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Gut Microbiota Dysbiosis in Human Obesity: Impact of Bariatric Surgery

  • Obesity Treatment (CM Apovian, Section Editor)
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Abstract

Purpose of Review

In this review, we summarize what is currently described in terms of gut microbiota (GM) dysbiosis modification post-bariatric surgery (BS) and their link with BS-induced clinical improvement. We also discuss how the major inter-individual variability in terms of GM changes could impact the clinical improvements seen in patients.

Recent Findings

The persisting increase in severe obesity prevalence has led to the subsequent burst in BS number. Indeed, it is to date the best treatment option to induce major and sustainable weight loss and metabolic improvement in these patients. During obesity, the gut microbiota displays distinctive features such as low microbial gene richness and compositional and functional alterations (termed dysbiosis) which have been associated with low-grade inflammation, increased body weight and fat mass, as well as type-2 diabetes. Interestingly, GM changes post-BS is currently being proposed as one the many mechanism explaining BS beneficial clinical outcomes.

Summary

BS enables partial rescue of GM dysbiosis observed during obesity. Some of the GM characteristics modified post-BS (composition in terms of bacteria and functions) are linked to BS beneficial outcomes such as weight loss or metabolic improvements. Nevertheless, the changes in GM post-BS display major variability from one patient to the other. As such, further large sample size studies associated with GM transfer studies in animals are still needed to completely decipher the role of GM in the clinical improvements observed post-surgery.

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Acknowledgments

The authors would like to thank Dr. Tim Swartz for the careful English language review of this work.

Financial Support

Funding to support NutriOmics research unit activity on this review topic was obtained from European Union’s Seventh Framework Program (FP7) for research, technological development, and demonstration under grant agreement HEALTH-F4-2012-305312 (Metacardis) and Metagenopolis grant ANR-11-DPBS-0001 and from the Clinical research program (PHRC Microbaria). JAW received grant from Institut Benjamin Delessert and Société Francophone du Diabète (SFD), and KC received an award from the Fondation de France.

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  1. Karine Clément and Judith Aron-Wisnewsky contributed equally to this work.

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  1. INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France

    Jean Debédat, Karine Clément & Judith Aron-Wisnewsky

  2. Assistance Publique Hôpitaux de Paris, Nutrition Departement, Pitié-Salpêtrière Hospital, Sorbonne Université, 47-83 bd de l’Hôpital, 75013, Paris, France

    Karine Clément & Judith Aron-Wisnewsky

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JD contributed to the research, discussion of content, and writing of this manuscript; J.A.W contributed to the research, discussion of content, writing, and editing of this manuscript; and K.C. contributed to the discussion of content, writing, and reviewing/editing the manuscript before submission. All authors reviewed the manuscript.

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Debédat, J., Clément, K. & Aron-Wisnewsky, J. Gut Microbiota Dysbiosis in Human Obesity: Impact of Bariatric Surgery. Curr Obes Rep 8, 229–242 (2019). https://doi.org/10.1007/s13679-019-00351-3

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