Background: Common obesity-associated genetic variants may exert their effects through increasing eating or decreasing metabolism. Such differences might influence individual responses to obesity genetic test results.Methods: This was an experimental analogue study: 191 participants were asked to imagine they had received a genetic test result indicating high eating-based (n = 37) or high metabolism-based (n = 41) risk of obesity, an enzyme test result indicating high eating-based (n = 35) or high metabolism-based (n = 41) risk of obesity, or no risk information (n = 37). Outcomes included perceived risk, self-efficacy (confidence in ability to eat healthily), response-efficacy (confidence that eating healthily will reduce risk), and intention to eat healthily. Results: The groups receiving increased obesity risk information reported greater perceived risk and intention to eat healthily than the no risk information group (both p < 0.01). There were main effects of test type on perceived risk (genetic vs. enzyme: 3.91 vs. 3.55, p = 0.031) and of causal pathway on worry (eating vs. metabolism: 3.33 vs. 2.86, p = 0.049), but no effects of either manipulation on any other outcomes. Conclusion: Personal risk information indicating increased obesity risk may increase motivation to eat healthily, regardless of whether the risk is described as genetic or non-genetic or as acting through an eating-based or metabolism-based causal pathway.

1.
Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM: Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 2004;291:2847–2850.
2.
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ: Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003;348:1625–1638.
3.
Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS: Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003;289:76–79.
4.
Thompson D, Edelsberg J, Colditz GA, Bird AP, Oster G: Lifetime health and economic consequences of obesity. Arch Intern Med 1999;159:2177–2183.
5.
Grilo CM, Pogue-Geile MF: The nature of environmental influences on weight and obesity: a behavior genetic analysis. Psychol Bull 1991;110:520–537.
6.
Koeppen-Schomerus G, Wardle J, Plomin R: A genetic analysis of weight and overweight in 4-year-old twin pairs. Int J Obes Relat Metab Disord 2001;25:838–844.
7.
Stunkard AJ, Sorensen TI, Hanis C, Teasdale TW, Chakraborty R, Schull WJ, Schulsinger F: An adoption study of human obesity. N Engl J Med 1986;314:193–198.
8.
Frayling TM, Timpson NJ, Weedon MN, Zeggini E, Freathy RM, Lindgren CM, Perry JR, Elliott KS, Lango H, Rayner NW, Shields B, Harries LW, Barrett JC, Ellard S, Groves CJ, Knight B, Patch AM, Ness AR, Ebrahim S, Lawlor DA, Ring SM, Ben-Shlomo Y, Jarvelin MR, Sovio U, Bennett AJ, Melzer D, Ferrucci L, Loos RJ, Barroso I, Wareham NJ, Karpe F, Owen KR, Cardon LR, Walker M, Hitman GA, Palmer CN, Doney AS, Morris AD, Smith GD, Hattersley AT, McCarthy MI: A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 2007;316:889–894.
9.
Cha SW, Choi SM, Kim KS, Park BL, Kim JR, Kim JY, Shin HD: Replication of genetic effects of FTO polymorphisms on BMI in a Korean population. Obesity (Silver Spring) 2008;16:2187–2189.
10.
Chang YC, Liu PH, Lee WJ, Chang TJ, Jiang YD, Li HY, Kuo SS, Lee KC, Chuang LM: Common variation in the fat mass and obesity-associated (FTO) gene confers risk of obesity and modulates BMI in the Chinese population. Diabetes 2008;57:2245–2252.
11.
Dina C, Meyre D, Gallina S, Durand E, Körner A, Jacobson P, Carlsson LM, Kiess W, Vatin V, Lecoeur C, Delplanque J, Vaillant E, Pattou F, Ruiz J, Weill J, Levy-Marchal C, Horber F, Potoczna N, Hercberg S, Le Stunff C, Bougnères P, Kovacs P, Marre M, Balkau B, Cauchi S, Chèvre JC, Froguel P: Variation in FTO contributes to childhood obesity and severe adult obesity. Nat Genet 2007;39:724–726.
