No one can deny Canada has an obesity problem. Statistically, a quarter of adults and ten percent of children suffer from this ailment. Yet despite the rising concern, finding effective means to combat the condition has been harder than finding a needle in a haystack.
At first glance, obesity may appear to be an easy problem to resolve. After all, most people may believe the answer lies in eating fewer calories and exercising more. While these are definitely helpful, obesity is incredibly complex and involves a number of factors ranging from genetics to socioeconomic status.
About ten years ago, another possible contributor was found in the form of gut bacteria. Researchers were able to identify a link between the presence -- or absence -- of different groups of microbial species with the development of obesity. At the time, the mechanisms behind this association were not known. Yet, the door was open to test a fairly easy form of treatment. Get rid of the bad bugs with antibiotics.
Unfortunately, using antibiotics was akin to a double edged sword. Because these drugs don't discriminate between species, researchers needed to understand how to best target the culprits while leaving the harmless and friendly ones unscathed. After all, losing too many of the helpful bacteria could lead to other health conditions. The goal was to ensure the condition could be treated without creating other calamities.
The effort took years but eventually, one particular antibiotic appeared to have some promise, at least in mice. The well-known drug vancomycin seemed to do the job effectively without causing too many problems for the animals. This allowed for the development of clinical trials to determine whether antibiotics could help to improve obesity. Last week, a European group of researchers reported on one such trial although the results suggested this direction may not be as beneficial as believed.
The group asked 56 people between the ages of 35-70 to volunteer for the study. These individuals were already obese and took part in less than three hours of exercise per week. The team performed metabolic tests, acquired fat-tissue biopsies and collected fecal samples to establish a baseline, better known as time zero.
Over the course of seven days, the individuals were given one of three possible treatments. One group was given vancomycin. The other two were controls made up of either cellulose (placebo) or the antibiotic amoxicillin. The latter control was used to determine whether any effects were specific to vancomycin.
Once the seven days were complete, the same barrage of tests was performed. If there were any changes due to the vancomycin, the researchers would be able to identify them easily. To ensure alterations were lasting, the same collections were performed eight weeks later.
After all the data was collected, the comparisons could begin. Although the hope was to see positive results in those receiving vancomyvcin, the researchers deduced other conclusions. The most important among these was the lack of any link between the experiments conducted in mice and those in humans.
Using vancomycin did have an effect on the microbial composition compared to time zero. That was expected. There was less diversity in the overall population as many species succumbed to the treatment. Unfortunately, many of the losses incurred were in the population of bacteria known to be friendly to the human body. In contrast, many potentially harmful bacteria survived. This result suggested the use of the antibiotic could possibly hurt rather than help the situation.
With such a shift in the microbial dynamics, the team expected to see changes in the metabolism of the individuals. In direct contrast to the theory, however, there were few modifications. The effect of the antibiotic on insulin was negligible. There were no changes in energy use. Even the immune system seemed to be relatively inert to the antibiotic treatment. The only noticeable alteration happened to be in the way fat cells expressed genes. But this didn't change the way the cells looked and definitely did not suggest they were about to melt away.
This study clearly point out the need for clinical trials in humans for any treatment involving complex diseases such as obesity. Unlike what was seen in mice, using vancomycin in humans might not be as helpful as thought and could possibly worsen the situation for the patient. Granted, this may not be good news for those looking for answers. But at least this trial may help to rule out the already controversial use of antibiotics.
The hunt for a medical treatment and cure for obesity will no doubt continue. In the meantime, those who suffer may still find solace in professionals aiming to reverse the trends of weight balance through non-pharmacological means. The answers may not be as easy as taking a pill but they may offer hope for improved health in the future.