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Researchers Hope To Control Obesity Through Fecal Transplants

If you think you've accidentally stumbled onto April Fools' Day, let me assure you, you haven't.  The hypothesis that a fecal transplant can help control obesity is not so far-fetched, as previous studies indicate that the treatment just needs a bit of tweaking....

Duodenal tube, or nasogastric tube, can be used for feces transplants.Duodenal tube, or nasogastric tube, can be used for feces transplants. In case you are not aware, fecal transplants, also known as bacteriotherapy, or human probiotic infusions, have been conducted throughout the world for several decades to fight suberbugs caused by Clostridium difficile (C. diff) that have not responded to antibiotics or other medicinal therapies. In these situations, fecal transplants have saved many lives, and it  has had a 95 percent rate, according to The Scientist

The procedure involves flushing out the patient's own bowel, ridding it, as much as possible, of the resistant bacteria.  Then the fecal matter of a healthy person, usually a relative of the patient, is made into a smoothie-type blend with the addition of saline solution, and is infused into the patient either through a mouth or nose (duodenal) tube or a colonoscopy tube.  Enema infusion is another manner of injection, but usually requires 5 to 8 applications.


Or you could receive a feces transplant by mouth...: image via chestofbooks.comOr you could receive a feces transplant by mouth...: image via chestofbooks.com

 

Recently, a team of researchers from the Academic Medical Center in Amsterdam performed a pilot study to test their theory that fecal transplants would have a positive impact on weight loss and metabolic syndrome (including insulin insensitivity) in obese persons.  Previous animal testing had shown these results.

They enrolled 18 obese men with metabolic syndrome, ages 21 to 65, in the trial. These men had not received treatment for the disease for the prior three months. The subjects had their own bowels flushed.  Randomly, half of them received transplants from lean male donors and half received autologous transplantation via duodenal tube. (There are videos of this procedure available, but most of you have visualized enough of this process by now.)

A feces transplant could be achieved through one's colon, via a colonoscopy tube: image via jhsmiami.orgA feces transplant could be achieved through one's colon, via a colonoscopy tube: image via jhsmiami.orgWhile weight loss was seen in animal fecal transplant procedures, it was not found among the human test group after 6 weeks.  However, subjects who received transplants from healthy feces showed increased sensitivity to insulin and lower triglyceride levels, two factors that lower risk for diabetes.  And without any changes in patients' diet or exercise during the six weeks, only the fecal implants could account for this success.

Unfortunately, the success was short-lived, as after 12 weeks, insulin insensitivity and high levels of triglycerides returned to the pre-transplant levels.

Dr. Andrew Rubman of the Southbury Clinic for Traditional Medicines in Connecticut, who practices naturopathic medicine, believes that the desired result of the fecal transplant, that of weight loss, can be achieved.  The secret is to sustain the levels of the right fecal parasites over a longer period of time, because "when insulin resistance is reduced, weight loss occurs quite naturally, but it takes time."

It may not take too much time for researchers to get to the right parasites and the right length of time for treatment.  As the cost of obesity and diabetes are both so high to insurance companies, employers, and patients, the prospects for fecal transplant research may become more and more palatable.

(No, I did not write that.)

Sources:MedPageToday, Bacteriotherapy Using Fecal Flora, The Scientist, Associated Press