That might still feel doomy. What if you told people that an antibiotic could slow their “metabolism”?
And what if that warning carried over to buying and eating food that was produced using antibiotics?
A great thing about the microbiome exhibit is that, for Perkins and colleagues, it’s a sort of living experiment in education. She sees what people react to; what conceptions they come in with, and what they leave with. “This connection between the microbiome and obesity—when people start to make those connections, I've watched it. They're not happy. They seem like they might be less likely to want an antibiotic.”
Perkins’s own friend was sick at Thanksgiving, and her doctor told her it was just a cold, advising her to rest, drink fluids, and give it time. But, no. She told Perkins—who has devoted her professional life to the study of molecular evolutions—that she was just going to take some leftover antibiotic. And she did. “Ten minutes later she said she was feeling better,” Perkins said, exasperated. “It's like, that's impossible. That's in your head. Then she came to the exhibit last week and was freaked out.”
In a video segment at the museum, there's a bit where Stanford microbiologist Justin Sonnenburg says that with every dose of antibiotics you take, you do damage to the microbiome. It recovers, but it never recovers to the place that it was before. “That seems to really hit people hard,” Perkins said. “I think there is an understanding that antibiotics disrupt the microbiome, but it's dismissed as necessary collateral damage. And, yes, that's true if you have a real bacterial infection. But thinking, I'm never going to get back to the place I was before. I will cause the extinction of species and taxa in my gut—” she paused, “well, I don't think most members of the public think of it exactly like that, in those ecological terms. But the idea that every dose is doing permanent damage really resonates with people.”
I asked her if we're at a time when that feeling about antibiotics—as a harmless panacea—is going to become obsolete?
“I mean, I hope so,” she said. “I don't know. I don't have that much faith in humans, in our education. At the moment.”
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In talking about the role that antibiotics play in obesity, the burden of proof that the latter is causing the former is extremely high. The meat and dairy industries would need about as much proof as the coal industry would need to be convinced that it causes global warming. But when you have an epidemic that’s affecting one in three Americans and fueling many of the leading causes of death and medical costs—and you have a plausible mechanism that could be (partly) behind that epidemic, and it has been demonstrated in animal models—how long do you wait to act?
“The tricky thing is we can't do these experiments in humans to prove the same causal link,” Perkins said. “Except that we already are, the way we use antibiotics in the real world. The correlation is really strong.”