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May 9, 2026Current Opinion in Clinical Nutrition & Metabolic Care2 citationsOpen Access

Reframing obesity through the gut microbiota: functional dysbiosis and metabolic disease

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AHAlaa HamdanAZAl Nabhani Ziad

Key Points

  • The review aims to understand the role of gut microbiota dysfunction in obesity and its metabolic complications.
  • Examined recent findings on gut microbiota's impact on metabolic health.
  • Discussed various interventions targeting microbiota, such as diet changes and fecal microbiota transplantation.
  • Analyzed the relationship between dysbiosis and key metabolic processes.
  • Dysbiosis leads to reduced short-chain fatty acid production and disrupted bile acid metabolism.
  • Impaired gut microbiota function contributes to inflammation, hepatic steatosis, and insulin resistance.
  • Targeted interventions can help restore gut function, improving metabolic outcomes.

Abstract

PURPOSE OF REVIEW: Obesity and its metabolic complications remain major global health challenges. Beyond excess caloric intake, emerging evidence implicates diet-induced gut microbiota dysfunction as a modulator of metabolic homeostasis. This review examines recent advances in understanding how functional alterations of the gut microbiota contribute to obesity pathogenesis. RECENT FINDINGS: Current data indicate that obesity is characterized less by specific microbial taxa and more by disruption of key microbial functions. Diet-induced dysbiosis alters short-chain fatty acid production, bile acid metabolism, tryptophan-derived signaling, and intestinal barrier integrity. These changes promote metabolic endotoxemia, impair enteroendocrine hormone secretion, and disrupt gut-brain and gut-liver communication, contributing to adipose tissue inflammation, hepatic steatosis, and insulin resistance. Experimental and clinical studies further suggest that microbiota-targeted interventions, including dietary fiber enrichment, prebiotics, synbiotics, and fecal microbiota transplantation, can partially restore microbial metabolic function and improve selected metabolic outcomes. SUMMARY: Obesity is increasingly conceptualized as a state of diet-driven functional gut microbiota disruption. Targeting microbial metabolic pathways rather than individual taxa may offer a promising adjunctive strategy to complement established therapies for obesity-related metabolic disease.

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Cite This Study

Hamdan et al. (2026) studied this question.

synapsesocial.com/papers/69fed071b9154b0b82877899https://doi.org/10.1097/mco.0000000000001230
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