Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Uncovering the truth about genetic mutations and weight loss

Franchell Hamilton, MD
Conditions
July 10, 2023
Share
Tweet
Share

“I do not feel full even after I eat” is what I heard from so many of my patients. Even after bariatric surgery, this feeling of fullness would go away initially but then it would come back, and they found themselves again overindulging. Why does this happen? Brain studies have shown that obesity impairs the dopamine signaling in the brain that tells the brain it is satisfied after nutrients enter the stomach. This was found to be normal in healthy-weight people but abnormal in people with obesity. Some say it is obesity that causes brain adaptations to alter the signaling. I feel like it is the genes that cause the brain to reconfigure over time, which is why people become obese. So what happened first, the chick or the egg? Did obesity cause the brain to change, or was it predestined due to genetics?

Some people have a gene along the dopamine pathway that does not allow for normal dopamine release in response to things that typically would increase dopamine, including food. Studies have shown that specifically dopamine receptor D4 gene regulates multiple cognitive functions with potential relevance for eating behavior and, thereby, body weight, including behavioral inhibition and flexibility, and motivation and reward processing. Human studies have found that diminished dopamine inhibitory feedback in DRD4-7R carriers is linked to weaker physiological dopamine signaling than non-carriers. People with this genetic deficiency do not feel “the high” as easily or at all compared to people with no alterations in this gene, which can lead to addictive behavior, food, or other vices. And studies show that the lower DRD4 expression in the pre-frontal cortex was associated with greater food intake in the satiated state among children in the context of lower socioeconomic status.

People overeat because their brain does not get the dopamine signal of having nutrients and being satisfied. This is due to both the brain and a person’s genetics; we now know it is not due to a lack of motivation or self-control. Studies also have shown that 10 percent weight loss still has not resolved this, so this may be why after weight loss people regain. So the reason you overeat is not due to a lack of self-control.

As a bariatric surgeon, I am not convinced that surgery will fix this genetic mutation. Although my previous work showed that surgery can have an epigenetic effect and change gene expression by methylation, I am unsure if it changes this gene. I have noticed clinically that these newer once-a-week GLP-1 medications have been able to affect this signaling, so people have been “able to feel full” and understand what that truly is.

Franchell Hamilton is a bariatric surgeon.

Prev

How artificial intelligence (AI) is transforming dermatology diagnosis and treatment

July 10, 2023 Kevin 0
…
Next

What Lucille Ball and Einstein can teach us about overcoming burnout

July 10, 2023 Kevin 0
…

Tagged as: Obesity

Post navigation

< Previous Post
How artificial intelligence (AI) is transforming dermatology diagnosis and treatment
Next Post >
What Lucille Ball and Einstein can teach us about overcoming burnout

ADVERTISEMENT

More by Franchell Hamilton, MD

  • Unlocking the secret to successful weight loss: Curiosity is the key

    Franchell Hamilton, MD

Related Posts

  • How social media leads to a loss of creativity

    Edwin Leap, MD
  • It is time for the FDA to re-evaluate metrics for weight loss drugs

    Tatum R. Dam, Diana A. Hla, Aditya Narayan, and Ank A. Agarwal
  • Unveiling the game-changing diabetic drugs: Revolutionizing weight loss and diabetes management

    Dinesh Arab, MD
  • A patient’s perspective on genetic testing

    Erin Paterson
  • The emotional side of genetic testing

    Erin Paterson
  • The truth about Caribbean medical schools

    Jessica K. Willett, MD

More in Conditions

  • The infectious hypothesis of heart disease revisited

    Larry Kaskel, MD
  • How timing affects chemical exposure risks

    Oluyemisi Famuyiwa, MD
  • A physician’s tribute to respiratory therapists

    Zoran Naumovski, MD
  • How to protect your voice like a professional

    Carly Bergey, CCC-SLP
  • Is Alzheimer’s an infectious disease?

    Larry Kaskel, MD
  • Life after GLP-1s: How to sustain weight loss

    Ricky Bloomfield, MD
  • Most Popular

  • Past Week

    • The mental health workforce is collapsing

      Ronke Lawal | Conditions
    • The stoic cure for modern anxiety

      Osmund Agbo, MD | Physician
    • Why doctors are losing the health care culture war

      Rusha Modi, MD, MPH | Policy
    • The hypocrisy of insurance referral mandates

      Ryan Nadelson, MD | Physician
    • The link between financial literacy and physician burnout

      Hayley Gates & Ketan Kulkarni, MD | Finance
    • A nurse practitioner on leaving the medical machine

      Carrie Friedman, NP | Conditions
  • Past 6 Months

    • Rethinking the JUPITER trial and statin safety

      Larry Kaskel, MD | Conditions
    • The ignored clinical trials on statins and mortality

      Larry Kaskel, MD | Conditions
    • How one physician redesigned her practice to find joy in primary care again [PODCAST]

      The Podcast by KevinMD | Podcast
    • I passed my medical boards at 63. And no, I was not having a midlife crisis.

      Rajeev Khanna, MD | Physician
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Why medicine needs a second Flexner Report

      Robert C. Smith, MD | Physician
  • Recent Posts

    • The link between financial literacy and physician burnout

      Hayley Gates & Ketan Kulkarni, MD | Finance
    • Treating autism and ADHD as a spectrum, not a contradiction

      Ronald L. Lindsay, MD | Physician
    • The infectious hypothesis of heart disease revisited

      Larry Kaskel, MD | Conditions
    • Why bureaucracy is threatening the survival of private practice physicians [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why direct primary care (DPC) models fail

      Dana Y. Lujan, MBA | Policy
    • The silent victories of medicine

      Dr. Bodhibrata Banerjee | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The mental health workforce is collapsing

      Ronke Lawal | Conditions
    • The stoic cure for modern anxiety

      Osmund Agbo, MD | Physician
    • Why doctors are losing the health care culture war

      Rusha Modi, MD, MPH | Policy
    • The hypocrisy of insurance referral mandates

      Ryan Nadelson, MD | Physician
    • The link between financial literacy and physician burnout

      Hayley Gates & Ketan Kulkarni, MD | Finance
    • A nurse practitioner on leaving the medical machine

      Carrie Friedman, NP | Conditions
  • Past 6 Months

    • Rethinking the JUPITER trial and statin safety

      Larry Kaskel, MD | Conditions
    • The ignored clinical trials on statins and mortality

      Larry Kaskel, MD | Conditions
    • How one physician redesigned her practice to find joy in primary care again [PODCAST]

      The Podcast by KevinMD | Podcast
    • I passed my medical boards at 63. And no, I was not having a midlife crisis.

      Rajeev Khanna, MD | Physician
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Why medicine needs a second Flexner Report

      Robert C. Smith, MD | Physician
  • Recent Posts

    • The link between financial literacy and physician burnout

      Hayley Gates & Ketan Kulkarni, MD | Finance
    • Treating autism and ADHD as a spectrum, not a contradiction

      Ronald L. Lindsay, MD | Physician
    • The infectious hypothesis of heart disease revisited

      Larry Kaskel, MD | Conditions
    • Why bureaucracy is threatening the survival of private practice physicians [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why direct primary care (DPC) models fail

      Dana Y. Lujan, MBA | Policy
    • The silent victories of medicine

      Dr. Bodhibrata Banerjee | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...