Did fecal transplant make woman obese?

[gottadobe]

If this is true, I will volunteer for FMT from a naturally thin person.
Volunteers?  


*****

The case of a normal-weight woman who rapidly became obese after receiving a fecal transplant from an overweight relative has raised new concern over the screening of donated stool.

The patient, who underwent the novel procedure to treat a recurring bacterial infection in her intestines, has gained more than 40 pounds since the transplant and continues to gain weight, according to a case report published Wednesday in the journal Open Forum Infectious Diseases.

The patient has been unable to shed the unwanted weight through diet or exercise, according to her doctors.

"This case serves as a note of caution when considering the use of non-ideal donors for fecal microbiota transplant (FMT), and we recommend selecting non-overweight donors," wrote the paper's authors, Dr. Neha Alang, an internist at Rhode Island's Newport Hospital; and Dr. Colleen Kelly, a gastroenterologist at the Warren Alpert Medical School of Brown University.

It remains unclear exactly what caused the dramatic weight gain. However, the physicians note that studies conducted on mice show that lean mice can become fatter if they receive fecal microbes from overweight mice.

"We're questioning whether there was something in the fecal transplant, where some of those 'good' bacteria we transferred may have had an impact on her metabolism in a negative way," Kelly said in a prepared statement.

Viewed for many years as a fringe medical treatment with a high "snicker factor," fecal transplants have recently shown promise in fighting Clostridium difficile infections.

So called C. diff infections cause swelling of the intestines, diarrhea and abdominal pain. They often occur when the microbes that naturally inhabit the gut are killed by antibiotics and invading C. difficile bacteria move in and take over.

By collecting stool from a healthy donor and placing it within the intestines of a patient, "good" bacteria are reintroduced to the gut and help to restore microbial order.

In the case of the then-32-year-old Rhode Island patient, doctors treated her C. diff infection with five courses of antibiotics, only to see the infection flare up again after each treatment.

Ultimately, she elected to have a fecal transplant.

"As per the patient's request, her 16-year-old daughter was chosen as the stool donor," the doctors wrote. "At the time of FMT, her daughter's weight was about 140 pounds, but it increased later to 170 pounds."

The patient weighed 136 pounds at the time of the transplant, according to authors, and her infection was cured by the procedure.

However, 16 months later she had gained 34 pounds, raising her body mass index, or BMI, from 26 to 33. "She weighed 170 pounds and had become obese," the doctors wrote. "She has continued to gain weight despite efforts to diet and exercise and at 36 months post-FMT her weight was 177 pounds (BMI 34.5)."

The doctors speculate on a variety of potential causes of the weight gain, including the effects of antibiotic treatment, stress caused by the illness, and the disappearance of the infection.

Yet based on the fact that the woman was not overweight prior to the procedure, as well as the animal studies, the researchers said it was now their policy to use only non-obese donors for FMT.

In an editorial that accompanied the paper, doctors at Massachusetts General Hospital wrote that genetics probably played a role in the woman's weight gain.

However, they said the case underscored the need to carefully vet stool donors on the basis of BMI and other health indicators.

Even though some patients might be more open to receiving stool from a family member, this could lead to a number of complications, the editorial says.

"The published case report raises many questions about the selection of FMT donors," wrote Drs. Ana Weil and Elizabeth Hohmann.

"FMT has not been studied in large-scale controlled trials, and we have much to learn about the effects of this treatment beyond the intended restoration of a diverse microbiota," they wrote.

LA Times

[Vespasia]

I went to a lecture where this we discussed recently. Specifically the research done in mice that demonstrated that obesity could be caused in through fecal transplants. I'm ready to blame being fat on all those antibiotics I had for recurrent strep as a kid. 

We joked about adding fecal samples to our next obesity study but no one wants to actually collect them! 

[wawa]

Oh, so you mean people who struggle to lose weight maybe aren't a bunch of lazy fucks who just can't math their calories in/calories out correctly, eat too much and don't exercise? HUH. HOW 'BOUT THAT??

[nomad100]

I was just coming to post this.

Another person wanting a thin person's poo signing in.

[wawa]

Feb 6, 2015 11:57:52 GMT -5 @soudesafinado said:

So, wait. I can get some shit transferred to me from one of you thin ladies and possible lose this weight? OK. I'm in.

I think you might need to have a horrific infection requiring multiple rounds of hardcore abx first to wipe out your existing flora.

