Pasteurized Akkermansia muciniphila MucT for weight loss maintenance in people with overweight and obesity: a controlled randomized trial.

Preclinical research suggests that the mucosal symbiont Akkermansia muciniphila prevents diet-induced obesity. In this randomized controlled trial, adults with overweight/obesity (n = 90) underwent an 8-week low-energy diet for ≥8% weight loss, followed by a 24-week healthy ad libitum diet with daily supplementation of pasteurized A. muciniphila MucT or placebo. The primary outcome was change in body weight during the maintenance period. Here we show that MucT led to lower body weight regain versus placebo at the end of the weight maintenance period (MucT: 1.2 ± 0.7 kg, placebo: 3.2 ± 0.4 kg, P = 0.012). Additionally, the MucT group had a greater net weight loss from baseline to end of maintenance than the placebo group (3.1 ± 0.7 kg, P = 0.009). Initial Akkermansia spp. abundance was associated with cardiometabolic response to MucT. No serious adverse events related to the treatment were observed. The relative short-term intervention and absence of groups receiving modified strains of MucT lacking active components are limitations that should be addressed in the future. Our findings suggest pasteurized A. muciniphila MucT as a strategy for weight loss maintenance. ClinicalTrials.gov: NCT05417360 .