Postbiotics: emerging regulatory mechanisms and therapeutic applications in obesity and its complications

Obesity is a growing global health issue, leading to complications such as cardiovascular diseases, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and chronic inflammation. Existing treatments for people with obesity, including lifestyle changes, pharmaceutical interventions, and surgical procedures, have certain limitations, highlighting the need for alternative therapies. Postbiotics, as inanimate microbial metabolites, offer a novel therapeutic approach. This review discusses how postbiotics exert anti-obesity effects through various mechanisms, including regulation of lipid metabolism and energy homeostasis, gut microbiota modulation, endogenous systemic regulation, inflammatory immunomodulation and intestinal barrier function enhancement, along with other synergistic effects. Our work also evaluates their clinical application potential, emphasizing the safety, efficacy, and advantages over traditional treatments like pharmaceuticals and surgery. Despite promising early clinical trial results, challenges remain in translating postbiotics into clinical practice, including the need for long-term studies to assess their sustained efficacy and safety, standardized production processes, scalability, and addressing individual variability in treatment responses. Overall, postbiotics represent a sustainable and personalized therapeutic strategy for managing obesity and its complications.