Gut Microbiome in Obesity Management

Abstract

Obesity is a worldwide pandemic causing increased morbidity/mortality and high cost for the society. Management of obesity requires multidisciplinary approaches including diet, food supplement, exercise, behavior change, drug, medical device, gut microbiome manipulation, and surgery. Over the past two decades, there has been a growing awareness of the importance of gut microbiome in human health and disease. Profound changes affecting the diversity and the abundance of gut microbiome are associated with several disorders including obesity. A decrease in microbiome diversity and an increase in the ratio of Firmicutes-to-Bacteroidetes phyla have been reported in obese subjects. The gut microbiome can be manipulated to change the host metabolism and manage obesity. Potential interventions include diet (e.g., low calories, low fat, and high fiber), prebiotics (e.g., inulin, lactulose, and resistant starch), probiotics (e.g., yogurt, cheese, and milk), synbiotics (combination of prebiotics and probiotics), bariatric surgery (e.g., Roux-en-Y gastric bypass), and fecal microbiota transplantation (through colonoscopy, esophagogastroduodenoscopy, orogastric tube, or oral capsule). A better understanding of the interactions between different diets and gut microbiome should help the development of new guidelines for the prevention and management of obesity.