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The Freaky Amazing Science Behind Fecal Transplants for Weight Loss… And a Whole Bunch of Other Stuff [Poop: The Other Bro

Posted Sep 18 2013 2:25am

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If only all poop looked this delish, this research would be a lot easier to take seriously! (P.S. These are real cookies. There’s a recipe and everything! They’re way too complicated for me to attempt but my birthday’s in June so y’all have some time to sort it out;))

Poop: It’s what’s for dinner! Oh, I’m serious. It’s the latest craze among those on the cutting-edge of health as scientists seek new and better ways to help people lose weight. And while other fads have gone the way of the dung heap (hah! I’ve been saving that one up for a week now. You’re welcome.), this one seems to have at least as much staying power as one of your uncle’s post-Thanksgiving bathroom bonanzas. Thanks to some pretty solid science calling someone a “poopy face” – as my kids are wont to do – may soon be the ultimate compliment!

In an experiment the NY Times calls “novel” (code for “who in the name of Schrodinger conceived this?!”), researchers from the venerable Harvard Medical School demonstrated the effects of gut bacteria on a person’s weight. First the intrepid scientists found a bunch of pairs of identical twins. So far, pretty normal – every good research study starts out with boxes full of identical twins. (Seriously, if you’re an identical twin who was raised separately from your twin then you’re basically worth your weight in gold to scientists. Not that they’d steal your body. Well they might. But it would be in the name of SCIENCE.) Then the researchers narrowed down the twins to pairs where one twin was thin and the other was obese.

Next they extracted the gut bacteria from each twin. The article did not say how this happened but – lucky for you! – I have done this and so can tell you. It involves pooping in sterile plastic bags inside ice cream buckets. You then put the bucket o’ crap in your car (and pray the day isn’t warm) to take back to the lab. Which, if you’re me, means that you forget about the poop bucket until you give your sister a ride and she asks why your car reeks like dirty diapers. (I’m sorry Laura!!) And then (if you’re still me) you fabricate an elaborate lie which makes far less sense than just telling her you’re saving stool samples for science. ANYHOW. The Harvard scientists – who officially now have the worst job in the world – took the twin poop and got the bacteria out of it.

Enter the mice. No good research study happens without mice! Yes, the researchers took the human poop and implanted it in the guts of mice specifically bred to have totally sterile guts. What happened? “The mice with bacteria from fat twins grew fat [to the tune of 15%-17% more fat!]; those that got bacteria from lean twins stayed lean.” Then, just to see how robust this bacteria was, they exchanged fecal matter between the mice. The article does say how this happened – lucky for you! – and it involves feeding the mice each other’s poop. Apparently it didn’t even take much coaxing as mice love eating poop.

And the results were pretty amazing, even by poo-eating mouse standards: “ The investigators discovered that given a chance, and in the presence of a low-fat diet, bacteria from a lean twin will take over the gut of a mouse that already had bacteria from a fat twin. The fat mouse then loses weight. But the opposite does not happen. No matter what the diet, bacteria from a fat mouse do not take over in a mouse that is thin.” Talk about a win-win! And the thin mice apparently didn’t even lose weight from Cholera! It was the coveted thin gut bacteria.

But, before you go scavenging in the port-a-potties at a cheerleading camp, it turns out this magical weight loss only worked if – wait for it – the mice were eating healthy chow. The mice made obese by the fattening bacteria lost weight when they got the skinny bacteria if they ate regular low-fat mouse food. However, if the obese mice ate the mouse equivalent of junk food (anyone else having visions of Templeton from Charlotte’s Web?) then the skinny bacteria could not take root and there was no weight loss.

This all was so groundbreaking that scientists got super excited in that weird geeky way that people who spend long hours in labs talking to mice often do. (And I say that, with much affection, as a person who once spent a year working in a lab, talking to mice.)

“This is all weird and wonderful!” enthused Robert Karp, a program director for genetics and genomics at the National Institute of Diabetes and Digestive and Kidney Diseases.

“I’m very excited about this,” added Michael Fischbach of the University of California, San Francisco, saying the next step will inevitably be to try using gut bacteria to treat obesity by transplanting feces from thin people. “I have little doubt that that will be the next thing that happens!”

I love Drs. Karp and Fischbach so hard right now. Not only are they super excited but they are super excited about poop! THESE ARE MY PEOPLE.

