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The gut microbiota as a therapeutic target for obesity: a scoping review

Published online by Cambridge University Press:  08 June 2021

Stephanie Santos-Paulo Open the ORCID record for Stephanie Santos-Paulo [Opens in a new window] ,
Samuel P. Costello ,
Samuel C. Forster ,
Simon P. Travis  and
Robert V. Bryant
Stephanie Santos-Paulo*
Affiliation:
University of Oxford, Medical Sciences Division, John Radcliffe Hospital, Oxford, United Kingdom
Samuel P. Costello
Affiliation:
Queen Elizabeth Hospital, Department of Gastroenterology, Adelaide, SA, Australia The University of Adelaide Faculty of Health Sciences, School of Medicine, Adelaide, SA, Australia
Samuel C. Forster
Affiliation:
Hudson Institute of Medical Research, Centre for Innate Immunity and Infectious Diseases, Clayton, VIC, Australia Monash University, Department of Molecular and Translational Sciences, Clayton, VIC, Australia
Simon P. Travis
Affiliation:
Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Nuffield Department of Experimental Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
Robert V. Bryant
Affiliation:
Queen Elizabeth Hospital, Department of Gastroenterology, Adelaide, SA, Australia The University of Adelaide Faculty of Health Sciences, School of Medicine, Adelaide, SA, Australia
*
*Corresponding author: Stephanie Santos-Paulo; email: stephanie.santos-paulo@gtc.ox.ac.uk
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Abstract

There is mounting evidence that microbiome composition is intimately and dynamically connected with host energy balance and metabolism. The gut microbiome is emerging as a novel target for counteracting the chronically positive energy balance in obesity, a disease of pandemic scale which contributes to >70 % of premature deaths. This scoping review explores the potential for therapeutic modulation of gut microbiota as a means of prevention and/or treatment of obesity and obesity-associated metabolic disorders. The evidence base for interventional approaches which have been shown to affect the composition and function of the intestinal microbiome is summarised, including dietary strategies, oral probiotic treatment, faecal microbiota transplantation and bariatric surgery. Evidence in this field is still largely derived from preclinical rodent models, but interventional studies in obese populations have demonstrated metabolic improvements effected by microbiome-modulating treatments such as faecal microbiota transplantation, as well as drawing attention to the unappreciated role of microbiome modulation in well-established anti-obesity interventions, such as dietary change or bariatric surgery. The complex relationship between microbiome composition and host metabolism will take time to unravel, but microbiome modulation is likely to provide a novel strategy in the limited armamentarium of effective treatments for obesity.

Keywords

MicrobiomeObesityObesity interventionFaecal microbiota transplantationDietBariatric surgeryProbiotics
Type
Review Article
Information
Nutrition Research Reviews , Volume 35 , Issue 2 , December 2022 , pp. 207 - 220
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

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