK (C1418/A10843). We would like to thank Professor Stephen O’Rahilly and Professor Sadaf Farooqi from Cambridge University, Institute of Metabolic Sciences, Cambridge, U.K. for their helpful and constructive advice, and David Withers for performing the DNA analysis.

Disclosure

The authors have no conflict of interest to declare.

Author information

Affiliations

Authors

Corresponding author

Correspondence to S. F. Meisel.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Meisel, S.F., Wardle, J. ‘Battling my Biology’: Psychological Effects of Genetic Testing for Risk of Weight Gain. J Genet Counsel 23, 179–186 (2014). https://doi.org/10.1007/s10897-013-9628-9

Download citation

Keywords

  • Genetic risk
  • Personalized medicine
  • Psychological reactions
  • Weight gain
  • Genetic testing
  • Genetic counseling