Fermented Milk as an Alternative Therapy for Obesity

Obesity is a global health concern closely associated with metabolic disorders, including fatty liver disease. Conventional treatment approaches rely on lifestyle modifications and pharmacological interventions, but functional foods, particularly fermented milk, have gained attention as promising alternatives. Fermented milk containing probiotics has emerged as a potential functional food for managing obesity and its complications, including nonalcoholic fatty liver disease (NAFLD). This review summarises current evidence on the role of probiotic-fermented milk in modulating lipid metabolism and related molecular pathways, with a focus on Sterol Regulatory Element-Binding Protein-1c (SREBP-1c). Probiotic fermentation can improve the composition of the gut microbiota, increase short-chain fatty acid production and regulate bile acid metabolism, thereby decreasing hepatic lipogenesis. Probiotic strains, such as Lactobacillus fermentum and Lactobacillus rhamnosus, have been reported in preclinical studies to downregulate SREBP-1c expression through multiple mechanisms, including activation of AMP-activated protein kinase (AMPK), short-chain fatty acid-mediated GPR43 signalling and modulation of bile acid pathways (FXR/FGF15). In addition, probiotic-fermented milk modulates systemic immunity through the gut-spleen-liver axis, thereby reducing chronic, low-grade inflammation associated with NAFLD. Recent in vivo and limited clinical studies have shown that probiotic-fermented milk reduces SREBP-1c expression, decreases hepatic triglyceride accumulation and improves insulin sensitivity. Collectively, these findings suggest that probiotic-fermented milk may be an effective dietary strategy for obesity-related liver disorders. Further clinical studies are needed to validate the therapeutic potential and optimise formulations for targeted interventions.