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The Rejuvenating Health Podcast
Join Women's Health Nurse Practitioner, Lindsey VanSchoyck for a weekly dose of Precision Medicine as she addresses the hot-button topics specific to Women's Health, Fitness and Nutrition, interviews expert guests and hosts round table discussions with the team of dedicated functional health care specialists.
The Rejuvenating Health Podcast
E145 | What Did Oprah Say!?: Genes, Willpower, And The Weight Debate
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A headline and a clip can warp the story. We tackle the genetics-and-obesity debate with clear science, zero shame, and practical steps you can use today. With Coach Laken back on board and Lindsey guiding the conversation, we break down what heritability really means, how FTO and MC4R variants affect hunger and satiety, and why environment determines whether those genes whisper or shout. If you’ve ever wondered why willpower feels weak against cravings, you’ll hear how dopamine, leptin, and insulin shape your choices long before you think about dessert.
We dig into the rise of obesity since 1980 and connect the dots to ultra-processed foods, delivery-on-demand convenience, and endocrine disruptors that nudge fat cells to multiply. Then we move from diagnosis to direction. Learn how protein targets, fiber-rich meals, resistance training, and consistent sleep blunt genetic risk and quiet “food noise.” We also address insulin resistance—the silent saboteur that stalls fat loss—and explain why testing fasting insulin can reset expectations and keep you from quitting too soon. Along the way, we highlight the role of muscle in long-term metabolic health and share a client story that proves predisposed isn’t predestined.
Medication has a place, and we say it plainly: GLP‑1s can help. But without strength training and protein, you risk losing lean mass and undermining your metabolism. Think of meds as scaffolding, not the house. What wins over time are the basics done well: quality nutrition, smart training, better sleep, and stress that’s managed instead of ignored.
Ready to reclaim control from your genes and your feed? Hit play, subscribe for more science you can use, and leave us a note to tell us which lever you’ll pull first.
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Welcome And Trigger For The Topic
SPEAKER_00Any views, thoughts, and opinions expressed on the Rejuvenating Health podcast are solely those of the speakers and are intended as such. Please consult your trusted healthcare practitioner for medical advice. Let's go, girls. Hey ladies, welcome back to the Rejuvenating Health Podcast. I'm Lindy, your nurse practitioner, and today we have Coach Lincoln back with us.
SPEAKER_01Hey guys, back all about the mindset behavior change and you know living life on the outside of the science side of health. But what are we talking about today?
SPEAKER_00So my husband, I don't know why he was watching The View or Oprah, but your secrets out, Matt.
SPEAKER_01Now we know that that's what you do on your week.
Genetics Claim And Why It Matters
SPEAKER_00He brought his phone to me on Sunday when we were like snowed in. He's like, you need to listen to this. And I'm like, okay. And it was a conversation. Um and it like now it's I've heard it and seen it everywhere because you know phones like bring stuff to you. But anyways, Oprah did an interview on The View where she discussed obesity and genetics. And I just want to talk about it.
SPEAKER_01Yeah. Because the the framing is like that it was medical fact, you know, that obesity itself is essentially the only genetic.
Heritability Versus Causation
SPEAKER_00Yeah. And there's some truth. Like obesity can be genetic. Like there are obesity genes that predispose you to genetics, but I feel like this is like an out for people. Oh, Oprah, the doctor on Oprah said it was genetic, so it can just be obese, it's genetic, right? And I think it's really important to slow down and bring in some science and talk about what's actually accurate and what's incomplete and where this narrative could be a little bit harmful because I've done a full fellowship in epigenetics and genetics, and I understand this stuff. So let's kind of start by paraphrasing like what exactly happened.
SPEAKER_01Yeah, so Oprah said something along the lines of, and I don't know if this is the exact quote, basically it was like that she realized obesity was a disease and that it wasn't about willpower, it's about genetics, and that once she understood that she was able to release the shame.
SPEAKER_00Which is great. Like I want to be super clear that releasing shame around weight, 100%. 100%.
