{"doi":"10.1001/jamanetworkopen.2022.47226","title":"Effectiveness of Fecal Microbiota Transplantation for Weight Loss in Patients With Obesity Undergoing Bariatric Surgery","abstract":"<jats:sec><jats:title>Importance</jats:title><jats:p>Severe obesity is a major health concern. However, a few patients remain resistant to bariatric surgery and other treatments. Animal studies suggest that weight may be altered by fecal microbiota transplantation (FMT) from a lean donor.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To determine whether FMT from a lean donor reduces body weight and further improves the results of bariatric surgery.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>This double-blinded, placebo-controlled, multicenter, randomized clinical trial was conducted in 2018 to 2021 among adult individuals with severe obesity treated at 2 bariatric surgery centers in Finland and included 18 months of follow-up. Patients eligible for bariatric surgery were recruited for the study. Data were analyzed from March 2021 to May 2022.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>FMT from a lean donor or from the patient (autologous placebo) was administered by gastroscopy into the duodenum. Bariatric surgery was performed 6 months after the baseline intervention using laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG)</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>The main outcome was weight reduction measured as the percentage of total weight loss (TWL).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Forty-one patients were recruited to participate in the study and were included in the final analysis (29 women [71.1%]; mean [SD] age, 48.7 [8.7] years; mean [SD] body mass index, 42.5 [6.0]). A total of 21 patients received FMT from a lean donor, and 20 received an autologous placebo. Six months after FMT, 34 patients underwent LRYGB and 4 underwent LSG. Thirty-four patients (82.9%) attended the last visit 18 months after the baseline visit. The percentage of TWL at 6 months was 4.8% (95% CI, 2.7% to 7.0%; <jats:italic>P</jats:italic> &amp;amp;lt; .001) in the FMT group and 4.6% (95% CI, 1.5% to 7.6%; <jats:italic>P</jats:italic> = .006) in the placebo group, but no difference was observed between the groups. At 18 months from the baseline (ie, 12 months after surgery), the percentage of TWL was 25.3% (95% CI, 19.5 to 31.1; <jats:italic>P</jats:italic> &amp;amp;lt; .001) in the FMT group and 25.2% (95% CI, 20.2 to 30.3; <jats:italic>P</jats:italic> &amp;amp;lt; .001) in the placebo group; however, no difference was observed between the groups.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>FMT did not affect presurgical and postsurgical weight loss. Further studies are needed to elucidate the possible role of FMT in obesity.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/ct2/show/NCT03391817\">NCT03391817</jats:ext-link></jats:p></jats:sec>","journal":"JAMA Network Open","year":2022,"id":612451,"datarank":0.6090664515819629,"base_score":4.060443010546419,"endowment":4.060443010546419,"self_citation_contribution":0.6090664515819629,"citation_network_contribution":0.0,"self_endowment_contribution":0.6090664515819629,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":57,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1027901,"name":"Anne Juuti","orcid":"0000-0002-9836-662X","position":1,"is_corresponding":false},{"id":1576918,"name":"Markku Luostarinen","orcid":null,"position":2,"is_corresponding":false},{"id":1576919,"name":"Leo Niskanen","orcid":null,"position":3,"is_corresponding":false},{"id":1576920,"name":"Tarja Liukkonen","orcid":null,"position":4,"is_corresponding":false},{"id":1576921,"name":"Jyrki Tillonen","orcid":null,"position":5,"is_corresponding":false},{"id":1576922,"name":"Jyrki Kössi","orcid":null,"position":6,"is_corresponding":false},{"id":1576923,"name":"Vesa Ilvesmäki","orcid":null,"position":7,"is_corresponding":false},{"id":1576924,"name":"Mikko Viljakka","orcid":null,"position":8,"is_corresponding":false},{"id":548650,"name":"Reetta Satokari","orcid":"0000-0002-4258-3414","position":9,"is_corresponding":false},{"id":1576927,"name":"Perttu Arkkila","orcid":null,"position":10,"is_corresponding":false},{"id":1576917,"name":"Perttu Lahtinen","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Effectiveness of Fecal Microbiota Transplantation for Weight Loss in Patients With Obesity Undergoing Bariatric Surgery","abstract":"<jats:sec><jats:title>Importance</jats:title><jats:p>Severe obesity is a major health concern. However, a few patients remain resistant to bariatric surgery and other treatments. Animal studies suggest that weight may be altered by fecal microbiota transplantation (FMT) from a lean donor.