Antibiotics and weight gain
I don’t know why—but today, as I was about to go to my computer, I thought, “I wonder if antibiotics can contribute to weight gain?”
It makes a certain amount of sense as a possibility. After all, it’s long been a practice to put antibiotics in animal feed in order to boost weight gain. In the past, when I’ve read about the practice, it’s been in the context of the perils of increased bacterial resistance to antibiotics as a possible result. But if animals gain weight from using antibiotics, why not humans? If you put it together with recent discoveries regarding gut flora and weight gain or loss, it makes perfect sense.
Sure enough, when I Googled it, I found not only a bunch of articles on the topic, but a recent one in The Atlantic entitled “Are Antibiotics Making People Larger?” An excerpt:
“Obesity is front and center,” [Andrew Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School and the former president of the American College of Gastroenterology] said, “but also diabetes, fatty liver disease, some of the cancer pathways. The microbiome can change you very quickly. If I take a rat that is genetically bred to be a skinny rat, and I transpose the stool from a genetically bred fat rat into the skinny rat, I can make that rat fat. And the weight goes up within two weeks.”
In 2014, Martin Blaser and colleagues at New York University found that steady exposure of mice to penicillin early in life predisposed them to become obese. That and similar evidence has begun to win over many scientists, including Johnson and Lee Riley, chair of the division of infectious diseases and vaccinology at the University of California, Berkeley, who comes off even more assured that the relationship is affecting humans.
“We’re animals, just like food animals,” Riley said “We give them antibiotics so they get fat. We are exposed to those antibiotics. It seems like a very common sense idea.”
Riley has dedicated his career to studying drug-resistant infections, especially urinary tract infections and bacteria associated with food-borne illnesses like salmonella. “We’ve always had this idea that drug-resistant forms of bacteria often originate in food-animal reservoirs,” he said. “This argument against antibiotic overuse never really got us anywhere, though.”
In the meantime, he started seeing intestinal-microbiome studies that demonstrated that changes in intestinal microbiota are associated with changes in body fat in people. “So I put two and two together and said, what happened in this country in the last 20 to 30 years where you really see a surge in the obesity epidemic? Well, I don’t think there has been a tremendous change in the amount of food people consume. I don’t think that’s the only explanation.”
But for me, this really hit home:
With every dose of antibiotics you take, you do damage to the microbiome. It recovers, but never to the place that it was before.
Well, I already knew that, and I’ve known it for a long time. About twenty-five years ago I had to have a root canal done, and because I’d once been told I had a heart murmur—and I answered “yes” on the dentist’s form to the question about it—I was told I had to take a mega-dose of antibiotics beforehand. Even though I hate to take antibiotics—having had an allergic reaction to one while I was in college—I took it, telling myself my fears were groundless and everything would almost certainly be fine.
Without getting too graphic about what actually happened to me, let’s just say it involved my lower GI tract, it was severe, and it lasted at least a month and perhaps two. Although I recovered, my gut never got back to “the place that it was before.”
Also, as I’ve gotten older, weight gain has become easier and easier. If I were a cow, I suppose that would be great. But since I’m not, I’ve had to eat less and less in order to not look like one (and please, don’t start with that “go on Taubes, go on Atkins, go on paleo” stuff—we’ve hashed that out already ad nauseam here, here, here, and here, and don’t forget to look at the comments).
I’d always imagined the increased ability to put on poundage had to do with growing older and the changes in metabolism and weight distribution that come with it. That’s difficult enough, although I suppose in a famine it would be a marvelous benefit. But now it occurs to me that perhaps antibiotics had something to do with it. For example, I remember that at one or two points I experienced a sudden weight gain with no change in eating or exercise habits, so sudden that it caught my attention. The gain only amounted to 5 or 10 pounds, but 5 or 10 pounds on a person who’s not so very tall (me) is certainly noticeable. Could one of those sudden leaps have occurred after that root canal? At the time, I would never have connected the two, so I have no idea.
[NOTE: Not long after I had that root canal I discovered that I didn’t have a heart murmur after all, so the antibiotic experience was all for nothing. And about fifteen years later the root canal failed, and that loss engendered a whole other dental saga—fortunately, minus the antibiotics.]
Interesting idea. Sadly, I had no choice in taking a bunch of antibiotics when I was a kid due to recurrent ear infections. I suppose the best solution would be to find the connection to weight gain and gut flora and then be able to replace what was lost.
I’m already excited by recent news talking about DNA-based diets that should be available by 2020. Research done in Israel points to DNA differences and our reactions to different types of food when it comes to weight gain.
For now, I will have to just watch what I eat. Back on the ‘diet’ cycle after a couple of months of too much indulgence. Love the calorie counting apps. Have helped me lose weight over the last few years just watching my food intake. No increase in exercise!
its none of the things you put forth… it has to do with how humans (and most other animals) have lived for thousands of years vs how they live now
prior to any kind of civilization, and putting the nobel savage aside, humans lived subsistence, where overeating was not possible let alone something to evolve a protection against.
our society wants to make deseases and conditions under the unstated assumption that we belong in cities and a prosperous society.
but we dont..