SPEAKER_01Yeah, we talk about that a lot, right? Especially in the mindset portion of the program of like, you know, shame, layering shame on top of anything doesn't make the situation better at all. It almost always makes it worse. Shame is a shadow that introduces a lot of self-doubt and insecurity and struggles with self-worth. And it by no means improves metabolic health ever. So it's not ever going to add anything positive. So yes, releasing the shame 100%.
SPEAKER_00Yeah, but where we need to like take a little bit of a pause is the implication that genetics are the primary driver of obesity.
SPEAKER_01Because yeah, because like you said, when people hear that, like they're people are gonna hear what they want to hear, right? And so they're gonna take away, they're gonna take it and run with it. It's like, oh, like that means that it's outside of my control and I don't have to do anything because there's nothing that I could do that's gonna change what's already in my genetics.
SPEAKER_00Exactly. So here's what the kind of science kind of says about genetics, right? A lot of studies show that heredibility of weight is around 40 to 70 percent.
SPEAKER_01What does that mean? The heredability of weight, of body weight.
SPEAKER_00Right. So heredibility does not mean causation, right? So you can get herited certain genes, like FTO genes and stuff like that, that might put you more at risk for obesity, but it doesn't cause obesity, right? It means genetic susceptibility in a given environment.
SPEAKER_01Okay, so it's essentially like the potential that you could inherit a gene that would be more predisposed to obesity.
FTO And Appetite Regulation
SPEAKER_00Right, but environment is key here, right? Because that's gonna matter a lot more than people realize. Right. So the FTO gene is often called the obesity gene. And I've seen a lot of people have FTO genes, right? Like we've got a ton of genetic porn. That's present. So essentially, if you have a certain variation of an FTO, you might have increased appetite, you might have reduced satiety, and you might eat a little bit of higher calorie intake, right? But physical activity and protein intake and all of the stuff we talk about can blunt the FTO expression of this, right?
SPEAKER_01Which means that does put things within our control, right? So we can implement lifestyle changes that can essentially outweigh the effect that our genetics can have. We've talked about this a little bit before, right? Of like the idea that genetics are the blueprint that's in place, but you don't have to build according to that blueprint. Like you can, you can adjust, you can accommodate and the discernment of using it in your favor, right? If I know that genetics are already a component that um, think about it like um how we would treat other environment or other environmental factors, right? If I know that I'm in a situation where I have certain things that are working against me environmentally, I need to accommodate and work around those or overcompensate in other ways, right? If there's a lever that I can't pull, I have to pull a little bit harder on the other one. Versus if I were to say, well, it's just genetics and I can't do anything about it. Genetics is just another component that we have to account for. And so if you have the information that allows you to say, oh, I know that I'm genetically predisposed to obesity, that means I need to go a little bit extra on the lifestyle lever. Any one of them, honestly, would be beneficial in order to overcompensate for that.
SPEAKER_00Yeah. And and we have the FTO gene, we also have an MC4R gene, which again is kind of those ones that affects appetite regulation, but it doesn't force obesity. Calories still force obesity, right? So it increases your vulnerability in a calorie-dense environment, right? So let's break down these genes just a little bit more. Okay, so FTO stands for fat mass and obesity associated gene.
SPEAKER_01And which is always interesting to me because I'm like, where well, where's the T and the O?
MC4R, Rare Defects, And Satiety
SPEAKER_00I guess the O is obesity. O is obesity, but I'm like, what's the T for? Yeah, yeah. I don't know. Um, but variants in this gene are associated with higher body weight, but not because they magically create fat.
SPEAKER_01Right. Okay. So FTO primarily affects uh appetite regulation, satiety, like you mentioned, and our food reward signaling in the brain, right? So like that dopamine effect that we get.
SPEAKER_00Yeah, and those like ghrelin leptin levels that we've talked about before, right? Like people with this gene are often gonna feel less full after meals, they're gonna have stronger hunger signals, they're gonna prefer hyperpalatable foods.
SPEAKER_01And this is not a lot of people will say, oh, I just have a slow metabolism where slow metabolism runs in my family, right? Like it's more behavioral biology. It's like how your brain is interacting with the signals and the hormones that are happening at that time.
