Subject: Can you ‘catch’ Obesity?
From: Alex Kemp
Date: Sunday, 08 February 2015 10:06:54 +0000
To: Oliver Kemp, Micaela Kemp, Liisa Kemp, Davin Kemp

The astonishing answer to this question appears to be ‘Yes’.

Bottom line:

A US woman received a poo transplant from her daughter. Her daughter was “overweight, becoming obese” & the 32-year old mother quickly gained 36lb (16kg) following this transpoosion and is now herself classed as obese.
NIH Human Microbiome Project:
These folks have conducted Genome sequencing which has created the first reference data for the microbes that live within healthy adults, published on June 14, 2012 in Nature and several journals in the Public Library of Science (PLoS).

These microorganisms:
  1. Outnumber human cells by 10 to 1
    their total number is in the trillions, although each is very small
  2. Comprise about 1 to 3 percent of the body’s total mass
    for a 200-lb (91kg) adult, that’s 2 to 6 lb (91 to 272g) of bacteria

    Putting it another way, they would fill a half-gallon (227ml) jug
  3. Inhabit almost every bit of the human body
    ‘Skin’, ‘gut’ & ‘up the nose’ are typical sites where microbes grow. The HMP researchers collected tissues from 15 body sites in men and 18 body sites in women as part of this project. They report that “each body site can be inhabited by organisms as different as those in the Amazon Rainforest and the Sahara Desert”.

    The previous paragraph reminds me of ancient humour:
    Advice when fishing:- It is best to keep bait (worms, etc.) warm whilst storing them before use; the most convenient place to use for this, of course, is the human body (mouth, etc.). In fact there are 5 places that can be used (6 if female).
  4. More than 10,000 microbial species occupy the human ecosystem; only a few hundred bacterial species were known previously
  5. Humans would be dead if not for these bugs
    the gut is perhaps the best example: bacteria in the gastro-intestinal tract allow humans to digest foods and absorb nutrients that otherwise would be unavailable
  6. It is reckoned that about 40 human genes appear to be bacterial in origin (read about prokaryotic and eukaryotic cells to understand more: Lynn Margulis (history), evolution (simple explanation), wikipedia).
    The entire Human Genome contains ~20,000 protein-encoding genes.
    The HMP researchers estimate is that the human microbiome contains ~8 million unique protein-coding genes (thus 360 times more bacterial genes than human genes).

    From all this, it seems perfectly reasonable to say that humans are more bacterial in origin than animal! In fact, a more accurate description of our situation is probably of a symbiotic, collaborative arrangement at both the micro (cell) & macro (gut, etc.) levels. However, this arrangement is far more strange than you may at first think (read on)...
  7. Passage through the birth canal gives the baby its first dose of microbes
    the vaginal microbiome undergoes a dramatic shift in bacterial species in preparation for birth, principally characterised by decreased species diversity (results from Baylor College of Medicine, Houston on 24 pregnant women contrasted with 60 women who were not pregnant)
  8. Every human routinely carries pathogens (the microorganisms known to cause illnesses)
    In healthy individuals these pathogens cause no disease; they simply coexist with their host and the rest of the human microbiome

    The big, BIG question: why then do some folks get sick from these pathogens, whilst others do not?

    It is likely that these sort of studies are going to utterly transform future medicine
  9. Antibiotics dramatically alter the makeup of the microbiome, as the bacteria that are it’s components are the ‘biotics’ that ‘antibiotics’ are antagonistic towards.

    The above also occurs when humans are sick, since the body attacks an entire section of the microbiome, and thus can dramatically alter it’s composition. Also, there are local variations in the parts of the microbiome provided by the district in which we live (the source of “gippy tummy” when we go on holiday to a hot country, for example). However, whilst the components of the human microbiome change over time, the metabolic functions provided by the microbiome do not (else the specific human in question will die).
Back now to the unfortunate lady that had the poo transplant; this patient had:

  1. Been given antibiotic treatment for bacterial vaginosis
  2. Simultaneously had exposure to a family member who had Clostridium difficile infection (CDI), and given a 10-day course of oral metronidazole for that
    (the above all resulted in 2- to 3-weeks of diarrhoea and abdominal pain)
  3. Her symptoms escalated after the end of the 10-day metronidazole treatment - she got CDI toxin polymerase chain reaction (PCR), and she was now given a 14-day course of oral vancomycin for that. In addition, she tested positive for Helicobacter pylori infection (causative agent for stomach ulcers) (personal comment: I’ve had that one!).
  4. Nausea and abdominal pain persisted after treatment of the CDI, so the H. pylori was tackled with a “triple therapy” course (that is the normal treatment required to eradicate it).
  5. A few weeks later her symptoms escalated again; she tested positive for PCR again. She was treated with a 12-week tapering course of oral vancomycin.
  6. 2 weeks before completion of the treatment, symptoms re-occur. Her doctors now throw rifaximin with Saccharomyces boulardii at her. At the same time, the H. pylori infection turns out to be ongoing.

It was at this truly horrible point in her life that her desperate doctors suggested a fecal transplant (a so-called transpoosion, but known by doctors as a Fecal Microbiota Transplantation (FMT)). The lady was up for it, and asked for her 16-year-old daughter as the stool donor, to which the doctors agreed.

The patient:

  1. 32 years old, female
  2. No significant past medical history.
  3. Physical examination was unremarkable.
  4. Always been of normal weight.
    weight before FMT was stable at 136 pounds (62kg) (body mass index [BMI]: 26)

The donor:

  1. 16 years old, female
  2. No health problems + was screened for human immunodeficiency virus 1 and 2, syphilis, and viral hepatitis A, B, and C, C. difficile, Giardia lamblia, and routine stool culture for enteric pathogens were negative.
  3. Weight was ∼140 pounds (64kg) (BMI: 26.4), but it increased later to 170 pounds (77kg)

The patient was re-treated for H. pylori, this time with quadruple therapy, and 2 weeks later was given the FMT via colonoscopy. The FMT completely fixed the CDI/PCR + all previous symptoms.

16 months after the FMT the patient reported an unintentional weight gain of 34 pounds. She now weighed 170 pounds and had become obese (BMI: 33). 36 months post-FMT her weight was 177 pounds (80kg) (BMI: 34.5).

An astonishing feature is that throughout the CDI she lost zero weight. At 16 months she was given a medically supervised liquid protein diet and exercise program but again lost zero weight. Her serum cortisol and thyroid panel were normal. At 36 months she had also developed constipation and unexplained dyspeptic symptoms.


One swallow does not make a summer, and nor does one case like this ‘prove’ that obesity can be caught like ’flu (although there are positive animal studies). However, Dr Colleen Kelly, from the Medical School at Brown University, and the doctor at the heart of this report, now checks all potential donors for obesity in addition to all other factors.

Alex Kemp