Gut microbiota in obesity management: from microbial clocks to precision microbial therapies

The gut microbiota exhibits robust circadian oscillations that synchronize with host metabolic cycles. Disruption of these microbial rhythms is increasingly recognized as a factor contributing to the pathogenesis of obesity. Clinical evidence supports that chrono-modulated interventions, including chrono-nutrition, temporal fecal microbiota transplantation (FMT), and engineered microbial systems, represent promising approaches in obesity management. This review synthesizes the features of gut microbiota circadian dynamics, the intrinsic and extrinsic factors regulating microbiota oscillations, and the precise microbial intervention measures targeting temporal patterns. Through the integration of insights into the microbiota-clock-metabolism axis, this review emphasizes the necessity of time-specific strategies in translating microbial circadian biology into effective, personalized obesity therapies.