What other animal, short of creatures like the koala, has all they can eat whenever they want it?
what is a maladaption for a society of plenty
is a perfect adaption to a world of marginal existence where a meal taken now, can mean living or dying.
one of the most interesting things in a documentary (though very sad), was about a scout troop that got stuck in the desert. they did not have enough water, or food, and were wasting energy.
however, the most interesting (AND VERY SAD) part of the story, was that everyone survived (i think) but one boy
what did he do differently? he ran up a kill to take a look around, and that going up that hill used the last of his reserve energy, and unlke the rest of the troop that remained waiting, he died
there are lots of critters like this..
and there are some that are not
most depends on whether or not they find food in excess or not… (and their life spans)
Artfldgr:
Actually, these are not things I put forth, these are quotes from researchers in the field. I’m not putting forth much, except the fact that they could be right.
Of course differences in lifestyle and food availiability are part of it. But it’s interesting that people’s weight changes dramatically without any change in lifestyle if their gut bacteria changes.
I am always amazed at the things I have in common with you, Neo!
Years ago, when I lived in Boston, I too answered yes to a dentist’s heart murmur question–but she wanted me to take antibiotics for a mere cleaning!!! Always anxious about my exposure to antibiotics, I asked my internist what he thought about that and he said no no and no, it wasn’t necessary at all and my heart murmur was so small anyway as not to be a problem. So I didn’t take them.( Needless to say the dentist was not pleased.) Afterwards, I asked this internist to recommend another dentist, and he was the best dentist I’ve ever had, bar none. Moral: get your internist–if he or she is good– to recommend other providers, if they will these days.
It amazes me that medical science seems to be just getting around to the idea that people have different digestive systems. There have been some very definitive studies recently showing propensity to weight gain based on gut biomes; and it seems rather obvious once one gives it a moment’s thought. We have millions (billions?) of things in our bellies and intestines that determine how much of which types of foods we break up into what. The number and types of things has to be important; very important.
Antibiotics can kill many of these things. Strong antibiotics can kill most of those things. Antibiotic use can also affect what returns and in what number. Many of the things in our bellies keep other things in check. If a different one starts to hold sway it can have negative effects.
When I first started thinking and reading about this a few years ago I proffered that there would soon be a burgeoning industry; starting with the very affluent, where weight reduction clinics take regular stool samples and tailor diets based to what they see (and don’t see). I still think this will happen.
Even beyond weight gain I think this will be a big area of research and focus in ensuing years. There are indications gut flora can contribute to heart disease and other disorders also.
Regarding age and diet; as I’ve written before, I think so much of this is individual, but one thing I seem to have in common with most people is a diminished need for calories as I age. I probably consume 1/3 (maybe 1/5) the calories I did 20 years ago and in my teens and early 20s I don’t think I could gain body fat no matter how much I ate.
Also watch out for Cipro. I have been taking it about once to twice a year for occasional diverticulitis flareups. Being an active person (golf and soccer referee) I was getting a lot of tendon strains which I chalked up to my age. I then discovered Cipro is notorious for causing tendon inflammation and sometimes tendon tears up to 8 weeks after the drug is stopped. Sure enough, my tendon issues happened about 4-6 weeks after using the antibiotic.
Next time I go in for a flareup I’m talking to the Dr. about a substitute for the Cipro!
What is really changing is the ability to identify and sequence bacteria within a few days. I would guess that eventually people will give gut and fecal samples before antibiotics are administered and then the original flora will be reimplanted after treatment. harmful bacteria in the samples could be taken out.
Most people have no idea how fast bacteria can be identified today and that even bacteria newly discovered, eg, from volcanic areas under the sea, can be sequenced wthin days and genes identified that allow them to thrive in harsh conditions. The same methods will be used to figure out which necessary bacteria have been eliminated from the gut by the antibiotics.
Years ago I had a prescription for erythromycin. Talk about GI symptoms. I had the runs and cramps. I called the doctor and asked about side effects and he admitted those were known side effects and prescribed a different antibiotic. I have never taken it again.
I follow both Mark’s Daily Apple (paleo-ish lifestyle) and Science News Daily. The microbiome is a fascinating topic and is the subject of many new studies. Weight is a big issue, as well as immune health.
As a result, I’ve started taking probiotics and will be fermenting my own saurerkraut. I truly believe our gut has significant influences beyond what we currently imagine. Google “mark’s daily apple microbiome” to see a variety of fact based articles. Yes, they lean paleo, but focus on veggies, bacteria, etc. and on weight issues as well.