SPEAKER_00Yeah, and people don't talk about the fact that physical activity, eating a high protein diet, eating fiber can significantly attenuate the effect of the FPO gene. So, in other words, people with the risk variant who exercise regularly have similar BMIs to people without the variant.
SPEAKER_01Yeah. And the protein intake matters a lot, right? Because a higher protein diet is automatically, again, that's this is the overcompensation. It's going to improve satiety. It's going to blunt the appetite dysregulation, right? And those are the things that the FTO gene is impacting. And so can I pull a little bit harder on those levers? My protein intake may need to be a little bit higher than you know, what the regular recommendation is if I have this gene present.
SPEAKER_00And I always think about this, like I'm sure that most people listening to this, have you ever seen that image of like the beach 15 years ago on the beach now?
SPEAKER_01Like Yeah, where like the water is like way, yeah.
SPEAKER_00No, no, no.
SPEAKER_01I mean like the people on the beach. Like the people on the beach, where like everybody used to be skinny naturally and now everybody's living skinny.
Environment’s Rise And Modern Food Systems
SPEAKER_00If obesity was purely genetics, why is it that obesity rates are so much higher now? Right? It's because the environmental factors that we live in, right? And that's really where that you that's really what tells us that genes are responsive to your lifestyle, right? And the same thing goes for that MC4R gene. It like it's one of the most important genes in appetite regulation, essentially.
SPEAKER_01What is that one doing?
SPEAKER_00Yeah, so it plays a role in energy balance, satiety, calorie regulation. It has a lot to do with your hypothalamus, right? So if it's functioning properly, it's gonna help your brain realize, like, okay, I've eaten enough. Like, I don't need any more energy right now. I'm satisfied. Like my I can I my like it's when the gas tank shuts off, right? Like it just clicks and it's done. It's like I have enough gas, right?
SPEAKER_01Okay, and then variants that are gonna like impair this signaling are gonna be increased appetite, reduced satiety, higher caloric intake before fullness. So very similar to that FTO.
SPEAKER_00Yeah, and a lot of times like stuff can get lost, and if you truly have a deficiency in this gene where it's like not functional, it's extremely rare, right? And these individuals develop severe obesity in childhood. They're not skinny until they're 20 and then suddenly blow up. They're the kids that have been obese since they were two.
SPEAKER_01Yeah, and this is uh not what we're talking about in general population. This is not the norm.
SPEAKER_00Yeah, and again, both of these genes create susceptibility, not inevitability, right? Like it doesn't like your lifestyle can totally impact how you express these genes.
SPEAKER_01Yeah, meaning like we said, right? It's just the blueprint or it's it's the potential of. Like I think about like potential energy, right? Like if I were to have a gun and I load it, then it's loaded, but it doesn't mean I have to fire it. Right. So it's potential energy that's stored, and I choose how it's expressed based on the environment that I place it in.
SPEAKER_00Yeah, and these genes are turned on and off by different signaling, right? So insulin sensitivity, inflammation, sleep quality, cortisol, like all like chronic elevated insulin, chronic inflammation, chronic electricity, chronic stress. It's all gonna blunt that signaling, right?
SPEAKER_01Yeah. Yeah, which means that if we improve our metabolic health and our satiety improves, even the people with these variants are going to be able to see improvements. Yeah, exactly.
Endocrine Disruptors And Fat Cells
SPEAKER_00And I just feel like this conversation kind of completely fell apart because it it wrote a specific narrative, right? And genes are not static at all. Your epigenetics determines whether those genes are turned on and off. So you have a blueprint, but certain situations have to happen for those genes to turn on and off. It's the same thing with breast cancer, right? Like you could have a broca gene, but something has to happen to turn on that gene to cause the cancer.
SPEAKER_01Yeah. Yeah. And it's, you know, it's the same stuff that we that we always talk about. It is the simple stuff, and people don't want that. They want it to be something that is um, you know, uh something that has to be removed from their body or some kind of crazy treatment that has to happen. But at the end of the day, it's like our quality, the quality of our nutrition, our insulin levels, our chronic stress and cortisol management, our anytime that we're depriving ourselves of sleep or our overall sleep hygiene, our inflammation, the environmental toxins that we are exposing ourselves to, all of those things are important and they are going to affect how those genes are expressed.
