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Science and innovation Fat facts According to a congressional study, people in the United States spent $33 billion in 1990 trying to lose weight. Obesity causes or aggravates diseases such as gallstones, diabetes, high blood pressure, and heart disease. Harvard University researchers estimated that medical treatment of obesity and the related diseases cost $45.8 billion the same year. Despite the expenditure of billions of dollars and the painfully sincere efforts of millions of people, more than half of all men and women in the United States remain clinically obese. Obesity is also a problem in most other industrialized countries. Are weight gain and obesity caused by cultural and environmental factors? Are they determined by an individual’s genetic inheritance? Or is obesity the result of emotional factors, such as depression or lack of willpower? Scientists and health professionals have discovered new evidence about the causes of obesity. They disagree on the interpretation of this evidence. Doctors have long observed that a tendency to gain weight runs in families. A 43-year study of 400 identical twins reared apart included a study of weight gain. The study attributed most obesity in the twins to genetic factors. Differing family activity levels did not affect the twins’weight gain. Neither did family eating patterns. Other studies show similar results. Obesity seems more closely tied to heredity than to environment. That does not mean that obesity is caused by genetic factors alone, but that genetic factors strongly predispose some individuals to obesity. This study and others like it support an explanation of obesity as a function of a genetic “set point.” According to set-point theory, a person’s genes determine his or her preferred weight. The brain adjusts a person’s metabolism(m?t?b?l?z(?)m ) and eating behavior to maintain weight at a genetically determined level. That level is “normal” weight for that person. The set point may change over a person’s lif