12.
Haworth CM, Carnell S, Meaburn EL, Davis OS, Plomin R, Wardle J: Increasing heritability of BMI and stronger associations with the FTO gene over childhood. Obesity (Silver Spring) 2008 [Epub ahead of print].
13.
Hinney A, Nguyen TT, Scherag A, Friedel S, Brönner G, Müller TD, Grallert H, Illig T, Wichmann HE, Rief W, Schäfer H, Hebebrand J: Genome wide association (GWA) study for early onset extreme obesity supports the role of fat mass and obesity associated gene (FTO) variants. PLoS ONE 2007;2:e1361.
14.
Hunt SC, Stone S, Xin Y, Scherer CA, Magness CL, Iadonato SP, Hopkins PN, Adams TD: Association of the FTO gene with BMI. Obesity (Silver Spring) 2008;16:902–904.
15.
Scuteri A, Sanna S, Chen WM, Uda M, Albai G, Strait J, Najjar S, Nagaraja R, Orrú M, Usala G, Dei M, Lai S, Maschio A, Busonero F, Mulas A, Ehret GB, Fink AA, Weder AB, Cooper RS, Galan P, Chakravarti A, Schlessinger D, Cao A, Lakatta E, Abecasis GR: Genome-wide association scan shows genetic variants in the FTO gene are associated with obesity-related traits. PLoS Genet 2007;3:e115.
16.
Gerken T, Girard CA, Tung YC, Webby CJ, Saudek V, Hewitson KS, Yeo GS, McDonough MA, Cunliffe S, McNeill LA, Galvanovskis J, Rorsman P, Robins P, Prieur X, Coll AP, Ma M, Jovanovic Z, Farooqi IS, Sedgwick B, Barroso I, Lindahl T, Ponting CP, Ashcroft FM, O’Rahilly S, Schofield CJ: The obesity-associated FTO gene encodes a 2-oxoglutarate-dependent nucleic acid demethylase. Science 2007;318:1469–1472.
17.
Stratigopoulos G, Padilla SL, LeDuc CA, Watson E, Hattersley AT, McCarthy MI, Zeltser LM, Chung WK, Leibel RL: Regulation of Fto/Ftm gene expression in mice and humans. Am J Physiol Regul Integr Comp Physiol 2008;294:R1185–R1196.
18.
Speakman JR, Rance KA, Johnstone AM: Polymorphisms of the FTO gene are associated with variation in energy intake, but not energy expenditure. Obesity (Silver Spring) 2008;16:1961–1965.
19.
Wardle J, Carnell S, Haworth CM, Farooqi IS, O’Rahilly S, Plomin R: Obesity associated genetic variation in FTO is associated with diminished satiety. J Clin Endocrinol Metab 2008;93:3640–3643.
20.
Wardle J, Llewellyn C, Sanderson S, Plomin R: The FTO gene and measured food intake in children. Int J Obes (Lond) 2009;33:42–45.
21.
Collins FS: Shattuck lecture – medical and societal consequences of the Human Genome Project. N Engl J Med 1999;341:28–37.
22.
Feero WG, Guttmacher AE, Collins FS: The genome gets personal – almost. JAMA 2008;299:1351–1352.
23.
Wright AJ, Takeichi C, Whitwell SC, Hankins M, Marteau TM: The impact of genetic testing for Crohn’s disease, risk magnitude and graphical format on motivation to stop smoking: an experimental analogue study. Clin Genet 2008;73:306–314.
24.
Shiloh S: Illness representations, self-regulation, and genetic counseling: a theoretical review. J Genet Couns 2006;15:325–337.
25.
Senior V, Marteau TM, Peters TJ: Will genetic testing for predisposition for disease result in fatalism? A qualitative study of parents responses to neonatal screening for familial hypercholesterolaemia. Soc Sci Med 1999;48:1857–1860.
26.
Witte K, Cameron KA, McKeon JK, Berkowitz JM: Predicting risk behaviors: development and validation of a diagnostic scale. J Health Commun 1996;1:317–341.
