The Gut Microbiome–Inflammation Axis: A Missing Link in Obesity Management

Dr Sneha Gadve, Kolhapur

Obesity is increasingly recognized as a microbiome-driven inflammatory disease, where gut dysbiosis sustains low-grade inflammation and fuels metabolic complications.

Obesity is no longer viewed solely as a disorder of excess calorie intake but as a complex, inflammatory condition driven by metabolic and immune dysregulation. Emerging evidence highlights the gut microbiome as a central mediator linking obesity to chronic low-grade inflammation, a key contributor to cardiometabolic and systemic complications. Dysbiosis in obesity is characterized by reduced microbial diversity, altered Firmicutes–Bacteroidetes balance, increased intestinal permeability, and enhanced translocation of pro-inflammatory bacterial components such as lipopolysaccharides.

Microbial metabolites, particularly short-chain fatty acids, play a pivotal role in maintaining gut barrier integrity, modulating immune responses, and improving insulin sensitivity. Reduced production of butyrate and other beneficial metabolites in obesity amplifies inflammatory signaling pathways, including NF-κB activation and Toll-like receptor–mediated immune responses. These mechanisms perpetuate adipose tissue inflammation and metabolic dysfunction.

Dietary patterns strongly influence microbiome composition. Western diets promote dysbiosis and inflammation, whereas Mediterranean, plant-based, and fermented-food-rich diets support beneficial microbial populations and anti-inflammatory pathways. Although pharmacological therapies for obesity primarily target appetite and metabolism, their indirect effects on the gut microbiome warrant further exploration.

Targeted modulation of the gut microbiota through dietary strategies, probiotics, and lifestyle interventions represents a promising adjunct in obesity management. Integrating microbiome-focused approaches may help shift obesity treatment toward more personalized, inflammation-centered care.

(Source: Pelc A, Fic W, Typrowicz T, Polak-Szczybyło E. Physiological Mechanisms of and Therapeutic Approaches to the Gut Microbiome and Low-Grade Inflammation in Obesity. Current Issues in Molecular Biology. 2025 Aug 8;47(8):637. )