SPEAKER_00Exactly. And exactly. And studies show that high insulin is going to upregulate fat storage genes, right?
SPEAKER_01Yeah. If someone's insulin resistant, which is what, everyone, right? Over like 88% of Americans, that's not that's not a genetic destiny that everybody's just fallen and tripped into, or it's like, oh, that's just we can't do anything about this because everyone's just destined to be obese because they're all, you know, in sitting in this 88%. No, it's because they're insulin resistant.
Insulin Resistance And Weight Loss Stall
SPEAKER_00Yeah, and that's your lifestyle and your environment, right? So if obesity were genetic, this would have not happened, right? Like, here's a good reality check for you. In 1980, adult obesity rates in the US were around 15%.
SPEAKER_01Yeah, and now we're easily over 40. Like we're getting close to half the population.
SPEAKER_00So did our genetics just like completely change in 40 years?
SPEAKER_01No, but how long does it take for genetics to change? It's like hundreds of years.
SPEAKER_00Like, but what changed? Our food system. Right.
SPEAKER_01Right. And our environment.
SPEAKER_00Yeah. We have ultra-processed foods, increased calorie intake, without increasing satiety, like it's it's proven and control. Like, how easy is it to get these palatable foods now? You don't even have to leave your house. Like, you can have stuff door dashed to you in a second. Like, used to, you have to even like used to, you had to get in your car and at least drive through.
SPEAKER_01There had to be some type of energy output in order to, you know, achieve the calories. But also, it's like because of the way that we process the foods, like you were saying, we have like no satiety because we're getting all these extra calories in throughout the day, but they're not anything that has any nutrient density to it. So they're just empty calories, and the calories still count towards what it's doing to your blood sugar and your fat stores and all of that, but they're not actually giving you any type of fuel that you need. So you're still hungry, you're not full, you're eating more, you're getting all these dopamine signals, so that's doubling down on you wanting to eat more. And then you also have all your endocrine disruptors, right? So we got like BPAs and everything that's in all the plastics and soaps and detergents and everything that we put on our body too, which also alter fat cell differentiation.
SPEAKER_00Yeah, like that stuff literally makes your fat cells multiply easily more easily, right? So if you're exposed to all these chemicals, you're gonna have more fat cells, which can grow, and then that leads to obesity, right? Let's kind of talk a lot of a little bit of physiology around this because this is where the willpower narrative and the genetics only narrative both like miss the mark a little bit.
SPEAKER_01Let's start with insulin because I feel like, like we said, cortisol was our word last year, and insulin's probably gonna be the word of 2026. Um, but that one is what we see most prevalently.
SPEAKER_00Yeah. So chronic elevated insulin, if you get your insulin checked, ideally you want it between two to five. It is a super easy and expensive test that should be ran yearly. Should be. You want it, you want it in the single digits, but you really want it between two and five. Okay.
SPEAKER_01And just to be, just to like put this is not something that gets run with your regular blood panel at your doctor. It should be, like you said, but it is not. And so it is something that you have to take that, you know, your health agency into your own hands and either request it or get a separate test that's going to show you what it is.
SPEAKER_00Yep, and it has to be done fasted and it elevates about five to ten years before your blood sugars and your hemoglobin A1C start elevating. It's okay. So if someone Oh, go ahead. It's important because chronically elevated insulin literally locks fat inside of your fat cells and it prevents lipolysis.
Tools, GLP‑1s, And Muscle Preservation
SPEAKER_01Okay. So if someone is insulin resistant, then that makes your weight loss physiologic, physiologically harder, regardless of motivation or effort or any of like all. It's like essentially you could put a lot of work into doing whatever it is that you're doing, whether it's the amount of workouts, cardio, changing your nutrition, all of that. And yes, all those can be good. But if you are not getting your insulin in check, a lot of that is gonna be wasted effort.