27.
Witte K, Allen M: A meta-analysis of fear appeals: implications for effective public health campaigns. Health Educ Behav 2000;27:591–615.
28.
Pinker S: The Blank Slate. General Psychologist 2006;41:1–8.
29.
Marteau TM, Weinman J: Self-regulation and the behavioural response to DNA risk information: a theoretical analysis and framework for future research. Soc Sci Med 2006;62:1360–1368.
30.
Harvey-Berino J, Gold EC, West DS, Shuldiner AR, Walston J, Starling RD, Nolan A, Silver K, Poehlman ET: Does genetic testing for obesity influence confidence in the ability to lose weight? A pilot investigation. J Am Diet Assoc 2001;101:1351–1353.
31.
Rief W, Conradt M, Dierk JM, Rauh E, Schlumberger P, Hinney A, Hebebrand J: Is information on genetic determinants of obesity helpful or harmful for obese people? – A randomized clinical trial. J Gen Intern Med 2007;22:1553–1559.
32.
Frosch DL, Mello P, Lerman C: Behavioral consequences of testing for obesity risk. Cancer Epidemiol Biomarkers Prev 2005;14:1485–1489.
33.
Khoury MJ, Mensah GA: Genomics and the prevention and control of common chronic diseases: emerging priorities for public health action. Prev Chronic Dis 2005;2:A05.
34.
Wroe AL, Salkovskis PM: The effects of ‘non-directive’ questioning on an anticipated decision whether to undergo predictive testing for heart disease: an experimental study. Behav Res Ther 2000;38:389–403.
35.
Sanderson SC, Michie S: Genetic testing for heart disease susceptibility: potential impact on motivation to quit smoking. Clin Genet 2007;71:501–510.
36.
Sutton S, Bickler G, Sancho-Aldridge J, Saidi G: Prospective study of predictors of attendance for breast screening in inner London. J Epidemiol Community Health 1994;48:65–73.
37.
Ajzen I: The theory of planned behavior. Organ Behav Hum Dec 1991;50:179–211.
38.
Moss-Morris R, Weinman J, Petrie KJ, Horne R, Cameron LD, Buick D: The revised illness perception questionnaire (IPQ-R). Psychol Health 2002;17:1–16.
39.
Weinman J, Petrie KJ, Moss-Morris R, Horne R: The Illness Perception Questionnaire: a new method for assessing the cognitive representation of illness. Psychol Health 1996;11:431–445.
40.
Sanderson SC, O’Neill SC, Brown White D, Bepler G, Bastian L, Lipkus IM, McBride CM: Responses to online GSTM1 genetic test results amongst smokers related to patients with lung cancer: a pilot study. 2009; under review.
41.
Cohen J: Statistical Power Analysis for the Behavioral Sciences, ed 2. Hillsdale, Erlbaum, 1998.
42.
Mosca L, Jones WK, King KB, Ouyang P, Redberg RF, Hill MN: Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. American Heart Association Women’s Heart Disease and Stroke Campaign Task Force. Arch Fam Med 2000;9:506–515.
43.
Rothman AJ, Kiviniemi MT: Treating people with information: an analysis and review of approaches to communicating health risk information. J Natl Cancer Inst Monogr 1999;25:44–51.
44.
Vernon SW: Risk perception and risk communication for cancer screening behaviors: a review. J Natl Cancer Inst Monogr 1999;25:101–119.
45.
Wright AJ, Weinman J, Marteau TM: The impact of learning of a genetic predisposition to nicotine dependence: an analogue study. Tob Control 2003;12:227–230.
46.
Wright AJ, French DP, Weinman J, Marteau TM: Can genetic risk information enhance motivation for smoking cessation? An analogue study. Health Psychol 2006;25:740–752.
47.
Persky S, Kaphingst KA, Condit CM, McBride CM: Assessing hypothetical scenario methodology in genetic susceptibility testing analog studies: a quantitative review. Genet Med 2007;9:727–738.