I also just finished reading “The Coming Plague” which is a look back at the various microbe pandemics/epidemics since the 1950s. There’s a lot of discussion about mutations, DNA and RNA swapping, etc. And of course, antibiotic use not just in people but in animals and soil as well.
As a result, I will try not to take antibiotics, and when I must be on them, I will try to keep away from exposure to other sick people. Bad bacteria will try to establish a stronghold so why possibly expose myself to some types I don’t already have.
neo-neocon Says: Actually, these are not things I put forth, these are quotes from researchers in the field. I’m not putting forth much, except the fact that they could be right.
you may forget that i work with those researchers and write programs for their work and watch them do politics not research.
its to the point they dont give us raises, they are working people like me to death, its policy not accident, and they are so political they skew research to match political whim of their party.
wish i was dead rather than working with these people till i do drop dead…
🙁
[a lot of research isnt worth the paper they print it on now, given how they dont really do research… ESPECIALLY the women who dont go in to do real research but to prove ideology more than anything else.. with academia of medicine loaded with them, they are loading up on really really bad work]
Artfldgr:
Yes, I take research with a grain of salt. But I’ve been reading a lot about this bacteria and weight thing for a long time, and as far as I can tell it has value.
I had almost the reverse curious experience after being prescribed Voltarin – a non-steroidal pain-killer, for a shoulder injury around 1995. As it turned out – I had a hellacious allergic reaction to it, which my health-care provider termed “chemically-induced hepatitis.” It felt like the worst case of flu ever – night sweats, bouts of complete exhaustion, but that was only the initial effect.
The long-term one was that I lost weight (about twenty pounds all told), and kept well under the military limits for my height — without trying, or changing my diet or exercise routine particularly for nearly three or four years afterwards. It wasn’t permanent, alas — but I have always wondered if taking Voltarin seriously readjusted my metabolism for some years.
I know – anecdote, not data. But I have fought the weight thing for decades, and that was the only time in my life after my mid-twenties that all the usual weight-control advice actually worked.
I feel for you on the antibiotic thing. I work at a hospital, have NO CONTACT with patients or with patient care areas. I came up mildly positive on the Mantoux TB test. It’s based on Bayesian Theorem of conditional probability, so the “positive” is based more on the likelihood that you’ve been exposed. Most hospitals risk management offices divide there populations up in a way that reflects the likelihood they might be exposed. If I had worked at pretty much ANY OTHER HOSPITAL IN THE COUNTRY, my “positive” reading would have been well within negative parameters. I got bounced to state health department. I was retested with a Interferon-Gamma Release Assay test. Which, because the CDC defines ANYONE who works in a hospital in the medium risk group, made me “positive” again. The IGRA is also based on Bayesian Theorem of conditional probability, so again, the “positive” reading again is more determined by your risk factor — if you work in the coroner’s and stick your head in corpse’s chests all day, you’re on a high risk group. If you sit at a computer all day, theoretically, your risk factor should be lower. Researchers have claimed as much, and also have claimed that since most IGRAs were treated in high incidence populations (e.g., Malaysia) that they cannot REALLY reliably test active TB in positions where there is a low incidence of TB.
Didn’t matter. Got stuck doing the full course of antibiotics.
If I had been categorized correctly by my risk, it would never have happened. First, my employer’s idiot risk management department. (If I had the same job at John Hopkins, or UCSF, or UCLA, or Mayo, or Cornell Weill, or NYU, or… I’d have been adjudged “negative” on the initisl Mantoux test.) And if the CDC understood that there are people who work in hospitals that have no patient contact and art low risk…
This research that developed an algorithm that personalizes diets to control glucose levels shows promise and supports the gut bacteria theory.
“For both groups of volunteers, “the differences were dramatic,” says Segal. “On the bad diets, blood glucose really reached abnormal level, but on the good diets, they normalized to healthy ranges.” And even though each participant ate different personalized meals, their gut microbes changed in consistent and perhaps beneficial ways. For example, several bacterial groups that had been associated with type 2 diabetes went down.”
http://www.businessinsider.com/researchers-built-an-algorithm-that-will-create-diets-that-work-for-you-2015-11
Artfldgr, I hope most medical researchers are more sincere than you depict. We are in serious trouble if they are not.
Rufus, there were at least two or more scientists and doctors here at Neo’s blog who claimed they they knew what was going on in the human body. Before the microbiome was considered a legit theory or application.
And by before, I mean they would have and probably did, belittle these “crackpot” theories, that the scientific consensus usually reacts to. Then later on, they find out the status quo is wrong. This is not unique. This isn’t even rare. Scientists have been doing this for a long time, being wrong about the status quo.
https://ymarsakar.wordpress.com/2014/10/03/hfcs-sugar-diabetics-and-human-microbiome/
Oo, look what I found. I first heard of the micro biome from Chinese traditional medicine martial artists, maybe in 2012 or a little before then.
I got a lot of sources.