Faecal microbiota transplantation offers little in terms of weight management

In obese, metabolically uncompromised individuals, faecal microbiota transplantation (FMT) is safe but does not effectively reduce body mass index (BMI), according to the results of a pilot study.

The study included 22 obese individuals without a diagnosis of diabetes, nonalcoholic steatohepatitis or metabolic syndrome. These participants were randomized to receive FMT by capsules (induction dose of 30 capsules at week 4; maintenance dose of 12 capsules at week 8) or placebo capsules. FMT capsules were obtained from a single donor with BMI of 17.5 kg/m².

Patients were followed for 26 weeks, with stool and serum samples collected at baseline and at weeks 1, 4, 6, 8 and 12 after administration of the first dose of treatment. Researchers analysed the samples using 16S RNA gene sequencing and liquid chromatography–mass spectrometry.

The incidence of adverse events did not significantly differ between patients who received FMT vs placebo. There was no increase in the area under the curve of GLP1 observed in either group.

Patients in the FMT group showed sustained changes in microbiomes associated with obesity toward those of the donor (p<0.001), as well as a sustained decrease in stool levels of taurocholic acid (p<0.05) compared with baseline. Additionally, bile acid profiles started to resemble those of the donor more closely at the end of the intervention.

There were no significant changes documented in mean BMI at week 12 in FMT and placebo groups.