FMT not linked to weight loss outcomes in patients undergoing bariatric surgery
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Fecal microbiota transplantation 6 months before bariatric surgery did not reduce body weight in a small cohort of patients with obesity in Finland, according to study results published in JAMA Network Open.
“The intestinal microbiota has aroused interest as a potential target for the treatment of obesity,” Perttu Lahtinen, MD, of the department of gastroenterology at Paijat-Hame Central Hospital, and colleagues wrote. “Fecal microbiota transplantation has been effective in treating obesity in mouse models.
“The differences in the intestinal microbiota of lean and obese individuals and established causality between the intestinal microbiota and body weight in animal models have fostered research on FMT for obesity and compromised metabolism and have resulted in slight improvements in insulin sensitivity, abdominal adiposity and lipid metabolism but have had less effect on body weight to date.”
In a double-blind, placebo-controlled trial, Lahtinen and colleagues aimed to determine whether FMT from a healthy, lean donor would affect weight reduction in patients undergoing bariatric surgery. Of 41 participants with severe obesity (71.1% women; mean age, 48.7 years; mean BMI, 42.5), 21 received FMT from a lean donor and 20 received autologous placebo via gastroscopy into the duodenum.
Six months after FMT, 34 patients underwent laparoscopic Roux-en-Y gastric bypass and four underwent laparoscopic sleeve gastrectomy. Researchers recorded 18-month follow-up results from 82.9% of patients.
According to study results, mean reduction in BMI from baseline to follow-up was 10.4 (95% CI, 8.2-12.5) in the FMT group and 10.15 (95% CI, 7.8-12.5) in the placebo group. The percentage of total weight loss was 4.8% (95% CI, 7-2.7) and 4.6% (95% CI, 7.6-1.5), respectively, at 6 months and 25.3% (95% CI, 31.3-19.5) and 25.2% (95% CI, 30.3-20.2) at 18 months. Although the percentage of weight loss was significant in both groups, researchers reported no differences between groups.
Further, mean fat percentage decreased by 8.8% (95% CI, 5.1-12.3) and 7.6% (95% CI, 4.8-10.6), respectively, at 12 months after surgery. The percentage of excess BMI loss from baseline to the end of follow-up also was comparable between groups (FMT = 62.9%; 95% CI, 77.6-48.2 vs. placebo = 69.4%; 95% CI, 81.5-57.4).
“FMT by gastroscopy into the duodenum did not affect the body weight of participants with obesity,” Lahtinen and colleagues concluded. “Bariatric surgery 6 months after FMT or placebo administration reduced weight equally in both groups during the 1-year follow-up. No major adverse events related to either intervention were recorded.”
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