Eat Sh*t and Die(t)

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Just when you thought you’d heard of every diet trend, someone starts putting poop in a pill. To be fair, the poop isn’t intended to make you skinny—yet. For now it’s a treatment against c. difficile, a nasty gut bacteria that kills 14,000 Americans a year. Scientists found that extracting healthy bacteria from donor poop (band name, anyone?) and dosing a sick person has a huge success rate: 94 percent cured versus 27 percent from the usual antibiotic treatment.

It’s just one of many recent discoveries about how important gut bacteria is to our health. The implications for tinkering with our metabolism are especially intriguing. In the Netherlands, researchers gave fecal transplants from healthy, lean donors to obese people with metabolic disorder and saw significant improvement in weight loss and insulin resistance.

To better understand how poop pills work and whether they might help us slim down in the future, we reached out to Dr. Emma Allen-Vercoe, a fecal-transplant pioneer.

DO NOT TRY THIS AT HOME. Despite a DIY subculture that’s sprung up around fecal transplants—yeah, it’s as disgusting as it sounds—experimenting with them on your own is dangerous. “Fecal matter is a good place to pick up pathogens so I wouldn’t suggest carrying out a ‘home-brew’ fecal transplant,” says Allen-Vercoe. “What we do is take poop from a healthy person, screen it for known pathogens, and if there are none, give it to a sick person. Here’s why: Recent research has shown that many diseases have their origins in the gut, and for most of these diseases, the problem is reduced gut microbial diversity. So the idea behind eating fecal matter is to replenish this diversity with the proper number of species that need to live in your gut.”

ACCEPT BACTERIA. “Hygiene is important: It’s there to protect us from pathogens. But the media has turned us into a society of germaphobes, which is a problem. The vast majority of microbes in the world aren’t pathogens. Waging war on them with Lysol and hand sanitizer is ridiculous in the extreme. We need our microbes; they’re part of ourselves. And so, the word microbe shouldn’t be synonymous with germ.”

IT’S NOT THE SAME AS THE PROBIOTIC IN YOUR YOGURT. “People like probiotics because they’re convenient, they don’t smell bad and the thought of swallowing them doesn’t make you retch. But here’s the rub: Probiotics don’t colonize the gut. Imagine a poop pill as a miniature city in a capsule—an entire community of microbes with schools, highways and all the things that make a functional city. This ecosystem finds it easy to live in a new body, as all the necessary amenities are built-in. Now take a probiotic. It’s like a small mobile home. It can’t easily take up residence in the gut as it might not have the right adaptors to integrate into the plumbing. So it eventually gets displaced. I’m not saying that probiotics don’t work, but their effects will be moderate at best.”

CAN YOU HAVE TOO MUCH OF A GOOD THING? “I have no idea what would happen if you took too many poop pills, but I suspect the body would quickly reject what it didn’t need—along with a rip-roaring fart.”

YEAH, YEAH, YEAH, BUT WILL IT HELP ME LOSE WEIGHT? “The concept is sound. Unfortunately, we don’t understand enough about the mechanism of obesity and what the microbial community is doing. So at the moment, the risk outweighs the benefit. What if you did a transplant and it had a moderate effect on obesity—I don’t think it would be a cure—but the transplant allowed colonization of a microbe that, while harmless to the donor, sets off an inflammatory reaction in the recipient’s gut that results in colorectal cancer 20 years later? We need to be cautious. The answer isn’t flinging a bunch of poop at the problem and seeing what sticks.”