
Woman becomes obese after fecal transplant from overweight donor - edward
http://www.upi.com/Health_News/2015/02/04/Woman-becomes-obese-after-fecal-transplant-from-overweight-donor/1581423067944/
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jimrandomh
So, a bit of background on fecal transplants. The idea is that you take the
gut bacteria from a healthy donor, and put it in an unhealthy person's gut.
This will make the recipient's metabolism/digestion more like the donor's.
This has been found to work for weight loss; you give a normal-weight donor's
microbiome to an overweight person, and they lose weight a significant
fraction of the time.

So, when I read:

> the woman received a fecal transplant from her overweight but healthy
> daughter, via colonoscopy

I cringed. There are _three_ things wrong with that. First: you don't need to
use a relative, because fecal transplants don't have risk of rejection.
Second, you wouldn't use a donor who's overweight. And third, it's normally
done with a swallowed capsule, not with a colonoscopy, which adds risk and
unpleasantness for no reason.

(Edit: The primary source says "With the occurrence of weight gain after FMT
in this case, it is now our policy to use nonobese donors for FMT. The
untoward consequences of using nonideal FMT donors are important, because
patients may prefer to use a family member rather than an unrelated or unknown
stool donor due to the perception that these sources are safer.")

~~~
DontBeADick
Almost nothing you said is correct aside from your basic description of the
procedure.

Weight loss is rarely the primary goal of FMT and its efficacy in that realm
remains unproven. Nowhere did the article imply that any of the things that
made you "cringe" are necessary. And oral administration isn't objectively
better than the alternatives, nor is it always an option since many people
understandably find the idea of swallowing a "poop pill" rather repulsive.

~~~
fit2rule
>>Weight loss is rarely the primary goal of FMT and its efficacy in that realm
remains unproven.

Well, doesn't this case demonstrate that FMT can be used to have an effect on
weight, albeit in the negative sense? So something is going on here, and while
the science is unproven, it sure seems like this incident demonstrates that it
has promise.

~~~
jessriedel
One case doesn't demonstrate anything. There are a million reasons why a
someone might suddenly start putting on weight.

Luckily there has been a rapid uptake in FMT and we'll have good correlational
data sooner rather than later.

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eof
In high school we did an experiment where we caught different types of food on
fire, and using them as fuel burning under a beaker, measured the temperature
change of the water in the beaker.

Later I learned that cow-dung was used for fuel in some of the poorer places
on earth.

I always assumed there must be some calories left in stool; and that this
seeming-dogma about 'calories in calories out' was completely ignoring what
could be a huge amount of calories getting shat out (or not).

~~~
jnevill
She didn't gain weight because of the calories in the fecal transplant. She
gained weight, it's suspected, because of the new gut flora from the
overweight donor. Different flora may mean a different metabolism.

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Balgair
Fecal transplants.... what a world we live in....

That said, the study of gut flora is just starting. Here's a summary of
<Nature Article I read a while ago but can't seem to find> : When raising
sterile mice (no bacterial whatsoever) they tend to do pretty badly. Low body
mass, overactive immune system, etc. Taking these mice and then doing fecal
transplants (method is for sure 'icky') from obese PEOPLE and thing PEOPLE
(totally strange), the mice tend to be obese or thin. Now, they then just cage
sterile mice NEAR transplanted mice, and see the same thing, the flora just
waft over and find a home. Then they cage sterile mice near thin and obese
mice at the same time. The sterile mice get obese, rarely thin, and NOT in-
between, it's all or nothing. Flora, this one article I once read states, come
in flavors (real icky ones) that like to be in certain relations to each
other. Why the mice tended to get obese is strange, and needs more funding.

Real cool stuff, I guess, but then you get to be known as the 'rat poop
eating' labs. So there is a detriment to the research.

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panzagl
I wonder what the reaction will be if it turns out obesity isn't just about
'fatty has no self-control'

~~~
chez17
>To treat ongoing CDI-related diarrhea problems, the woman received a fecal
transplant from her overweight but healthy daughter, via colonoscopy.

One possible situation is that she was eating poorly but didn't gain weight
due to diarrhea and when she had healthy stool she gained the weight. Also,
'fatty has no-self control' is a way to stifle opposition to your opinion.
Ther is no need for that. The laws of physics apply to all people. Burn more
calories than you take in, you lose weight. Clearly there will be factors that
determine how many calories you burn (perhaps someone burns them much slower
than the average person), but as far as I've read magic isn't real yet. The
laws of the universe still apply to everyone. I've yet to see anyone eat well
and exercise and not maintain a healthy weight. Ever. Not once.

~~~
freyr
> _I 've yet to see anyone eat well and exercise and not maintain a healthy
> weight. Ever. Not once._

I too had never, ever met an overweight person who ate well and exercised. Not
even once! Until I did meet one. Your anecdotal absence of proof is not proof
of absence. The vast majority of overweight people may eat poorly and not
exercise, but that doesn't exclude other possibilities.

In my case, I eat junk food and lead a sedentary lifestyle, and yet I'm lean
and muscular. Care to explain?

~~~
chez17
Look at my original comment. Clearly there will be people who can get away
with doing little and maintain weight while others will have to work much
harder. I would guess you're pretty young as well, most young people stay
relatively fit without doing much.

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sparkman55
There is an excellent New Yorker article on fecal transplants and gut flora.

The article spends considerable time talking about the donors, and the
rigorous screening process to make sure the donated bacteria are good ones.
Obviously, that procedure wasn't followed in this particular incident.

Worth a read!

[http://www.newyorker.com/magazine/2014/12/01/excrement-
exper...](http://www.newyorker.com/magazine/2014/12/01/excrement-experiment)

------
e40
It has been posited before that bacteria or viruses might play a role in
obesity. This is an interesting development, for sure.

------
sarciszewski
[https://xkcd.com/605/](https://xkcd.com/605/)

Please be careful not to read too much into one data point.

~~~
delecti
Alternatively, the alt text from: [http://xkcd.com/552/](http://xkcd.com/552/)

> Correlation doesn't imply causation, but it does waggle its eyebrows
> suggestively and gesture furtively while mouthing 'look over there'.

There seems to be enough evidence that it's not unreasonable to believe your
weight is strongly influenced by your gut bacteria.

~~~
sarciszewski
I wasn't talking about the relationship between the two, I was talking about
"it happened to her, therefore it must be true".

------
hipcactus
Dr. R. Kelly

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gambiting
>>Her weight gain continued despite a medically supervised liquid protein diet
and exercise regimen.

How is this possible? If they were supplying her with a certain amount of
calories per day, she absolutely HAD to lose weight. Unless she was snacking,
in which case the whole mystery is solved.

~~~
Symmetry
The number of calories that go into your mouth can be very different from the
number of calories absorbed by your body. To give a simple example you'll
absorb way more calories by eating a piece of bread with olive oil than if you
eat the two pieces of food a couple of hours apart. And someone with
intestinal parasites will receive notably less nutrition from their food than
someone without. It would would actually be very surprising if intestinal
flora didn't effect the ratio of calories consumed to calories absorbed.

~~~
elmin
Can you cite your source on this please?