SPEAKER_00And this is where a lot of people do quit, right? Like I'll check our clients' insulin levels and it's 30, and I'm like, okay, I'm gonna have a real conversation with you right now. You're gonna work really hard for the next four weeks and you're not gonna lose any weight. But I promise if you stick with it, the weight will come off once we get your insulin levels down. But if you don't have someone working with you on that and keeping you in that frame of mind and reminding you, it's not slash your calories, it's not do these crazy extreme things. It's like doing it in a safe scientific way to get that insulin down so that your body can start releasing the fat. But here's people want results overnight. And so, oh my gosh, I ate healthy for three days and I didn't lose any weight.
SPEAKER_01So um and to be fair, it's not like you said, it does take time, right? And this is where we have so many people, and women are uh disproportionately more impacted by insulin resistance than men, right?
SPEAKER_00It's estrogen, yeah.
SPEAKER_01Yeah, and so this is where we see the whole narrative of like where we have women that have honestly been making lifestyle changes, right? Where it's I've been doing, I've been working out consistently for you know a month, I've been changing my eating habits, I've removed soda, like these little things, right? Where they're they're making a solid effort and nothing is changing. But if you're flying blind and you don't realize that it's due to insulin resistance, you just assume that nothing works for you. And we hear that all the time. And so if we don't know that that's what the cause of it is, then at least we can get that information to be a little bit more reassuring to say what you're doing is positive and it will work eventually, but it is going to take some time before we can get this marker back to where it needs to be. And then your body can respond.
SPEAKER_00Yeah, and maybe you do need some tools to help with that. Maybe you need some estrogen to help with it. Maybe you need some low-dose naltroxone to help with your inflammation. Maybe you do need a GLP one with a coach to help lower it so you can get some results, right? But it I want to acknowledge that that does make it harder, right? And having leptin resistance make it harder too. Like food noise is real. I like want to acknowledge that. When people say they're always hungry and they're always thinking about food, like it's real.
SPEAKER_01Yeah, and it's not it's not simply just a lack of discipline, right? Like discipline is important, and that that what's happening there is a it's a disruption between the fat tissue and the brain, the signaling that's happening between the two. So it's it's more yeah, it's deeper than just being like, well, I'm just not going to allow myself to do it. You're fighting a losing battle.
Compassion, Epigenetics, And Real-World Wins
SPEAKER_00But you can also improve it, right? By reducing inflammation. So cut out those inflammatory foods that you're eating. Eat a whole foods diet, get sleep. Your leptin is gonna be so much worse off if you're not getting good sleep. Strength train, eat your protein, like all of these things that we've said over and over before, they are gonna help your growing, your leptin, your insulin, your inflammation, all of those types of things.
SPEAKER_01Yeah, and they're all factors that are modifiable, right? Like you have to pick the things that are gonna meet you where you are and progress it from there. And but that's where the realistic expectations have to come in, right? I can't say like, okay, well, I have to meet myself where I am because this is what's realistic for me right now, but I want results in two weeks. That's not realistic.
SPEAKER_00Yeah. And Oprah is really honest about using GLP ones and getting weighed off with that. And GLP ones are a great tool, right? Like they can absolutely improve appetite signaling and insulin sensitivity.
SPEAKER_01But they are but they're a tool. Right. Like they're not an easy button and they're not the end all be all cure. And it's definitely not something that is um without any consequences.
SPEAKER_00Yeah, so I left that episode with the thought that here's what the public hears. Obesity is genetic, therefore, medication is the answer.
SPEAKER_01Yeah, but when we when we believe that, when we end it there, then we erase the importance of muscle mass, of metabolic flexibility, nutrition education, and the importance of coaching if you are struggling with doing those things on your own.
SPEAKER_00And you're literally then committing yourself to a lifetime of taking a medication.
SPEAKER_01Yeah.
SPEAKER_00Right.
SPEAKER_01And any side effects that come with it.
SPEAKER_00Right. And there's already so many studies showing that if you are not doing Doing the right things on a GLP one, like resistance training and eating your protein, you are going to lose lean muscle mass. And if you're a woman, you are setting yourself up to be in a nursing home.
