4 ms·

There is some evidence to think that a fecal transplant could help treat obesity, but not a ton. There is no evidence of the existence of people who can eat wh

by wdewind 10y ago

There is some evidence to think that a fecal transplant could help treat obesity, but not a ton. There is no evidence of the existence of people who can eat whatever they want and stay skinny. The thing is, with all the tweaks etc. that we've discovered, like gut flora effecting how many calories you absorb, none of them are hugely impactful. None of them explain obesity by themselves. So far nothing outside of massively over eating explains obesity in any kind of useful way that could be turned into a medical intervention.

tormeh 10y ago
The gut flora does have a decisive role when it comes to appetite, I seem to recall.
- wdewind 10y ago
  Right, I agree, the major thing we need to be studying when it comes to diet are the psychological aspects of it. But the difference is the important part is not "you absorb more food due to your gut makeup" because that part is real, but not hugely significant. Put simply: obesity is a food addiction. There are a ton of things that go into it, like depression, the reward system etc. We aren't likely to find the solution to obesity in small dietary tweaks, or fecal transplants.
  - gingerrr 10y ago
    Your claim about obesity being psychologically caused ignores the growing amount of research indicating that gut flora may very well impact decisionmaking, stress response and anxiety/depression [1]. Gut bacteria can even create and dispatch their own neurotransmitters [2]. You're firmly claiming causal direction on something the current research no longer supports. Psychology may be a result of digestive biome (or at least influenced by), rather than the seminal cause as you seem to think. Edit: none of the above is to claim causality in the other direction, but to point out that the absolute nature of the claims you are making is not necessarily borne out by the prevailing research. -- [1] http://www.pnas.org/content/108/38/16050 http://www.pnas.org/content/108/38/16050 [2] http://www.journalofpsychiatricresearch.com/article/S0022-3956(15)00065-5/fulltext http://www.journalofpsychiatricresearch.com/article/S0022-39...
    - wdewind 10y ago
      I don't disagree with anything you wrote here. The "mind body connection" makes the line between physical and psychological issues hard to draw. I think the addiction framework is extremely apt. But the point is that there is evidence that suggests certain factors cause you to eat more, but there is not really evidence to suggest that similar people do significantly different things with similar caloric loads and that it's just a matter of tweaking biology to make people process the same caloric load differently. The problem with this study is that it's suggesting inflammation as a cause to obesity, but we know that the only long term cause for obesity is caloric surplus. Inflammation definitionally is not causing caloric surplus (in fact it's using more calories than one otherwise would) so it doesn't seem like a useful thing to be studying, and the fat gains from it don't immediately appear to be permanent. The most important thing to study is why people eat more than they should, not necessarily what happens in the body after they eat it (though, again, I agree with your larger point that those two could be connected).
      - gingerrr 10y ago
        I see - I think we disagree less than I originally thought. However, I am not sure there is no gain to be had from a change in digestive bacteria in terms of caloric intake, because chemical changes in the digestive process could conceivably alter the efficiency of energy extraction. In the case study linked above, the woman who received fecal transplant and gained weight was placed on a medically supervised liquid diet and exercise program, and still kept gaining. She had never been obese prior, so it's not as likely that she had the kind of dietary habits that would predispose her to obesity. Also strange: her weight gain closely tracked the weight gain experienced over the same time by the fecal donor, despite dietary and exercise differences between the two. It was enough of an effect that the researchers who presented the case study have since ensured they only use fecal donations from healthy-weight donors. That all being said, I do think you're right that psychology of obesity is a very important aspect to consider, especially that of food addiction. I hope this is solved in our lifetimes, because it will be interesting to discover just how much gut influences brain and vice versa.
        10y ago
Havoc 10y ago
>There is no evidence of the existence of people who can eat whatever they want and stay skinny. Sure there is. They're called 18 year olds. Sadly the effect fades at round 25.
- bcassedy 10y ago
  Yes, your metabolism declines as you age. It's not that 18-year-olds can eat whatever they want and not gain weight, it's that 18 is the age where most people settle into eating habits based on their equilibrium at that time. As their daily expenditure slows by roughly 150 calories per decade, they don't adjust their eating habits and slowly gain weight.
- wdewind 10y ago
  The shockingly large and increasing incidence of adolescent onset T2 diabetes disagrees with this.

