Australian lifestyle medicine with Professor Trim and therapootics

Professor Gary Egger's "Professor Trim's Waistline" lifestyle medicine newsletter, had the following wonderful bit on our gut microbiome and weight loss in the winter 2012 issue (39.)

Your next weight loss program could be a load of crap!

But it just might work! Here is a ‘lowdown’ on Faecal Microbial Transplants.

The world of weight control has thrown up some weird and wonderful weight loss ideas over the years, most of which have had little or no scientific support. Now there’s a new possibility that really is a load of crap – literally – but for which there could be more support than most other ideas to date.

It’s called FMT – or ‘Faecal Microbial Transplants’. It involves transplants of mixed faeces (poo to you) from lean healthy individuals, into the lower digestive tract of those who are overweight or obese.

Now before you throw up your lunch, let’s give this a good hearing in typical scientific fashion.
In the first instance it needs to be stated that while the idea of transplants for weight loss is being considered, there is not yet solid evidence to support its efficacy in this (except for some limited studies in animals).
There is a sound theory behind it and good evidence to support the approach with gut and lower bowel problems, where other treatments have failed.

The Theory

The idea of faecal transplants arose from the fact that the human gut consists of families of trillions of micro-organisms – bacteria mainly, which weigh up to 2kg on their own and make up a ‘virtual organ’ in the body.

According to Professor Tom Borody from the Centre for Digestive Diseases in Sydney,“ …poo is a zoo.” It contains a myriad of living species, all with their own genetics and biology. The gut, from which it originates, is a living teaming structure of families of micro-organisms called the ‘microbiome’.

Disruption to the normal mix of families can cause problems in the gut, which may lead to increases in body weight.
This occurs through development of a ‘leaky gut’ through which noxious products can pass. This also enables the more efficient ‘harvesting’ of food (meaning greater ability to store this as energy in the body) rather than passing it through the system.

It’s also known that the mix of the biome can be changed through several, although until now, unconsidered processes. Putting sterile lean mice in a cage with fat mice for example can lead to the thin ones becoming fat.
This lead one astute researcher in 1957 to ponder whether injecting healthy bacteria from one person to another might change the well-being of someone not on top of their game. As is often the case with science, it took 30 years for this to sink in, until others, including Dr Borody further tested the idea.

Speaking at a recent ‘Nutrition in Medicine’ conference, Dr Borody claimed his interest stemmed from a frustration in being able to treat common gastointestinal problems like irritable bowel symptoms, ulcerative colitis and Clostridium difficile, an ailment cause by over use of antibiotics. With a hardy group of recent assistants (who mixed the poo!) he tried faecal transplants in a small number of people – with almost 100% success.

Since that trial in the 1990s, Dr Borody has continued to research the process, and although it’s less successful in some problems, the higher total recovery rate in others has now led to the technique starting to become more mainstream.

FMT and weight loss

But where does weight loss fit into this?
The answer is, nobody quite knows at the moment. It’s clear that inflammation and a leaky gut is common in overweight individuals and that this is associated, in some way, with the gut microbiome.

According to Borody, faecal transplants from the lean to the obese (he suggests in the form of ‘crapsules’), could just have an impact on weight by restoring gut function.

It’s a simple, though as yet untested idea – but think of the benefits: Lean healthy students would no longer have to donate blood or sperm to make a living. They could make a s**tload of money twice a day! Much less sewerage would be pumped out to sea, reducing the numbers of two-headed fish. And the field of therapeutics could be revolutionised to become ‘therapootics’. Giving someone the s**ts would be seen as a compliment rather than an insult. The possibilities are endless. In any case, it should lead us to question throwing the poo out with the bathwater.

Faecal Microbial Transplant Update

See the Fecal transplant Foundation founder's message

Reference for lifestyle medicine page

1. Borody T. Faecal Microbial Transplants. Paper presented to the ACNEM Nutrition in Medicine Annual Conference, Melbourne, May 2012.

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