1. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 1
Obesity; a nature versus nurture analysis
Renee Lewis, Yesenia Guerro-Flores, Elizabeth Chavez & Chris Herrera
Mt. St. Mary’s College

2. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 2
Abstract
This paper investigates various research articles that explore studies of differing variable
constructs and result in findings that are said to account for factorial relationships or causes of
obesity. The articles contain an array of findings that result in singular and manifold views on
the factors that produce or bring about extreme weight gain. This work examines these
discoveries in order to critique the (in)effectiveness of interventions used in practice that are
founded on the question of whether inborn or external causal measures ensue obesity in order to
implement one in which the evidence strongly supports. Supplementary to the external
investigation of research, we also applied this evidence in practice on our client Layla. A 38-
year-old Samoan woman whose height is 5' 11", weight is 303 lbs, has a family history of
diabetes, heart disease and obesity. She is complaining of fatigue, difficulty with losing weight,
lack of motivation, and weight-related emotional stress. She states that she is afraid of not being
able to get healthy. In addition, she is faced with the conflict of trying to be a part of her
community and environment. Before treatment and in depth research inquiry, we hypothesize
that the underlying roots for obesity are correlated with the nurture effect. After examining
numerous theories and studies, we decided to treat the condition via dietary modification and
exercise. Progress will be monitored via physical examination, and supplemental questionnaires
about lifestyle habits to monitor for needed modification suggestions. Our findings resulted in
our client seeing a 30% weight decrease in three months and displayed that a change in external
occurrences can have a direct effect on an individual’s mass. That being said, in true scientific
form, we now invite you to judge the evidence for yourself.

3. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 3
Obesity; a nature versus nurture analysis
Many studies have been and are currently being conducted that seek to determine exact or
relational components that cause or lead to obesity. In order to be labeled obese by a physician,
a person must accumulate fat that is 20% -30% greater than the recommended amount for their
relevant height. Aside from the mobility related limitations that extreme weight gains cause, it
can initiate other harmful conditions. An unhealthy amount of fat accumulation puts people at
risk for several serious conditions including diabetes and heart disease. Obesity in the United
States and globally is on the rise. The epidemic is said to have the potential to bankrupt the
healthcare system. Due to this, researchers seek to scrutinize information to the point where
their findings lead to or have an impactful influence on the intervention methods, ideologies, and
socialized theories conveyed by practitioners and generalized into common knowledge. This
effort specifically seeks to understand similar and contrasting elements within these inquiries in
order to answer the evidence-based practice (EBP) question; does nature or nurture have the
greater impact on obesity?
Literature Review
Research by Boutin (2001) details the genetics of human obesity explored through genetic
experimentation. An identification of monogenic genes that contributed to weight gain was
made. While the detection of an inherited character difference that is controlled by one gene
seems to back the argument that obesity is caused by internal factors, the authors themselves
state that theirs and previous evidence label genes that affect weight gain as polygenetic. No
evidence concluded that the differing sources that affect polygenetic gene composition are all
internal.

4. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 4
Thusly, their findings deemed obesity to be a multifactorial condition. The components of
which, cause people with a predisposition to weight gain to be at risk when in environments that
contain unlimited food supplies. The results of this study are in partial agreement with both the
nature and nurture fueled effects on the disease. However the research was unclear as to how a
monogenic gene was linked with the disease since polygenetic findings require a grouping of
different origin sources. This conflicting information may have been what led them to defer to a
compounded viewpoint. The next article we will probe delves a little deeper into genes and how
the identification of such can influence thoughts and behaviors.
Meisle & Wardle (2013) performed a qualitative analysis of genetic detection in order to test
reactions in a sample of overweight adults. They found that participants who were discovered to
have multiple obesity related genes found relief in knowing that factors outside of their control
contributed to their disease. In contrast, participants who had low-risk genetic abnormalities
reported letdown. In addition the low-risk participants then directed the cause of their weight
gain toward alternate explanations non-inclusive of those under their control. While the aim of
the study sought to decrease split thinking and allied genetic-based determinism, in our opinion,
they fostered these notions. Those who were identified as high-risk got resolve in knowing that
something inherent imposed this condition upon them. Furthermore the low-risk participants did
not identify positive and negative qualities of themselves and others that contributed to their state
and displayed even further dissociative cognitions. The subsequent study isolates the genetic
factor to an even higher degree and examines their effects within a controlled environment.

5. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 5
Lynch & Kemp (2013) conducted an experiment in order to test causality in evolutionary
genetics. They utilized cloned rats and raised them in different environments. The findings
resulted in both rats having significant behavioral and developmental differences suggesting that
genes interact with the environment. While this information appears novel and fascinating, its
fundamental theory of the environment affecting inherited characteristics is longstanding. For
example, within a few generations a domesticated pig, that returns to the wild can transform into
a feral pig, creating offspring that have a different physical make-up due to receptor genes and
their interaction with the environment. The illustration below depicts this type of change.
Even though the ideas displayed by this study’s findings are not first-hand, they do convey the
original notions of internal and external relations in a contemporary and credible fashion. Now
that environmental connections have been furthered to this degree, our focus will turn to
surveying these interfaces in order to tangibly associate them with the subject matter.
Australian scientists (Hendrie, Coveney & Fox 2011) conducted a study in order to delineate
connections amongst family environments, behavior, and weight gain. They utilized an
exploratory structural equation model to detect, categorize and quantify relationships amid these
factors.

6. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 6
The results indicated nutrition and physical activity as having the strongest association with
children’s body mass index (BMI) score. Furthermore physical activity and food environments
were linked with children’s activity habits and level of sedentariness. What we found most
fascinating about these findings was that the information was gleaned via self-report by the
participants. The outcome of the study further facilitates the predominant influence ones
surrounding has on weight acquisition. Investigating family dynamics and the power its
undercurrents have on impacting behavior is fascinating. That being said, it leaves room for
debate when contemplating obesity on a larger scale. The ensuing article explores the topic on a
more all-encompassing sociological level.
In Johnson’s (2012) article, obesity in the United States is investigated and associated with
environmental factors and social constructs. “The U.S. obesity epidemic is not the result of
changing biology or genetics. It is the result of changing human behavior in response to a
changing social and built environment” (Johnson, 2012). She goes on to further this ideal by
exploring the facets of obsogenic environments and detail sets of circumstances that encourage
people to eat and drink more calories than they expend. The illustration below provides a visual
representation of this analysis.

7. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 7
While we agree with the socioecological model presented, the inclusion of biological
predisposition was not discussed. In addition the results of the findings supported the addition of
behavior therapy. This too was not conferred when the association of prevention methods
derived from negative occurrences within social and built constructs were reviewed. All in all,
this review brought us to the final point of deliberation regarding whether or not the research
evidence on the subject matter of obesity gleaned more heavily towards nature or nurture derived
influences. As a result, our treatment method was fashioned based on controllable changes that
were measurable and observable.
Based on our hypotheses, the underlining roots for the obesity epidemic are correlated with
the nurture effect; we formulated an action plan in that would improve not only our client’s but
others quality of life. Our goals were to; increase the awareness of obesity as a major public
health threat, heighten the detection of early recognition of overweight and/or excessive weight
gain, improve management (medical and non-medical) of people who are overweight or obese
and those with obesity-related disease, stress the importance of lifelong healthy eating, and
promote continuous physical activity. In order to accomplish our objective we formulated a
treatment plan.
The treatment implementation consisted of dietary modification and exercise. More
specifically, low calorie diets (LCDs) individually planned to include 500 to 1,000 calories a day
less than you exert through physical activity, very low calorie diets (VLCDs) limited intake to
only 400 to 800 calories a day and feature high-protein, low-fat liquids, setting realistic weight
loss goals — short term and long term, self-recording of diet and exercise patterns in a diary and
identifying high-risk situations in order to avoid them. Furthermore, positive actions were also
applied.

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Rewarding specific actions, such as exercising for a longer time or eating less of a certain
type of food provided positive reinforcement. We also taught the client the importance of
adopting realistic beliefs about weight loss and body image, developing a support network,
including family, friends and co-workers, or joining a support group that helped in focusing on
the end result or weight loss goal. Due to the large amount of weight our client had to lose, her
exercise plan consisted of large and small physical movement modification.
Some of her exercise consisted of parking at the far end of parking lots and walking through
them, reducing television time, biking, swimming or low-impact water aerobics, taking the stairs
instead of the elevator, and walking briskly for five minute increments. In order to monitor
progress an observational model research design was applied and generalized in order to account
for external validity. As follows is a hypothetical make-up of a non-isolated or individual case
study sample.
Within our conjectural study population: subjects will be recruited from the general
population through different healthcare- and non-healthcare settings to ascertain the inclusion of
treatment-seeking and non-treatment-seeking individuals. Healthcare settings included
university based obesity clinics, physician offices and health insurance agencies. Non-healthcare
settings included schools, job centers, and employment agencies. Additionally, clients must
meet the BMI requirements of having extreme obesity BMI ≥35kg/m2 or obesity BMI 30-
34.9kg/m2. Changes in BMI-SDS-Height and weight will be measured with standardized
instruments and Body Mass Index Standard Deviation Score (BMI-SDS) will be calculated.

9. OBESITY; A NATURE VERSUSNURTURE ANALYSIS 9
In conclusion, we found that the evidence for external contributory factors outweigh
internal happenings. Thusly prevention methods that include lifestyle and behavior change
would have a greater impact on the reduction of obesity than pharmacotherapy and surgical
methods. While the findings are in line with our hypothesized environmental variable, inherent
components that cause predispositions or abnormal biological response are not without merit.
That being said, our treatment method is in line with the most promising evidence that increased
physical activity and healthier food consumption can decrease weight. Both of which, are within
an individual’s realm of control.

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References
Boutin, P. (2001). Genetics of human obesity. Best Practice & Research Clinical
Endocrinology & Metabolism, 15, 391-404. doi: 10.1053/20010153.
Meisel, S., & Wardle, J. (2013). Responses to FTO genetic test feedback for obesity in a
sample of overweight adults: a qualitative analysis. Genes & Nutrition, 9, 373-376.
doi: 10.1007/s12263-013-0374-2.
Lynch, K., & Kemp, D. (2013). Nature-via-nurture and unravelling causality in evolutionary
genetics. Trends in Ecology & Evolution, 29, 2-4. doi: 10.1016/j.tree.2013.10.005.
Sallis, J., Story, M., & Lou, D. (2009). Study Designs and Analytic Strategies for
Environmental and Policy Research on Obesity, Physical Activity, and Diet
Recommendations from a Meeting of Experts. American Journal of Preventive
Medicine. doi:10.1016/j.amepre.2008.10.006.
Hendrie, G., Coveney, J., & Cox, D. (2011). Defining the complexity of childhood obesity and
related behaviors within the family environment using structural equation modeling.
Public Heath Nutrition, 15, 48-47. doi: 10.1017/51368980011001832.
Johnson, S. (2012). The U. S. Obesity Epidemic; Causes, Consequences, and Health Provider
Response. Retrieved from www.apa.org.