And lest you think their enthusiasm only extends to the bespectacled set, of course “fecal transplants” in humans are already happening. We’re talking about miracle weight loss (well except for that whole eat-healthy-food buzzkill)! Of course it has started. First: it should be known that fecal transplants to cure severe gut diseases and disorders have actually been a thing for awhile now. Doctors have been using “extracted gut bacteria” (read: plain ol’ poop) from healthy people to repopulate the guts of people suffering from things like Crohn’s disease and antibiotic-resistant C. difficile. It works so well that in the latter group, over 95% of patients were cured from a bacteria that currently has no known drug treatment – with poo! And the results for inflammatory bowel disease, as described by both patients and doctors, are nothing short of miraculous. There’s even an entire website,   The Power of Poo , devoted to helping match people up for fecal transplants. It has DIY tips. I KNOW. 

Even better, doctors consider these types of fecal transplants extremely safe. The American College of Gastroenterology writes in their  C. difficile treatment guidelines  that “no adverse effects or complications directly attributable to the procedure have yet been described in the literature.” Which frankly is good news for me since all of my children have, at one time or another, eaten their own or one of their siblings’ brown betties. (Don’t ask. If you’re a parent you likely already know how this happens and if you’re not a parent I don’t want to scare you away from ever having children.)

However, the FDA has recently imposed tight regulations on the procedure. At first glance this seems wise – especially after this most recent weight -loss connection. You don’t want “health spas” suddenly serving up butt brownies for dessert, right? But most experts say this regulation will actually stymie the growth of a very promising treatment and drive it underground. (What? However would a gigantic government entity hold research back?!). Bummer.

So where does this leave the poor, overly enthused researchers? There are lots and lots of questions yet to be answered about fecal transplants, writes Beth Skwarecki for the PLoS blog.

“We’re just coming to grips with the gut microbiome’s impact on health and disease, and we know so little about what is actually in that magical brown pellet (which is about  55% bacteria , in case you were wondering.) Does a donor have to be matched to the patient, or is any healthy stool good enough? Do some patients respond to the treatment and others don’t – maybe in a predictable way? Does the sample need to be fresh, and if not, what is the best way to store it? Can poop be  replaced entirely  by a synthetic, probiotic concoction? Are there legions of failed FMT patients who are too disappointed, or embarrassed, to publish negative results?”

I’m not scientist but here are a few of the important conclusions I think we can draw from all this:

1. The mice were genetically identical and ate exactly the same amount and type of calories – and yet one group was obese and the other was thin. The difference was not in calories taken in through food nor even through a difference in calories expended but rather, the researchers surmised, the gut bacteria in the obese mice were “hoarders” of nutrition while the gut bacteria in the lean mice let a lot more food go by undigested and therefore un-absorbed. Remember that next time you feel like telling someone that weight loss is a simple matter of calories in-calories out. Gut bacteria had more of an effect on weight than did diet and exercise combined. 

2. It does, however, matter what you eat. If you chance to somehow ingest a skinny person’s poop then it will be wasted if you’re eating junk. The healthier leaner bacteria (and I say “healthier” because the scientists observed favorable metabolic changes as the obese mice lost weight after eating the lean poop) only likes nutritious food. Eating healthy food is important for far more than weight loss. 

3. Maybe don’t try this one at home. Yet. Confession: I did actually go read the directions on how to give yourself a home fecal transplant. And it’s ridiculously easy. (Turns out you don’t need to sterilize or “clean” the donor poop because the bacteria is exactly why you want it. Trick is to pick a friend that you are 100% sure has no communicable diseases.) But the science, especially as it pertains to weight loss, is still so emergent. (Plus I totally don’t want anyone to come back and be all, “Well Charlotte told me to eat sh*t!”)  Stay tuned as I’m sure there will be much more about this in the future.

4. Gut bacteria is freaking amazing stuff. I’m still mourning the loss of my appendix since while it was once thought to be a useless bacteria-laden source of pain, now it’s known to be a repository of good bacteria (like the tonsils I’m also missing). And don’t forget the mood-gut connection I wrote about in my post on panic attacks . Several of you readers (Kristy Forbes!) pointed out that “90% of the body’s serotonin (the chemical that regulates your mood) is made in your gut.” Me, being me, I had to fact-check that one and it turns out you were wrong. It’s 95% (!!!). I learn new stuff from you guys every day. For more explanation of the major connection between your gut and your mood, definitely read this article from Scientific American called “ Think Twice: How the Gut’s ‘Second Brain’ Influences Mood and Well-Being .”

5. Mice are gross. At least as gross my kids. Also, I guess my cat’s incessant butt-licking makes more sense now.

What do you think about fecal transplants? Did the science win you over? Be honest: Is this something you’d ever consider trying for weight loss?

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