Obesity is impacted by genetic, environmental and physiological factors that affect a patient’s ability to achieve and sustain weight loss1-4 Obesity is impacted by genetic, environmental and physiological factors that affect a patient’s ability to achieve and sustain weight loss1-4 Actor portrayal Genetic factors1 Geneticfactors1 Influence an individual’s response to the external or environmental factors that can contribute to obesity1 Account for 40% to 70% of interindividual differences in BMI1 Environmental factors2,3 Behaviors conducive to developing obesity can be influenced by societal and environmental factors, including cultural influences and socioeconomic status2,3 Physiological factors4 Hormonal adaptation that occurs after weight loss may result in increased signals for energy intake, due to changes in appetite-regulating hormones4 BMI-body mass index Hormonal adaptation can affect long-term weight loss Glucagon-like peptide-1 (GLP-1) is an appetite-regulating hormone. As a patient loses weight, GLP-1 decreases—resulting in an increase in hunger.4,5 References: Hebebrand J, Hinney A, Knoll N, et al. Molecular genetic aspects of weight regulation. Dtsch Arztebl Int. 2013;110(19):38-344. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xiii, 1-253. Affenito SG, Franko DL, Striegel-Moore RH, Thompson D. Behavioral determinants of obesity: research findings and policy implications. J Obes. 2012;2012:1-4 Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-160. Drucker D. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metabolism. 2018;27:740-756.