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The Weight of our genes: The Role of genetics in obesity 

According to the world atlas obesity and despite countless efforts to highlight its importance, the numbers of people suffering from obesity continues to rise and it’s expected that by 2035, the number of people with a high BMI (BMI ≥25kg/m²) is expected to exceed the phenomenal number of 4 billion people, compared to 2.6 billion in 2020. Illustrating a significant increase from 38% to over 50% worldwide. With such staggering numbers, we are compelled to dissect each stepping stone that has brought us to this critical worldwide crisis. 

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Obesity represents a clear predisposition to present any metabolic disease, including type 2 diabetes, dyslipidemia, and a host of heart-related conditions that not only affect the quality of life but are leading causes of death, this translates into over 2.6 billion people living with the looming risk of having this serious health issues solely because of obesity.



While the surge in obesity is undeniable and designating a specific factor would make the job to eradicate obesity much easier, as it is widely accepted to be the result of a multifaceted and complex labyrinth. Two principal players have taken center stage: environmental factors, often termed obesogenic environments, influenced by variables such as energy intake and physical activity, which have demonstrated the potential for lifestyle changes to prevent and combat obesity, and genetic factors. Genetic contributions offer an explanation for the absence of a universal formula for obesity prevention.

The field of genetics in relation to obesity has undergone significant evolution, as a burgeoning body of research underscores the pivotal role of hereditary predisposition.

This newfound understanding posits genetics as a linchpin in our endeavor to confront, mitigate, and eventually eradicate obesity.

Gene vs. Jeans: Unraveling the Hereditary Health Puzzle.

As we untangle the genetic foundation of obesity, we open the door to understanding why some individuals can effortlessly shed pounds and sustain weight loss through diet and exercise, while others grapple with a formidable challenge. This insight not only broadens our horizons for alternative approaches but also beckons us to scrutinize this issue through the lens of hereditary health.



Within the vast landscape of obesity research, specific genes have emerged as key components in various pathways central to our appetite, the regulation of satiety, and the broader sphere of metabolic health. Genes like BDNF and MC4R play intimate roles in processes related to appetite and satiety regulation, while others, including FTO, RPTOR, and MAP2K5, intricately influence energy metabolism and lipid management. Simultaneously, TCF7L2 and IRS1 take center stage in insulin secretion and the complex world of adipogenesis, the formation of fat cells.



While our quest for a specific gene alteration responsible for obesity is an ongoing pursuit, expanding knowledge from the human genome acknowledges the likelihood of a polygenic foundation, where multiple genes, rather than a solitary gene, are connected to this complex issue. This is the result of the cumulative effects of distinct variants that we continue to learn about.

Gut Microbiome and Genetics:

Here is where the fun begins, as we learn about the relationship between our genes and gut microbiota. The latter being a diverse compound of microorganisms that play an important role in our health’s most critical functions, such as the absorption and metabolism of essential nutrients, the synthesis of vital vitamins, and the regulation of bile acids. Research also confidently shows that along with environmental factors, our genes exert a profound influence on the composition and functionality of our gut microbiota.



Recent studies have shown that the expression of polymorphic genes on and activity of the gut microbiota share an intricate relationship in our hereditary predisposition that can alter the genes that manage our weight susceptibility, playing the pivotal role played by the microbiota in shaping our health and predisposition to metabolic diseases. Furthermore, within the realm of obesity, malnutrition surfaces, bringing with it deficiencies in essential vitamins and minerals. These deficiencies, exacerbated by alterations in the gut microbiota’s production of essential vitamins, pose a significant threat to our health.

Obesity is intrinsically linked with gut microbiota impairment and micronutrient deficiencies.

Significantly, bariatric surgery, which results in significant weight loss and improvements or remission of obesity-related health issues, have been proven to contribute to changes from the gut microbiota in favorable manners for its composition and essential functions.

Conclusion

As our knowledge about our hereditary health continues to evolve, we encounter the symbiotic bond between our genes and the gut microbiota. This intricate community of microorganisms, residing within our gastrointestinal tract, wields a profound influence over our health, learning that we might have a genetic predisposition from a wide range of genes that help poblate our microbiome. Its pivotal role in the absorption and metabolism of essential nutrients, the synthesis of vital vitamins, and the modulation of our immunity are subjects that have been widely studied 

In conclusion, our exploration of the genetic and microbial dimensions of obesity is far from complete but it keeps growing. The multifactorial nature of this global epidemic continues to intrigue us, propelling further research and investigation. It is within the intricate layers of genes, microbes, and the choices we make that we will unearth the answers to the obesity enigma. 

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INTERNATIONAL CENTER OF EXCELLENCE FOR OBESITY


Dr. Pompa is a member of several distinguished organizations, where she attends meetings regularly and serves as faculty at:

  • Mexican Association of General Surgery
  • Mexican College of Obesity and Metabolic Surgery
  • Fellow of the American College of Surgeons
  • American Association of Surgery for Obesity and Metabolic diseases as an international member
  • International Bariatric Club
  • Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)
  • French Society for Digestive Surgery
  • American Diabetes Association
  • Harvard Alumnin Association

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