[orangeblossom]

Very interesting. Fecal transplants provide such relief for people, Iitll be interesting to see if more hospitals adopt a non-obese donor policy.

[wawa]

Feb 6, 2015 12:01:58 GMT -5 @soudesafinado said:

Feb 6, 2015 12:00:10 GMT -5 wawa said:

I think you might need to have a horrific infection requiring multiple rounds of hardcore abx first to wipe out your existing flora.

It's a risk I'm willing to take.

In that case you should get sushi to poop in a bucket for you while she's local. 
She's a medical professional and everything, so that's not weird AT ALL.

[snarkymalarky]

I wonder if the illness caused the woman to be malnourished from diarrhea and then once she got the new poo, she felt better and actually started absorbing her food and nutrients.

[Deleted]

Feb 6, 2015 12:00:10 GMT -5 wawa said:

Feb 6, 2015 11:57:52 GMT -5 @soudesafinado said:

So, wait. I can get some shit transferred to me from one of you thin ladies and possible lose this weight? OK. I'm in.

I think you might need to have a horrific infection requiring multiple rounds of hardcore abx first to wipe out your existing flora.

I would do this if it didn't involve getting C.Diff first. DH had it last year and ended up needing 4 units of blood transfused due to intestinal bleeding. And that was an infection that only took 1 round of abx to kick.

[MWOS]

I took a bacterial pathogenesis class 5 years ago and we discussed that obese people have a different intestinal flora makeup than non-obese people. Back then it was a chicken or egg thing. Did the obesity come first or the bacteria? In this specific case, it seems to be the bacteria.

[sam19]

"As per the patient's request, her 16-year-old daughter was chosen as the stool donor," the doctors wrote. "At the time of FMT, her daughter's weight was about 140 pounds, but it increased later to 170 pounds."

So at the time of the transplant, the daughter was a normal weight and only later became overweight. It wasn't an obese person she was getting the transplant from.

[ringstrue]

Feb 6, 2015 12:06:48 GMT -5 snarkymalarky said:

I wonder if the illness caused the woman to be malnourished from diarrhea and then once she got the new poo, she felt better and actually started absorbing her food and nutrients.

Like- she was normal weight with a severe and lingering digestive issue? That just seems unusual. You'd assume she'd be lighter or not able to hold onto weight.

To me it seems understandable that she'd have to have a new eating routine post-surgery anyway.

I do remember the thing about obesity and spechul bacterias.

[Skyesthelimit1212]

[btdt]

Feb 6, 2015 11:57:52 GMT -5 @soudesafinado said:

So, wait. I can get some shit transferred to me from one of you thin ladies and possibly lose this weight? OK. I'm in.

Yep, sign me up.

[pt716]

If the daughter wasn't obese until after the procedure, how will using normal weight people help? How would you predict that the donor will become obese later?

[bluelily]

Feb 6, 2015 14:01:33 GMT -5 pt716 said:

If the daughter wasn't obese until after the procedure, how will using normal weight people help? How would you predict that the donor will become obese later?

Right? It would be awesome if this leads to a way to create a gut flora profile of the donor to be sure it's got the right balance. Ostensibly, the daughter had an imbalance that led to the weight gain that followed.

[elleblue]

Well this is timely, lol. If you live near Massachusetts, you can sell your poo for science. 

[tres3]

I've read a couple of studies about how obesity could be caused by a virus.

[mich1]

Feb 6, 2015 12:00:10 GMT -5 wawa said:

Feb 6, 2015 11:57:52 GMT -5 @soudesafinado said:

So, wait. I can get some shit transferred to me from one of you thin ladies and possible lose this weight? OK. I'm in.

I think you might need to have a horrific infection requiring multiple rounds of hardcore abx first to wipe out your existing flora.

Unfortunately, that doesn't do it.....

I underwent 6 months+ of IV antibiotics (4 different ones until they got the sensitivities back - with some vancomycin thrown into the mix), which really fouled up my gut.  When the antibiotics stopped, the weight came back on.....dammit!

[hi725]

They have both gained 30 something pounds since the surgery?

That seems odd to me.

[sushi]

Feb 6, 2015 12:02:56 GMT -5 wawa said:

Feb 6, 2015 12:01:58 GMT -5 @soudesafinado said:

It's a risk I'm willing to take.

In that case you should get sushi to poop in a bucket for you while she's local. 
She's a medical professional and everything, so that's not weird AT ALL.

Hey now! What are you volunteering me for?!