CharonY

Overweight is a general problem, but with regard to obesity the UK is doing a bit better especially compared to the US, but also (slightly surprising to me, tbh) somewhat in European comparison. I believe France was always doing well in that regard.

In addition there is a rectal treatment (Rebyota). Both are human microbiome-derived. IND would be required for approved other uses, but otherwise it should not be different from "regular" off-label use. So using FDA-approved treatments, is obviously the easiest option due to the standardization and available safety information. Now if you want to use stool banks, the issue is more complicated as they would fall under biologic drug regulations, which will differ from jurisdictions. At minimum there must be documentation of the screening procedure and outcomes but there is bit of a regulatory gap in the FDA (or there was a decade or so ago) which basically allowed FDA discretion. It was only really catered for Clostridium difficile treatment, as they considered that more of an emergency situation and the risk/benefit was rather obvious there. But for other uses and given the relative paucity of trial data, I would assume IND or equivalent pathways would be necessary (AFAIK FDA and similar agencies only issued statements regarding C. difficile but have not mentioned other uses, but I may be wrong). I am vaguely aware of the struggle of OpenBiome, and the fight over regulations (though I think they submitted INDs by now). In Europe the legal framework is flexible, meaning that member states have significant discretion in how they regulate FMT. From what I have heard, it is a bit of a mess how FMT are classified and different monitoring criteria (e.g. donor selection vs microbial composition). From second-hand info it seems that at least in some countries it would be easier to conduct research studies on FMTs, but we really never got into details.

Well the check there is the senate which has to consent to the appointment. The founding fathers seemed to have envisioned a system where the executive, legislative and judicial system were all participating in governance. They did not expect that folks would simply cede their powers so willingly.

That is true in most parts in the world, but I believe that lack of calories is limited to a relatively small subset in Western countries (typically elderly and homeless folks). For most others it is more about having enough nutrients in the calories consumed.

Somewhat unrelated, but I started seeing that for google searches, the AI summary keeps pushing random posts from social media (e.g. Reddit) as part of the answers. We are putting a lot of effort into means to make us dumber it seems.

Interesting. I did now know that, but it seems intuitive. Only partially related, but that also reminds me that in rural areas, access to grocery stores is often poor and perhaps slightly counter-intuitively, in rural areas obesity rates are generally higher.

Another element is to look at the points of failure and perhaps consider a redesign.

That has also been brought up as an issue to the rise of dual-income families, where time for household jobs, including cooking, is diminished.

While the US has a a poor diet, especially among low income folks, it is a bit of an overgeneralization to state that these things are absent in Europe. Processed foods has been making inroads for some time unfortunately and obesity as well as diabetes rates in many European countries have been climbing. There is still a 10-point gap (30ish vs 40ish) among the high obesity European countries and the US, but it is a bit false to assume that there is nothing to worry about. And this is why video is a horrible way to spread information but a great source for misinformation. There are many farmer's markets in the US and in regular grocery stores there is always a vegetable section with loose vegetables. Not necessarily though, and it boils down to how much is being bought. In fact, buying directly from farmers can be more expensive as an individual, as you do not have the negotiating power, say, McDonald's has.

I believe the article is referring to a recent study in N Engl J Med and the issue pointed out in the study are a range of social factors including weaker social structures, but also diet. It is suggested that health care is a huge (known) driver of mortality among the poor, which is also seen in the much larger mortality gap between poor and rich in the USA compared to other countries. Other issues potentially affecting the wealthy in the US could also include environment, social mobility, and social attitudes. But the study also points out that they really are not able to tell with this specific study. It should also be noted that this study did things a bit differently than prior studies. Others often focused on income, where other studies showed similar survival rates between USA and Europe in the higher income brackets. But looking at wealth bins, the reduction in the US becomes visible. They speculate that this caused by income differences at a given wealth distribution. I.e. the US has a higher concentration of high-income individuals in the top wealth bin and argue that their approach might be better at finding the impact of socio-economic status on health. And just to show some additional maps of the US (all from HDPulse: An Ecosystem of Minority Health and Health Disparities Resources. National Institute on Minority Health and Health Disparities), which likely are going to vanish at some point:

And likewiese, BMI is inversely associated with socioeconomic incomes. A trend that is not only found in the US. However, in the US the impact (i.e. the level of obesity) is higher than e.g. in the UK or Germany.

Poverty is a big factor, as does being black. Especially in the south, access to health care is limited and in conjunction with poverty is a significant driver low life expectancy, for example.

