Clinical Significance of the Gut Microbiota

Obesity is a comorbid disease that also carries social stigma. The media often correlate beauty with low body weight, as is reflected by the vast majority of advertisements depicting the typically thin model selling everything from tools to fashion. Television and movies follow suit. Coupled with the increased health risks that obesity imposes, these social constructs can have a detrimental effect on an obese individual’s self-esteem, body image, and overall well-being. Identifying factors that affect metabolism has the potential to provide a pathway to success for those who struggle to attain an appropriate body weight. Diet and exercise are not the only contributors to a successful weight loss program. Recognition of the gut microbiota as a metabolic organ may change the way we view and think about obesity.

Unidentified variables influencing body habitus exist and until now, the intestinal microbiota was one of them. Several intestinal microbiome studies currently in progress are focusing on this relatively newer thought process; however, enough information currently exists to enhance the understanding of the role the human microbiota has on body composition. Although clinical applications and benefits are still in the early stages of research, the correlation between the lack of diverse gut microbiota and obesity may identify opportunities for novel treatment options.

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Therapeutic Potential of FMT

The idea of incorporating FMT as a treatment for obesity emerged in 2004 with a study that looked at gut microbiota as a factor in metabolism. Conducted at the Washington University School of Medicine, this study involved feeding stool from traditionally raised mice to germ-free mice. The outcomes of the study demonstrated a 60% increase in body fat content and insulin resistance in germ-free mice 14 days after intestinal colonization, despite no change in caloric intake.7

Launched in 2007, the Human Microbiome Project identified our metabolic landscape, revealing a connection between the variable human microbiome and disease.6 This project was an international summary reflection of multiple works connecting medical and environmental microbiology to identify new pathways of disease intervention. This framework created the opportunity to intentionally manipulate gut microbiota, subsequently optimizing an individual’s host metabolism. We now know that the digestive capacity of the gut microbiota influences the nutrient and caloric value of food. Turnbaugh and colleagues initially identified the gut microbiome as a contributing factor in the pathophysiology of human obesity.8 Further research has uncovered that the obese microbiome has an increased capacity to harvest energy from food and that the intestinal microbiota not only differs between the lean and obese but is also transferable between human subjects.