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Short abstract:

This paper examines responsibilization linked to genetic tests in the context of childhood obesity. We argue that the emerging dimensions of responsibility for families are inadequate, and we call for public involvement in the governance for the appropriate management of the risk assessment.

Long abstract:

This paper explores the role of biomedical tests in the context of childhood obesity, by focusing on the consequences in terms of reshaped dimensions of responsibility. The increasing rates of obesity in the global population is among the most serious public health emergencies of our time. The increasing use of genetic testing offers an important opportunity to prevent and treat obesity, especially in children, by timely identifying and targeting its molecular causal mechanisms, but it also raises important concerns. The interplay between molecular and socio-environmental factors is particularly relevant in the context of obesity: we interrogate how a genetic-based risk-assessment approach to obesity redistributes responsibilities between individual families and institutions, and the effects in terms of costs, stigma and calls for action. Grounding ourselves on the STS literature on responsibilization and on personal and social responsibility in health, we argue that the costs and responsibilities (in terms of healthcare, screening, and lifestyle changes) redistributed by genetics of obesity, contrasted with the socioeconomic constraints to the “control” condition of responsibility, pose novel challenges to equity in health. We conclude that institutional support to address specific socioeconomic and psychosocial barriers is vital for the equitable efficacy of genetic approaches to obesity, and we call for the consultation and the involvement of obesity patient advocates as well as the general public in the governance of genetic testing and in the interpretation and the communication of the assessed risk.