Pasteurized <i>Akkermansia muciniphila</i> Muc<SUP>T</SUP> 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 Muc(T) or placebo. The primary outcome was change in body weight during the maintenance period. Here we show that Muc(T) led to lower body weight regain versus placebo at the end of the weight maintenance period (Muc(T): 1.2 +/- 0.7 kg, placebo: 3.2 +/- 0.4 kg, P = 0.012). Additionally, the Muc(T) 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 Muc(T). No serious adverse events related to the treatment were observed. The relative short-term intervention and absence of groups receiving modified strains of Muc(T) lacking active components are limitations that should be addressed in the future. Our findings suggest pasteurized A. muciniphila Muc(T) as a strategy for weight loss maintenance. ClinicalTrials.gov: NCT05417360.