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To determine whether FMT from a lean donor reduces body weight and further improves the results of bariatric surgery.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>This double-blinded, placebo-controlled, multicenter, randomized clinical trial was conducted in 2018 to 2021 among adult individuals with severe obesity treated at 2 bariatric surgery centers in Finland and included 18 months of follow-up. Patients eligible for bariatric surgery were recruited for the study. Data were analyzed from March 2021 to May 2022.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>FMT from a lean donor or from the patient (autologous placebo) was administered by gastroscopy into the duodenum. Bariatric surgery was performed 6 months after the baseline intervention using laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG)</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>The main outcome was weight reduction measured as the percentage of total weight loss (TWL).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Forty-one patients were recruited to participate in the study and were included in the final analysis (29 women [71.1%]; mean [SD] age, 48.7 [8.7] years; mean [SD] body mass index, 42.5 [6.0]). A total of 21 patients received FMT from a lean donor, and 20 received an autologous placebo. Six months after FMT, 34 patients underwent LRYGB and 4 underwent LSG. Thirty-four patients (82.9%) attended the last visit 18 months after the baseline visit. The percentage of TWL at 6 months was 4.8% (95% CI, 2.7% to 7.0%; <jats:italic>P</jats:italic> &amp;amp;lt; .001) in the FMT group and 4.6% (95% CI, 1.5% to 7.6%; <jats:italic>P</jats:italic> = .006) in the placebo group, but no difference was observed between the groups. At 18 months from the baseline (ie, 12 months after surgery), the percentage of TWL was 25.3% (95% CI, 19.5 to 31.1; <jats:italic>P</jats:italic> &amp;amp;lt; .001) in the FMT group and 25.2% (95% CI, 20.2 to 30.3; <jats:italic>P</jats:italic> &amp;amp;lt; .001) in the placebo group; however, no difference was observed between the groups.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>FMT did not affect presurgical and postsurgical weight loss. Further studies are needed to elucidate the possible role of FMT in obesity.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/ct2/show/NCT03391817\">NCT03391817</jats:ext-link></jats:p></jats:sec>","is_dataset_classified":null,"base_score":4.060443010546419,"endowment":4.060443010546419,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36525272","pmcid":"PMC9856235","openalex_id":"https://openalex.org/W4312093773","authors":[],"funders":[],"total_grants":0,"fwci":9.0344,"citation_percentile":0.98737031,"influential_citations":0,"citation_trend":[{"year":2023,"count":11},{"year":2024,"count":18},{"year":2025,"count":14},{"year":2026,"count":14}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2799634/lahtinen_2022_oi_221335_1670604884.37386.pdf","host_type":"journal"},{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2799634/lahtinen_2022_oi_221335_1670604884.37386.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1001/jamanetworkopen.2022.47226","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/36525272","host_type":"repository"},{"url":"http://hdl.handle.net/10138/354702","host_type":"journal"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9856235","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC9856235","host_type":"Europe_PMC"}],"fields_of_study":["Bariatric Surgery and Outcomes","Gut microbiota and health","Clostridium difficile and Clostridium perfringens research","Female","Humans","Obesity, Morbid","Fecal Microbiota Transplantation","Weight Loss","Bariatric Surgery","Obesity"],"mesh_terms":["Fecal Microbiota Transplantation","Female","Humans","Obesity","Obesity, Morbid","Weight Loss","Bariatric Surgery"],"keywords":["Medicine","Weight loss","Surgery","Placebo","Body mass index","Obesity","Randomized controlled trial","Sleeve gastrectomy","Gastric bypass","Internal medicine"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-02T03:30:13.724356Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}