Obesity is a serious health issue in the developed world and is becoming increasingly important on a global scale. The development of an obesogenic environment, due to ease of access to highly calorific food and reduced energy expenditure in work and leisure activities, has increased the proportion of overweight individuals in society.
Over and above the increase in overweight individuals, there has been a dramatic rise in those who can be defined as morbidly obese. As suggested by the 'thrifty gene' hypothesis, these individuals might possess 'obesity-promoting' genetic variants that were previously advantageous, but that now lead them to become morbidly obese in the current environment.
The physiology of energy balance is complex, with the arcuate nucleus of the hypothalamus having a central role in this mechanism. Mouse models have been useful in initially highlighting many of the genes and proteins that are involved.
Rare, monogenic forms of human obesity — such as mutations in genes that encode leptin, its receptor, pro-opiomelanocortin, and the melanocortin 4 receptor — have provided insights into the pathogenesis of obesity. There are also syndromes where obesity is a component of the phenotype; however, their aetiology is more complex.
Heritability studies have demonstrated that genetics also has a significant role in common obesity, which is thought to be caused by a combination of multiple genetic and environmental factors.
Using both candidate-gene and whole-genome linkage strategies, novel genes and regions have been found to be linked and/or associated with obesity phenotypes. Studies to define the roles of these genes and their products in the pathophysiological mechanisms that lead to obesity are currently in progress.
New strategies, such as whole-genome association studies and the use of microarrays, could allow the identification of large numbers of genes that are involved in obesity in the near future.
Obesity is an important cause of morbidity and mortality in developed countries, and is also becoming increasingly prevalent in the developing world. Although environmental factors are important, there is considerable evidence that genes also have a significant role in its pathogenesis. The identification of genes that are involved in monogenic, syndromic and polygenic obesity has greatly increased our knowledge of the mechanisms that underlie this condition. In the future, dissection of the complex genetic architecture of obesity will provide new avenues for treatment and prevention, and will increase our understanding of the regulation of energy balance in humans.
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The authors wish to acknowledge the continuing support for their research that is provided by the Medical Research Council and Imperial College London.
The authors declare no competing financial interests.
- BODY MASS INDEX
(BMI). An anthropometric measure of body mass that is calculated by dividing a person's weight in kilograms by the square of their height in metres.
Ingestion of a greater than optimal quantity of food; an abnormally increased appetite for and consumption of food.
Decreased muscle tone from the average and reduced resistance to passive stretching of muscles.
- HYPOGONADOTROPIC HYPOGONADISM
Absent or decreased function of the male testis or the female ovary (the gonads). It results from the absence of the gonadal stimulating pituitary hormones, FSH (follicle stimulating hormone) and LH (luteinizing hormone).
- UNIPARENTAL DISOMY
The presence in a cell of homologous chromosomes from the same parent, with no chromosome of that pair from the other parent. This can result from non-disjunction events during meiosis, and might be composed of both homologous chromosomes from one parent (heterodisomy) or a duplicate of one chromosome (isodisomy).
- GS PROTEIN
The heterotrimeric guanine nucleotide-binding protein (G protein) that stimulates adenylyl cyclase and functions as a molecular switch in many signal-transduction pathways.
- ROD-CONE DYSTROPHY
Hereditary, progressive degeneration of the neuroepithelium of the retina that is characterized by night blindness and progressive contraction of the visual field.
A developmental anomaly that is characterized by the presence of more than five fingers on the hand or more than five toes on the foot.
The proportion of phenotypic variance that is due to genetic effects.
- SUBSCAPULAR SKINFOLD THICKNESS
The skinfold measure that is taken below the inferior angle of the scapula.
- SUPRAILIAC SKINFOLD THICKNESS
The skinfold measure that is taken midway between the hip joint and the bottom of the ribcage.
- METABOLIC EFFICIENCY
Energy intake per kilogram that is required to maintain bodyweight.
- RELATIVE RISK
The ratio of the risk of the expression of a phenotype among individuals with a particular exposure, genotype or haplotype to the risk among those without that exposure, genotype or haplotype.
The mixture of two or more genetically distinct populations.
A set of closely linked genetic markers on a single chromosome.
- MINOR ALLELE FREQUENCY
The frequency of the less common allele of a polymorphism. It has a value between 0 and 0.5, and can vary between populations.
A subject that is ascertained on the basis of their phenotype; often used to identify affected families for genetic studies.
- QUANTITATIVE TRAIT
A continuously varying trait; for example, weight, height and skin colour.
- VARIANCE COMPONENTS METHOD
The variance components (VC) approach is a method that expresses the phenotypic variances and covariances among individuals as a function of the estimated number of shared alleles that are identical by descent at a given locus.
- NUCLEAR FAMILY
A family that is composed of a father, mother and their children.
- LONGITUDINAL PROSPECTIVE STUDIES
Studies in which individuals are followed up over time to assess who develops a certain outcome (often disease).
- METABOLIC SYNDROME
The occurrence of hyperinsulinaemia, glucose intolerance, dyslipidaemia, hypertension and obesity in an individual.
The presence of several subgroups within a study group, either through genuine population subdivision or recruitment bias. Differences in both allele frequency and disease prevalence between these subgroups can lead to spurious associations with disease.
- MULTIPLE-HYPOTHESIS TESTING
Testing more than one hypothesis in an experiment. As a result, the probability of an unusual result occurring by chance in the entire experiment is higher than the individual significance value associated with that result.
- PROSPECTIVE STUDY
A study in which participants are divided into groups that are exposed or not exposed to the intervention(s) of interest before the outcomes have occurred.
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