03.13.14

Is obesity the ticket to fighting antibiotic resistance?

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Research points to the possibility that taking antibiotics could lead to weight gain. Could this reality be the necessary catalyst to change the way we use antibiotics in general?Antibiotic overuse is a public health crisis. For decades, scientists have supported changing antibiotic prescribing practices in response to the alarming consequences of their overuse – most notably, the increasingly common presence of superbug infections.  A report by the Centers for Disease Control, Antibiotic resistant threats in the United States, 2013, found that at least 2 million people become infected with antibiotic resistant bacteria every year, of whom 23,000 die from this infection (note this statistic does not include those who will die from complications of an antibiotic-resistant infection). In reporting for a PBS Frontline documentary, Hunting the Nightmare Bacteria, David E. Hoffman challenges Americans to “jump out of their complacency” and not to view superbugs as “someone else’s problem, some other time.”

 Antibiotics unequivocally remain one of the greatest achievements of modern medicine. But doctors must be more judicious about prescribing the pills and consumers should be more wary of readily taking them.  Director-General of the World Health Organization, Margaret Chan, warns that antibiotic resistance could mean “in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.”

 Hoffman supports the creation of a broad collaboration of scientists, clinicians, hospitals, regulators and the pharmaceutical industry, to fight this crisis. Right now the federal government has a task force in place to address antimicrobial resistance, but it only meets once a year. Hoffman emphasizes that the “government can light a spark and galvanize people toward a result that each could not achieve acting alone in the face of a real threat.”

While Hoffman’s call for action is right, he leaves out one crucial stakeholder. Consumers. Making a push for consumers to lower their reliance upon antibiotics is an avenue that must be explored to mitigate the current crisis.  Consumers’ demands for medications to treat conditions that do not necessarily require pharmaceutical intervention, the widespread willingness of physicians to overprescribe medications, physician over prescription, and patients’ failure to follow the entire course of treatment all contribute to the problem. Unfortunately, the threat of dying of infection has not provoked the consumer ire needed to demand the creation of the kinds of collaboration Hoffman suggests.  

But, what if consumers were made aware of a more tangible threat resulting from antibiotic usage? That threat is obesity.

Antibiotics are famous for their ability to treat bacterial disease. But they are also commonly championed for a lesser-known reason, to fatten the meat supply. In fact, antibiotics are heavily relied upon by the meat industry to raise fat animals in cost efficient ways. Back in 1948, a biochemist named Thomas H. Jukes  used an antibiotic laced feed to grow chicks to twice their normal size.  The rest is history.

The theory is that antibiotics cause changes in intestine bacteria that can lead to obesity. Studies of children and men in the 1950s who were routinely fed antibiotics found that regular consumption led to weight gain.  More recent studies following infants treated with antibiotics before six-months of age showed higher rates of obesity at age three, teetering off at age seven.

 The scientific data remain inconclusive on when in life, how much and how often a person needs to take antibiotics to find these results. Still, significant links can be made. For example, studies of antibiotic consumption today closely mirror patterns of obesity. The maps below, cited from an article in Mother Jones entitled, Maps: The Mysterious Link Between Antibiotics and Obesity indicate a striking correlation between heavy antibiotic use and higher rates of obesity. Notice the pattern of antibiotic use and obesity rates in the color blocked maps below.

 antibiotics-map-01 

antibiotics-map-02_1

The connection between antibiotic use and obesity rates should help to raise alarm bells for consumers about the overuse of antibiotics. Public health advocates should take this into account. The potential to appeal to the average consumer’s concern over their waistline may be the ticket to addressing antimicrobial resistance. Could the threat of obesity reengage the consumer in this debate?

Posted in FDA, Global Health, Healthcare, uncategorized ; Tagged: , .

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