Innovative strategies in microbiota-targeted weight management: A review

The global prevalence of obesity is increasing rapidly. Obesity is a complex, multifactorial disease rather than simply a condition of excess body weight. The gut microbiota plays an important role in body-weight regulation. However, conventional approaches to treat obesity such as diet and exercise do not specifically target the microbiota-mediated mechanisms involved in weight control. In addition, conventional weight-management approaches may have economic and health-related limitations, increasing interest in microbiota-targeted interventions for obesity management. This review provides a comprehensive overview of the effects of microbial interventions on obesity. The gut microbiota regulates host nutrient absorption, energy metabolism, and inflammatory responses. Modulation of the gut microbial composition and metabolite production may influence obesity through multiple mechanisms, including by regulating energy metabolism, modulating appetite and satiety, and inhibiting adipogenesis. The principal microbial intervention strategies include the use of probiotics, the use of prebiotics, the use of postbiotics, and fecal microbiota transplantation (FMT). Current evidence suggests that specific probiotic strains may improve obesity-related outcomes by modulating the gut microbiota composition, increasing short-chain fatty acid production, and reducing oxidative stress and systemic inflammation. Furthermore, prebiotics and postbiotics exert beneficial effects on weight management and metabolic health by promoting the growth of beneficial microbes, improving gut barrier integrity, and activating lipid metabolism-related gene expression. FMT may ameliorate obesity-related metabolic dysfunction by restoring gut microbial balance and modulating host metabolism. In summary, microbiota-targeted interventions offer a complementary approach to obesity management and may improve selected metabolic outcomes, although their effects on body weight remain variable.