Family history matters — but so do the daily choices you’ve been quietly avoiding accountability for
Somewhere between the third helping and the decision not to go for a walk, a lot of people land on the same comforting conclusion: it is genetic. My mother was this way. My grandfather was this way. My entire lineage, as far back as anyone can trace it, was apparently this way. The body is simply doing what the body was always going to do, and personal choices have very little to do with any of it.
This is partially true and mostly convenient — and the wellness industry has done an excellent job of letting people stay comfortable in the partially true part indefinitely.
What genetics actually controls
Genetics are real. This is not a column arguing that DNA is fiction. Certain gene variants genuinely influence metabolic rate, fat distribution, insulin sensitivity, appetite hormone regulation and how the body responds to specific foods. Some people are legitimately predisposed to higher body weight, more aggressive fat storage and stronger hunger signals than others. That predisposition is not imaginary and dismissing it entirely is both inaccurate and unkind.
What genetics largely does not control is whether vegetables appear on the plate, how often movement happens, how much processed food gets consumed weekly or whether sleep is being taken seriously. The gene variants associated with obesity risk increase the probability of certain outcomes — they do not determine them. A predisposition is an inclination, not a sentence. The distinction is important and also, apparently, very easy to skip past.
The part that is definitely not genetic
The specific contents of the refrigerator are not genetic. The number of times fast food was chosen this week because it was easier is not genetic. The habit of eating in front of a screen until well past fullness is not genetic. The decision to sit rather than move most evenings is not genetic. The portions are not genetic.
These are behaviors. Behaviors are shaped by environment, habit, stress, access, culture and a hundred other legitimate factors — but they are changeable in ways that actual genetic code is not. Conflating the two creates a very tidy exit from the conversation about which parts of the situation are within reach and which parts genuinely are not.
The cruelest part of the genetics narrative is that it is most appealing precisely when change feels hardest — and that it provides the most convincing cover for the choices that are, in fact, most worth examining.
What family history is actually telling you
A family history of heart disease, type 2 diabetes or obesity is not a destiny. It is a warning — arguably one of the most useful pieces of health information a person can have, because it identifies specific risks early enough to do something about them. The appropriate response to learning that your father had type 2 diabetes is not to conclude that your fate is sealed. It is to take blood sugar management more seriously than someone without that history needs to.
Epigenetics — the study of how gene expression is influenced by environment and behavior — has made the picture considerably more complicated and considerably more hopeful than the old deterministic model suggested. Lifestyle factors including diet, exercise, sleep and stress management influence which genes are expressed and how. The genetic hand is dealt at birth. How it is played is an ongoing process.
The version of this conversation worth having
None of this is a lecture about willpower. Willpower is a limited resource and an unreliable strategy, and anyone who has tried to eat differently through sheer determination alone has already discovered that. The point is not that change is easy or that people who struggle with food and weight are simply not trying hard enough.
The point is that assigning the cause entirely to genetics closes off the part of the picture that is actually movable. Environment can be changed. Habits can be restructured. Access to better food options can be worked toward. Stress — one of the most powerful drivers of food behavior — can be addressed. None of that work starts until there is an honest accounting of what is genetics and what is everything else. The plate, most of the time, is mostly everything else.