Yes, which is why I am a bit skeptical that their off-label use would be illegal. Especially as the FDA-approved FMTs (such as Vowst, but I am sure the rectally applied one is similar) have no history of serious side effects, and there are far more critical (legal) off-label uses of more harmful medication. What could be the case is that some physicians don't like to make off-label recommendations, as there is more uncertainty. But again, I don't that legal nor board sanctions are likely in this case. That being said, I imaging that doing FMTs from donors is a bit different- after all physicians have no real experience in creating safe formulations. Unless they have a certified lab and provide all the documentation, QA/QC and permits, it is likely not allowed as treatment. There is a potential grey zone if they label it as supplement rather than treatment. That area is a bit a of a wild west out there.

Are there any specific statutes that apply to FMT? If not It seems to me that the risk is similar to other off-label prescriptions. While off-label use has led to sanctions from medical board in the past, they were usually careless administrations, without proper consideration of risk and/or lack of informed consent. Now, it is true that if there are negative outcomes, there could be consequences and the medical practitioner (such as lawsuit). However, liability insurance does cover off-label use there, too. The only exception I am aware of is if there was gross negligence involved. IOW, unless there are specific guidance of FMT in terms of off-label use, I think it should fall under the same. I am vaguely aware that Vowst has been tested outside of a clinicals to (unsuccessfully) improve inflammatory bowel diseases and I do not think that there were extra documentations as for clinicals required.

They didn't. As others already said, during the time of the founders, there were no parties. Moreover, impeachment requires action of congress and senate. In modern times, parties were more likely to protect their own from impeachment, but rarely as blatant as it has been done in case of Trump. Well, yes. Except, the party did not yet exist, as mentioned. Also the republicans were more different than one might imagine, especially considering the flip during the Southern strategy (https://en.wikipedia.org/wiki/Southern_strategy). Cult-like features did start to emerge at least during the tea party, where folks started to lose their minds that a person with mixed descent (who identified as black) could become president of the USA.

It is unlikely. There are few things were the President is actually doing things. While Trump signed executive orders which are against the law, the remedy is for the institutions to follow the law. So, for example the DHS might have deported folks illegally, and they are either obligated to not do that and/or to bring those deported back. If the officials fail to do so or their lawyers lie about it, contempt charges might be levvied against them. But as Trump is not the one in actual charge of the deportation, he is conveniently separated from those (I think, I am not a lawyer, but that is how I read the articles about it). But as others said, even if he was personally in charge of deportations for some reasons, the SCOTUS ruling has rendered him functionally immune, anyway.

Also, the contempt would not be levied at Trump- while he might (or might not, there are other folks like Miller who are more likely to be involved in the details) be in charge, it is ultimately lawyers from the DOJ who will argue in court. This is directly connected to the resignations of high level DOJ officials in a number of lawsuits, including in the Garcia case. I am also a bit confused as OP seemed to acknowledge the situation somewhat: But to summarize, AFAIK, contempt can be held against officials of the administration (other than Trump himself), but enforcing it is a different matter. It is also not trivial but in the case of unlawful deportation of folks to El Salavador, the judge specifically required officials to provide regularly updated and signed reports on high they facilitated their return. Lying on these documents could at minimum lead to contempt charges (and were likely to set up this way exactly for that purpose). This is actually still ongoing :https://www.reuters.com/world/us/abrego-garcias-return-should-not-end-trump-contempt-probe-lawyers-say-2025-06-09/ The only remedy against unlawful actions against the president according to SCOTUS is impeachment, which won't happen for as long as Reps are in charge.

Moderator NoteAs the topic is speculative, it has been moved to the speculations section. Please check out the guidelines for this section of the forum. It is also suggested to take a look at existing literature on this matter.

I don't think it is illegal in either jurisdiction, but any use beside treatment of clostridia is considered off-label. These are generally not covered by insurance and many just won't do it because of practical and liability issues. But not being approved is not the same as being banned. Trials are one pathway were off-label use can be tested and funded, and a prerequisite is that they are not banned for that purpose (there might be ways to get an exemption but I am not sure). A big issue specifically related to autism is the paucity of placebo data for FMT. There is longish history of a strong placebo effect on the treatment of autism with sometimes really high effect sizes (One recent review is found here https://doi.org/10.1111/dmcn.15574). So much in fact I am wondering whether placebo treatment shouldn't be on the table. After all, if symptoms lessen and the folks feel better, why not do it even if we do not really understand why? After all, if FMT provides relief, we also do not really know, we mostly speculate).