by wdewind 10y ago

tormeh 10y ago

The gut flora does have a decisive role when it comes to appetite, I seem to recall.

wdewind 10y ago
Right, I agree, the major thing we need to be studying when it comes to diet are the psychological aspects of it. But the difference is the important part is not "you absorb more food due to your gut makeup" because that part is real, but not hugely significant. Put simply: obesity is a food addiction. There are a ton of things that go into it, like depression, the reward system etc. We aren't likely to find the solution to obesity in small dietary tweaks, or fecal transplants.
- gingerrr 10y ago
  Your claim about obesity being psychologically caused ignores the growing amount of research indicating that gut flora may very well impact decisionmaking, stress response and anxiety/depression [1]. Gut bacteria can even create and dispatch their own neurotransmitters [2]. You're firmly claiming causal direction on something the current research no longer supports. Psychology may be a result of digestive biome (or at least influenced by), rather than the seminal cause as you seem to think. Edit: none of the above is to claim causality in the other direction, but to point out that the absolute nature of the claims you are making is not necessarily borne out by the prevailing research. -- [1] http://www.pnas.org/content/108/38/16050 http://www.pnas.org/content/108/38/16050 [2] http://www.journalofpsychiatricresearch.com/article/S0022-3956(15)00065-5/fulltext http://www.journalofpsychiatricresearch.com/article/S0022-39...
  - wdewind 10y ago
    I don't disagree with anything you wrote here. The "mind body connection" makes the line between physical and psychological issues hard to draw. I think the addiction framework is extremely apt. But the point is that there is evidence that suggests certain factors cause you to eat more, but there is not really evidence to suggest that similar people do significantly different things with similar caloric loads and that it's just a matter of tweaking biology to make people process the same caloric load differently. The problem with this study is that it's suggesting inflammation as a cause to obesity, but we know that the only long term cause for obesity is caloric surplus. Inflammation definitionally is not causing caloric surplus (in fact it's using more calories than one otherwise would) so it doesn't seem like a useful thing to be studying, and the fat gains from it don't immediately appear to be permanent. The most important thing to study is why people eat more than they should, not necessarily what happens in the body after they eat it (though, again, I agree with your larger point that those two could be connected).
    - gingerrr 10y ago
      I see - I think we disagree less than I originally thought. However, I am not sure there is no gain to be had from a change in digestive bacteria in terms of caloric intake, because chemical changes in the digestive process could conceivably alter the efficiency of energy extraction. In the case study linked above, the woman who received fecal transplant and gained weight was placed on a medically supervised liquid diet and exercise program, and still kept gaining. She had never been obese prior, so it's not as likely that she had the kind of dietary habits that would predispose her to obesity. Also strange: her weight gain closely tracked the weight gain experienced over the same time by the fecal donor, despite dietary and exercise differences between the two. It was enough of an effect that the researchers who presented the case study have since ensured they only use fecal donations from healthy-weight donors. That all being said, I do think you're right that psychology of obesity is a very important aspect to consider, especially that of food addiction. I hope this is solved in our lifetimes, because it will be interesting to discover just how much gut influences brain and vice versa.
      - 10y ago

Havoc 10y ago

>There is no evidence of the existence of people who can eat whatever they want and stay skinny. Sure there is. They're called 18 year olds. Sadly the effect fades at round 25.

bcassedy 10y ago
Yes, your metabolism declines as you age. It's not that 18-year-olds can eat whatever they want and not gain weight, it's that 18 is the age where most people settle into eating habits based on their equilibrium at that time. As their daily expenditure slows by roughly 150 calories per decade, they don't adjust their eating habits and slowly gain weight.
wdewind 10y ago
The shockingly large and increasing incidence of adolescent onset T2 diabetes disagrees with this.