Obesity and associated comorbidities, like non-alcoholic fatty liver disease (NAFLD), possess a great threat to public well-being globally due to their high prevalence among the population. Therapeutic approaches for obesity-associated disorders utilizing lifestyle modifications and pharmacological therapies have shown restricted efficacy. 

Recent researches have demonstrated a significant role of intestinal microbiota (IM) on obesity building and NAFLD development. Intestinal microbiota dysbiosis and related gut-liver axis activation have shown a crucial role in NAFLD development. Lack of a gold standard treatment for fatty liver disease demands the development of novel therapeutic strategies in priority to manage NAFLD patients. Therefore, modulating IM seems to be a promising therapeutic strategy for obesity-associated diseases. 

Different approaches have been utilized to modulate intestinal microbiota like pre/probiotics administration, FMT, and lifestyle modification including physical exercise interventions, which all lead to NAFLD and associated metabolic disturbances remission in in-vivo models, but clinical trials are still warranted. 

It is further important to note that different strategies are not mutually exclusive and probably could work more effectively when combined synergistically. 

Source- Front. Physiol., 18 December 2018 | https://doi.org/10.3389/fphys.2018.01813