SPEAKER_01Yeah. Well, not only that, but then you it's it's counterintuitive because as you lose more and more lean muscle mass, that's actually going to worsen your long-term metabolic mod uh metabolic health over time, right? So these markers that we're trying to get into a good place, they're not gonna go in the direction that you want because you're relying on this synthetic hormone to take care of these signals for you instead of allowing your body to start to turn back on the way it needs to.
SPEAKER_00Exactly. So here's where I agree and disagree. Is some obesity genetic?
SPEAKER_01Yes. Yes. But it's not it's also not like a moral failure, right? Like I always say all the time, it doesn't have to mean anything about you that you have these genes.
SPEAKER_00And it's also not purely, okay, I have obesity genes, I'm gonna be obese, right? Like I don't want everyone out there going to test to see if they have obesity genes. Literally, that's literally just giving you permission to say, I have an obesity gene, so I'm just gonna do whatever I want. Right?
SPEAKER_01And it's not gonna be solved by just medication alone.
SPEAKER_00Right. Genetics, load the gun.
SPEAKER_01An environment pulls the trigger with everything, right?
SPEAKER_00And so the way that you live your lifestyle, the way that you expose yourself to foods, to chemicals, to all of that stuff, it's literally gonna determine whether that safety is on or off on that gun as to whether the trigger gets pulled.
SPEAKER_01Yeah. And so the idea is like a lot of people will think like, you know, something's wrong with me if they are predisposed to obesity. And it's the message that we want to reiterate is like this, it doesn't have to be your fault, but it is changeable. Like you have the opportunity, just like you have the potential to be obese based on what like the blueprint that you're given, you also have the potential to choose differently and to not be.
SPEAKER_00Yeah. So I think if you're leaving this maybe like a little bit more confused than you started, the clear takeaway is like, yes, obesity, you can be predisposed to having obesity, but you have control over it and there are tools that you can use to help you, but you have to use the tools in relationship to the lifestyle changes that turn the genes on and off, right? And if you're someone that has trouble losing weight, uh like I hear you. It like there are some people that have had that lifelong struggle of losing weight, and I get it, it's not that is not a willpower issue.
SPEAKER_01I I hear you, but there are also things that you can do, like I the story can't just stop there, right?
SPEAKER_00So I have this client, Sarah, and she lives in Florida and she's a nurse practitioner, and I've been working on and off with her for five years, and perfect example of obesity genes. She has them, like, but she is not letting that define her. Like, she quit drinking alcohol, she strength trains this every day, she watches what she eats. We have her on hormones, we have her on a GLP one, and she is like changing her body composition the right way, but she's using the tools in the toolbox and she's not allowing these like genes to control her life, right? Like we've tested her, we know that she has them, like but she's doing the lifestyle stuff along with it, and she's not gonna be on a GLP one forever because she's doing the lifestyle along with it, right? So your body is super adaptable, and when you pair science with compassion and responsibility and work through, like she had to work up giving alcohol and and like work on true healing, yeah, then that's where magic happens.
SPEAKER_01And that's the key, right? I think that's really important to remember is that we are talking about healing your body. And these genes leave you exposed to a potential wound that can be really, really difficult to heal from, but the healing is required either way, right? So, like the time can either go by and you can continue to like make that cut deeper, or you can start working on healing it and allow your body that time and the recovery that it needs to be able to provide what you need from it. All right, but that healing is really important.
Context, Takeaways, And Closing
SPEAKER_00Yeah. So if you watched the view or Oprah, or you know, this just resonated with you, comment, share it with someone who you think would relate with it.
SPEAKER_01Um also, we love you, Oprah. We love you.
SPEAKER_00Yes, yes. It's not bashing you at all. I just want to make a big at Oprah. Gotcha. No, we just want to make sure that conversation gets put into the right context because conversations like this can just get like clips on social media and you're out of clips, yeah, and it's not the whole thing for sure.
SPEAKER_01Yeah, yeah.
SPEAKER_00So we will catch you next time.
SPEAKER_01Yes, share, like, and subscribe. Please rate and review. We appreciate it, and we'll see you on the next one.
SPEAKER_00Bye.