I think that description of especially the temporary relief is emblematic for the challenges of FMT. I think it is a bit misguided to think in terms of a good or bad donors exclusively. Rather the question in my mind is matching the right type of donor with the right type of recipient. It is already not trivial to ensure reliable short-term benefits, but there clearly will also be compatibility challenges between the gut environment of individual recipients and the what potentially and what is put into them. The big issue is that the gut flora is highly dynamic to begin with, of course. Obviously, FMT will create short-term changes and those will in somewhat unpredictable ways modulate immune responses, so they are quite likely to impact for example inflammation responses. However, whether those responses are able to provide relief (beyond placebo treatment, which is yet another interesting approach) will highly depend on the individual. In short, from a microbiological perspective I think we need a better understanding of the functionality and dynamics of the human gut microbiome so that we can actually make better classification (beyond what is currently done) and also improve our understanding of host-pathogen interactions. This would ultimately allows us to make better functional predictions. But again, this type of research is a bit tricky and does not satisfy the immediate desire for better treatments.

Sorry, lab lingo- yes tetracycline. One of the reasons is its wide use in agriculture to promote growth.

This dilemma presupposes that whatever trait under discussion is highly predictive for violence and related actions. The issue starts already with the classification as mentioned earlier in this thread. Even a term such as Antisocial Personality Disorder is not specific but describes broad patterns. Among those diagnosed with APD, only about 30% have traits that align with what is called sociopathy (e.g., only bonding with primary group, high impulsiveness, higher likelihood of violent outburst, morality often limited to to primary group), which is likely associated with environmental factors, such as adverse childhood experiences. Only a small subsection of the folks diagnosed with APD, have are aligned to what OP seemingly refers to as psychopathy traits (including lack of bonding, insensitivity to pain or suffering of others, even as children, lack of guilt or remorse). So it is a very small and AFAIK not clearly defined group of people. Depending on the criteria, some studies have found successful leaders with psychopathic tendencies (though some early studies suggesting that psychopathy is positively correlated with success in corporate leadership is probably overblown). While violence is more common in psychopaths, I have seen figure of around 2x more likely, the likelihood of men conducting violence compared to women is also around that order of magnitude. So just that does not seem to me as a sufficient indicator for broad intervention (or at least we do not seem to really contemplate treating all men). The question is then whether there is a way to identify those most at risk for selective treatment, if such a thing was available.

The study was designed as pilot and beside the limited participant numbers a big challenge is the lack of controls (and it is open label). That is especially problematic as many previous attempted autism treatment studies had fairly strong placebo effects (I think I also read at least one study where the calculated effect size for the placebo treatment was actually higher than the intervention, but I cannot recall the authors anymore). I think one of the issues he is looking at is donors who have had prior drug treatments that lead to growth of drug-resistant bacteria in the gut. In 2019, a person died in the United States after receiving an FMT that contained drug-resistant bacteria. I am providing link partly so that Mr Harrop will understand I have been reading about this aspect of FMT. There is also the complication that resistant bacteria have become ubiquituous in the environment. You can find certain resistances in pretty much any water stream and they are also present in our food chain. Of course, oral consumption does kill off some, but there there are bacteria that can survive stomach acids reasonably well and even if not, their DNA carrying resistance genes can be stochastically taken up by some incumbents of the gut. While without selective pressures they might vanish again, there is really not guarantee. This is especially true as some exporters and other genes can confer other selective advantages. Although not a main part of my work, I occasionally see those data sets and samples and virtually all samples to contain some sort of resistances. Tet resistance is ubiquitous, for example. Anything that has been exposed to sanitary systems and/or agriculture pretty much has them.

https://www.nytimes.com/2025/07/24/world/middleeast/gaza-starvation.html?unlocked_article_code=1.Y08.EwGn.XHUloxRwrpu2&smid=url-share

I think the issue is that your good intentions are not matched by the effort put in in trying to understand the discussion at hand. I think the error you are making is assuming that you need to appear knowledgeable in all topics under discussion. This is not the purpose of this forum. While folks who often have some level of understanding, we tend to hash out things collectively, in part by providing literature (which we actually have read!). Thereby we try to scope out what is known about a particular topic and ask each other questions (and sometimes there is just no clear answer). This is also why search engines and LLMs are not loved here- they provide definitive and declarative statements which suggest some form of authority and understanding of the matter, but frequently miss the point. This almost always rubs folks the wrong way. A better way to engage in topics that one is curious about but does not know much is to ask questions and see if someone can explain things. The forum is intended for human interactions, not for showboating.