“Your genes aren’t deterministic, but they bracket the possibilities,” Is Obesity a Choice-Giles Yeo

Dr. Yeo poses the question “Is obesity a choice?” tl:d watch: No.

This video was shared recently on Facebook from someone at Barbell Medicine. It dates back to 2019, but contains information that isn’t yet in the popular consciousness. That’s unfortunate since Dr. Yeo does a great job concisely summarizing the genetic influences that impact our eating decisions in ways that can result in obesity. Mostly, this isn’t groundbreaking stuff. Some of what he discusses was known when I was an undergrad twenty years ago. But some of it is newer, and the really powerful bit is realizing how deeply multifaceted and multivariate these genetic influences are–with increased risk alongside increased genetic factors. And due to natural, human biological variability, some folks are going to have more risk factors in their genes than others will. And therefore, some of us will have a harder time influencing our behaviors in the context of our current eating environments.

Having a really solid grounding in this science I hope lends people to having more compassion for others and for themselves when it comes to eating decisions. It can be difficult to accept that elements of our decision-making and personal choices may be deeply influenced by biology–the illusion of complete personal control and self-efficacy can be very strong. And similarly, knowing that our genes play a role in our choices needn’t require us to conclude that we have NO control, either. The truth is complex and multivariate, just like the biology. We have some control, not none and not all.

And if we can accept that as a fact, we can learn to create systems that work for us out of that place of acceptance. I know, for example, that I am highly cued by seeing delicious, highly palatable foods. So, I store them out of sight in closed containers, usually in my freezer. Does that mean I will never be influenced to eat them? No, but it accepts the reality of how my brain works and builds a solution that works for me. And I can meet my goals by often avoiding those foods. I don’t need to (or want to) avoid them entirely. I don’t need to completely reverse the influence of my biology or psychology, I simply need to learn to work with it. And part of that also means being kind to myself when I fail to avoid a temptation that I had plans to not partake in.

Acceptance of the reality of these challenges and my personal biology is also why my physique goals are not defined by a particular number on a scale, a measuring tape or clothing size. I want to continue to work towards the lean, muscular physique that I can achieve healthfully, in keeping with the realities and limitations of my own personal, complex biology. I don’t know what that outcome will look like. I don’t know what size I’ll be or how much I’ll weigh. I don’t know if I’ll finally “look” like a bodybuilder, or if I’ll just be a somewhat-stronger-than-average, normal looking person. I won’t be measuring my success based on those metrics. Success for me is a lifestyle that I can achieve and maintain without risking my physical or mental health. It’s possible that I’m already there. I wonder if might be something I can only really know in hindsight.

If you’re interested in these issues, I hope you’ll take the time to watch the video and learn more about the complex genetic influences on our eating behaviors. It’s a good reminder that human behaviors are not entirely in anyone’s control, and an evidence-based approach begins with recognizing that reality. Solutions need to come from a place of compassion and acceptance, an acknowledgement that some folks are going to have more challenges than others, and the same solutions will not result in the same outcomes for everyone.