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Ituzzip t1_j2p4ysz wrote

Reply to comment by SaltZookeepergame691 in A study on obese patients suggests the gut microbiome affects obesity levels. Microbial diversity decreased in obese subjects, and the reduction trend was correlated with the severity of obesity. by glawgii

I suspect that scientific research interest and funding has been too fixated on obesity itself as a catch-all target for all the health issues associated with obesity.

There might be more value in understanding why all these conditions are connected to obesity, and whether microbes play a role in them.

But that’s just conjecture on my part. Given the complexity of this phenomena and our very limited current understanding of the microbiome, we have not come close to exhausting all the options.

But again, we won’t know what questions to ask until we get a wider base of information to use to find patterns.

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SaltZookeepergame691 t1_j2qxy40 wrote

I think the take home here from the above trials is that the hype far, far exceeded the evidence - if microbiota modulation for obesity was a drug requiring substantial financial investment, it very likely would have been dropped in preclinical development, and it certainly would have been dropped after these negative pilot trials. By contrast, the effect of, say FMT on single and multiple recurring C diff is very obvious, and the RCT evidence for an effect in ulcerative colitis is at least mixed, if not somewhat promising.

The reason for the focus on obesity, rather than say obesity-associated CVD or CKD or NAFLD or extra-GI cancers, is that these conditions take years to develop, in a relatively small number of people - it should be much easier to see an effect on weight in people already obese, if one exists. There is some very limited evidence that microbiota intervention can improve glucose homeostasis in people, but I wouldn’t hang my hat on those studies.

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