Long-term health outcomes in adolescents with obesity treated with faecal microbiota transplantation: 4-year follow-up

Faecal microbiota transplantation (FMT) has been explored as a potential treatment for obesity, but its long-term effects on metabolic health remain unclear. Here, we report 4-year follow-up findings from a double-blind, randomised, placebo-controlled trial assessing FMT in adolescents with obesity (ACTRN12615001351505, Australian New Zealand Clinical Trials Registry). This unblinded follow-up study evaluated 63% (55/87) of the original participants (27 FMT, 28 placebo). There was no difference in BMI between the two groups, after adjusting for sex, age, diet, and physical activity (-3.6 kg/m<sup>2</sup>, p = 0.095). However, FMT recipients showed clinical improvements in body composition and metabolic health compared to the placebo group. Specifically, FMT recipients had smaller waist circumference (-10.0 cm, p = 0.026), total body fat (-4.8%, p = 0.024), metabolic syndrome severity score (-0.58, p = 0.003), and systemic inflammation (-68% hs-CRP, p = 0.002) and higher levels of HDL cholesterol (0.16 mmol/L, p = 0.037). No group differences were observed in glucose markers, or other lipid parameters. Shotgun metagenomic sequencing revealed sustained long-term alterations in gut microbiome richness, composition and functional capacity, with persistence of donor-derived bacterial and bacteriophage strains. These findings highlight the potential relevance of FMT as a microbiome-augmenting intervention for obesity management and metabolic health, warranting further investigation.

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Publication Details

Journal
Nature Communications
Published
2025-08-28
DOI
https://doi.org/10.1038/s41467-025-62752-4
Citations
15
Primary Topic
Gut microbiota and health
Type
article
Field-Weighted Citation Impact
12.09
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article

Long-term health outcomes in adolescents with obesity treated with faecal microbiota transplantation: 4-year follow-up

Ry Y. Tweedie‐Cullen, Michele Zuppi, José G. B. Derraik, William Schierding et al.
15 citations
Nature Communications
Gut microbiota and health
12.09
article

Long-term health outcomes in adolescents with obesity treated with faecal microbiota transplantation: 4-year follow-up

Ry Y. Tweedie‐Cullen, Michele Zuppi, José G. B. Derraik, William Schierding, Valentina Chiavaroli, Wayne S. Cutfield, Darren M. Svirskis, Kathryn L. Beck, Mark H. Vickers, Tommi Vatanen, Felix R. Day, David J. Holland, Benjamin B. Albert, Brooke C. Wilson, Yannan Jiang, Cathryn Anne Conlon, Karen S. W. Leong, Justin Martin O'Sullivan, Taygen Edwards, Theo Portlock, Chris Pook, Marysia Depczynski, Christine Creagh, Thilini N. Jayasinghe
article en
15 citations

Abstract

Faecal microbiota transplantation (FMT) has been explored as a potential treatment for obesity, but its long-term effects on metabolic health remain unclear. Here, we report 4-year follow-up findings from a double-blind, randomised, placebo-controlled trial assessing FMT in adolescents with obesity (ACTRN12615001351505, Australian New Zealand Clinical Trials Registry). This unblinded follow-up study evaluated 63% (55/87) of the original participants (27 FMT, 28 placebo). There was no difference in BMI between the two groups, after adjusting for sex, age, diet, and physical activity (-3.6 kg/m<sup>2</sup>, p = 0.095). However, FMT recipients showed clinical improvements in body composition and metabolic health compared to the placebo group. Specifically, FMT recipients had smaller waist circumference (-10.0 cm, p = 0.026), total body fat (-4.8%, p = 0.024), metabolic syndrome severity score (-0.58, p = 0.003), and systemic inflammation (-68% hs-CRP, p = 0.002) and higher levels of HDL cholesterol (0.16 mmol/L, p = 0.037). No group differences were observed in glucose markers, or other lipid parameters. Shotgun metagenomic sequencing revealed sustained long-term alterations in gut microbiome richness, composition and functional capacity, with persistence of donor-derived bacterial and bacteriophage strains. These findings highlight the potential relevance of FMT as a microbiome-augmenting intervention for obesity management and metabolic health, warranting further investigation.

Nature CommunicationsVol. 16(1)
Agency for Science, Technology and Research (SG), The University of Sydney (AU), University of Helsinki (FI), University of Auckland (NZ), Singapore Institute for Clinical Sciences (SG), Counties Manukau District Health Board (NZ), Maurice Wilkins Centre (NZ), MRC Lifecourse Epidemiology Unit (GB), University of Southampton (GB), Chiang Mai University (TH), Massey University (NZ)
Zero hunger
Openalex Percentile: Top 1%
Gut microbiota and health
12.09
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