48.
Lazarus RS: Vexing research problems inherent in cognitive-mediational theories of emotion – and some solutions. Psychol Inq 1995;6:183–196.
49.
Robinson MD, Clore GL: Simulation, scenarios, and emotional appraisal: testing the convergence of real and imagined reactions to emotional stimuli. Pers Soc Psychol B 2001;27:1520–1531.
50.
Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. BMJ 2000;321:694–696.
51.
Crowson CS, Therneau TM, Matteson EL, Gabriel SE: Primer: Demystifying risk – understanding and communicating medical risks. Nat Clin Pract Rheumatol 2007;3:181–187.
52.
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH: Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869–873.
53.
Loos RJ, Lindgren CM, Li S, Wheeler E, Zhao JH, Prokopenko I, Inouye M, Freathy RM, Attwood AP, Beckmann JS, Berndt SI; Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, Jacobs KB, Chanock SJ, Hayes RB, Bergmann S, Bennett AJ, Bingham SA, Bochud M, Brown M, Cauchi S, Connell JM, Cooper C, Smith GD, Day I, Dina C, De S, Dermitzakis ET, Doney AS, Elliott KS, Elliott P, Evans DM, Sadaf Farooqi I, Froguel P, Ghori J, Groves CJ, Gwilliam R, Hadley D, Hall AS, Hattersley AT, Hebebrand J, Heid IM; KORA, Lamina C, Gieger C, Illig T, Meitinger T, Wichmann HE, Herrera B, Hinney A, Hunt SE, Jarvelin MR, Johnson T, Jolley JD, Karpe F, Keniry A, Khaw KT, Luben RN, Mangino M, Marchini J, McArdle WL, McGinnis R, Meyre D, Munroe PB, Morris AD, Ness AR, Neville MJ, Nica AC, Ong KK, O’Rahilly S, Owen KR, Palmer CN, Papadakis K, Potter S, Pouta A, Qi L; Nurses’ Health Study, Randall JC, Rayner NW, Ring SM, Sandhu MS, Scherag A, Sims MA, Song K, Soranzo N, Speliotes EK; Diabetes Genetics Initiative, Syddall HE, Teichmann SA, Timpson NJ, Tobias JH, Uda M; SardiNIA Study, Vogel CI, Wallace C, Waterworth DM, Weedon MN; Wellcome Trust Case Control Consortium, Willer CJ; FUSION, Wraight VL, Yuan X, Zeggini E, Hirschhorn JN, Strachan DP, Ouwehand WH, Caulfield MJ, Samani NJ, Frayling TM, Vollenweider P, Waeber G, Mooser V, Deloukas P, McCarthy MI, Wareham NJ, Barroso I, Jacobs KB, Chanock SJ, Hayes RB, Lamina C, Gieger C, Illig T, Meitinger T, Wichmann HE, Kraft P, Hankinson SE, Hunter DJ, Hu FB, Lyon HN, Voight BF, Ridderstrale M, Groop L, Scheet P, Sanna S, Abecasis GR, Albai G, Nagaraja R, Schlessinger D, Jackson AU, Tuomilehto J, Collins FS, Boehnke M, Mohlke KL: Common variants near MC4R are associated with fat mass, weight and risk of obesity. Nat Genet 2008;40:768–775.
54.
Tarini BA, Singer D, Clark SJ, Davis MM: Parents’ concern about their own and their children’s genetic disease risk: potential effects of family history vs genetic test results. Arch Pediatr Adolesc Med 2008;162:1079–1083.
55.
Loomba R, Hwang SJ, O’Donnell CJ, Ellison RC, Vasan RS, D’Agostino RB Sr, Liang TJ, Fox CS: Parental obesity and offspring serum alanine and aspartate aminotransferase levels: the Framingham heart study. Gastroenterology 2008;134:953–959.
56.
Paradis AM, Perusse L, Godin G, Vohl MC: Validity of a self-reported measure of familial history of obesity. Nutr J 2008;7:27.
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