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Nutrients
Volume 17
Issue 18
10.3390/nu17182942
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Review

Targeting the Gut Microbiota in Pediatric Obesity: A Paradigm Shift in Prevention and Treatment? A Comprehensive Review

by
Gianmario Forcina
,
Pierluigi Di Filippo
,
Delia De Biasio
,
Francesco Giustino Cesaro
,
Vittoria Frattolillo
,
Alessia Massa
,
Maria De Cesare
,
Pierluigi Marzuillo
,
Emanuele Miraglia del Giudice
and
Anna Di Sessa
*
Department of Woman, Child, and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(18), 2942; https://doi.org/10.3390/nu17182942 (registering DOI)
Submission received: 18 August 2025 / Revised: 8 September 2025 / Accepted: 11 September 2025 / Published: 12 September 2025
(This article belongs to the Special Issue Safeguarding the Next Generation: Nutritional Strategies for Preventing Childhood Obesity)
Versions Notes

Abstract

Pediatric obesity represents a growing global health challenge, closely associated with increased cardiometabolic risk and long-term adverse outcomes. Although lifestyle modifications remain the cornerstone of treatment, sustained success is often limited. Emerging evidence suggests that the gut microbiota (GM) plays a pivotal role in the pathogenesis of obesity, influencing host metabolism, energy homeostasis, and systemic inflammation. This narrative review aims to provide a comprehensive and up-to-date overview of the complex interplay between GM and pediatric obesity, with a particular emphasis on microbiota-targeted interventions. These include probiotics, prebiotics, synbiotics, postbiotics, dietary modulation, and fecal microbiota transplantation (FMT). Findings from preclinical studies and early-phase clinical trials indicate that gut dysbiosis may contribute to obesity-related mechanisms, such as altered nutrient absorption, increased adiposity, and dysregulated appetite control. Interventions targeting the microbiota have shown promise in modulating inflammatory pathways and improving metabolic profiles. While preliminary findings underscore the potential of the GM as a novel adjunctive target in managing pediatric obesity, current evidence remains heterogeneous, and robust clinical pediatric data are limited. Further research is needed to clarify the therapeutic efficacy, safety, and long-term outcomes of microbiota-modulating strategies in children with obesity.
Keywords: pediatric obesity; gut microbiota; dysbiosis; targeted interventions pediatric obesity; gut microbiota; dysbiosis; targeted interventions

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MDPI and ACS Style

Forcina, G.; Di Filippo, P.; De Biasio, D.; Cesaro, F.G.; Frattolillo, V.; Massa, A.; De Cesare, M.; Marzuillo, P.; Miraglia del Giudice, E.; Di Sessa, A. Targeting the Gut Microbiota in Pediatric Obesity: A Paradigm Shift in Prevention and Treatment? A Comprehensive Review. Nutrients 2025, 17, 2942. https://doi.org/10.3390/nu17182942

AMA Style

Forcina G, Di Filippo P, De Biasio D, Cesaro FG, Frattolillo V, Massa A, De Cesare M, Marzuillo P, Miraglia del Giudice E, Di Sessa A. Targeting the Gut Microbiota in Pediatric Obesity: A Paradigm Shift in Prevention and Treatment? A Comprehensive Review. Nutrients. 2025; 17(18):2942. https://doi.org/10.3390/nu17182942

Chicago/Turabian Style

Forcina, Gianmario, Pierluigi Di Filippo, Delia De Biasio, Francesco Giustino Cesaro, Vittoria Frattolillo, Alessia Massa, Maria De Cesare, Pierluigi Marzuillo, Emanuele Miraglia del Giudice, and Anna Di Sessa. 2025. "Targeting the Gut Microbiota in Pediatric Obesity: A Paradigm Shift in Prevention and Treatment? A Comprehensive Review" Nutrients 17, no. 18: 2942. https://doi.org/10.3390/nu17182942

APA Style

Forcina, G., Di Filippo, P., De Biasio, D., Cesaro, F. G., Frattolillo, V., Massa, A., De Cesare, M., Marzuillo, P., Miraglia del Giudice, E., & Di Sessa, A. (2025). Targeting the Gut Microbiota in Pediatric Obesity: A Paradigm Shift in Prevention and Treatment? A Comprehensive Review. Nutrients, 17(18), 2942. https://doi.org/10.3390/nu17182942

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