A new clinical trial is recruiting people diagnosed with anorexia nervosa as researchers hope to discover if fecal microbiota transplant (FMT) capsules could help better manage this eating disorder.
Led by researchers at London Health Sciences Centre Research Institute (LHSCRI), Lawson Research Institute of St. Joseph's Health Care London and Western University, the novel study will investigate whether these capsules can restore healthy gut bacteria (the microbiome), improve nutrition and modify how people make food choices.
Anorexia nervosa is a severe and sometimes life-threatening condition that leads a person to perceive themselves as overweight and believe they must restrict food consumption or exercise continuously to reduce their weight.
Researchers have noticed patients with anorexia nervosa also have a disturbance in their gut microbiome which could be linked to how they think about food and their body.
"There appears to be a direct link between the gut microbiome and how the brain functions," said study co-lead Dr. Elizabeth Osuch, a professor of psychiatry and medical biophysics, researcher at LHSCRI and psychiatrist at London Health Sciences Centre.
"This connection is thought to occur through chemical processes that convey information from the gut to the brain. Since we take the FMT capsules from healthy donors, we think we can enhance the microbiome of people with anorexia nervosa, which in turn could also signal the brain to develop a healthier emotional process, improve nutrition and positively impact self-perception."
Researchers at Western, Lawson Research Institute and London Health Sciences Centre Research Institute are exploring whether fecal microbiota transplant (FMT) capsules - tasteless, odourless pills made from stool samples given by healthy donors - could help manage anorexia. (L to R) Microbiologist Jeremy Burton and psychiatrist Dr. Elizabeth Osuch. (LHSCRI)
The research would not be possible without the pioneering work of the Lawson Research Institute (Lawson) FMT team, collaborators on the study process who have customized the capsules specifically for this study. The Lawson team - under the leadership of scientist Dr. Michael Silverman, medical director of the Infectious Diseases Program at St. Joseph's, and Seema Nair Parvathy, scientific director of the FMT program at Lawson - screens stool donors, ensuring only healthy stool without harmful bacteria or other issues is used, and processes samples into tasteless, odorless pills.
"Eating disorders can be stubbornly difficult to treat, even with a combination of psychological therapy, nutritional counselling and medical monitoring," said microbiologist Jeremy Burton, interim vice-president research of St Joseph's, scientific director of Lawson and co-leader of the study with Dr. Osuch.
"As unconventional as the FMT approach may seem, it could give hope to struggling patients and their families - while also supporting evidence that mental health and physical health are often linked through the gut microbiome." - Dr. Jeremy Burton, microbiologist and study co-lead
Participants will ingest capsules and complete questionnaires as well as provide stool samples before and several times after the intervention. They will be followed carefully to examine the effects of the procedure.
Both Lawson and LHSCRI are leaders in FMT research and have conducted world-first studies also showing promise in the field of cancer. It also is an approved treatment for patients with Clostridioides difficile (C. diff), which is a condition where bacterium produces toxins and infects the colon causing inflammation.
The study is being funded by the Academic Medical Organization of Southwestern Ontario (AMOSO).
"Our hope is that the clinical trial shows positive outcomes for individuals with anorexia nervosa and it becomes a standard treatment option for those whom there are currently very few treatment choices," said Osuch.
The study is seeking to recruit 20 research participants. To be eligible, participants must be:
- Ages 16 - 35
- Diagnosed with anorexia nervosa, restricting type and not in active cognitive behavioural therapy (and not in hospital)
- Able to travel to London Health Sciences Centre at 54 Riverview Avenue and St. Joseph's Hospital at 268 Grosvenor Street
- See full eligibility criteria here
For more information or to express interest, please contact michael.wammes@lhsc.on.ca or 519-646-6000 ext. 65196.
