Fizikalna I Rehabilitacijska Medicina · Mar 5, 2026
THE IMPORTANCE OF PROPER NUTRITION IN PROTECTING THE MUSCULOSKELETAL SYSTEM DURING WEIGHT LOSS
By Verbanac D
Today, we no longer view obesity as an exclusively aesthetic problem, but as a multifactorial metabolic and neuroendocrine disease that carries multiple health problems and risks. Previous treatment methods were limited to a combination of reducing caloric intake and increasing energy expenditure through exercise, but such methods rarely led to the desired results because of low long-term adherence. However, the emergence of new classes of drugs, initially used to treat type 2 diabetes mellitus, that have a positive effect on reducing body weight and associated comorbidities is establishing itself as an important therapeutic option. GLP-1 agonists mimic the action of the endogenous human incretin GLP-1 (glucagon-like peptide-1, English: glucagon-like peptide-1), which, among other things, promotes postprandial insulin secretion and euglycemia, slows gastric emptying, and reduces appetite. The aim of this study was to investigate how the GLP-1 agonist liraglutide, together with lifestyle interventions involving diet and exercise, affects the gut microbiome of overweight female participants. Three middle-aged female participants (43, 49 and 55 years) with a body mass index above 29 (one participant) and above 30 (two participants) participated in this pilot study. Blood, urine, and stool samples were collected from the participants at the beginning and end of the study, which lasted three months. A standardized questionnaire, completed by the participants before the intervention, was used to gain insight into their health status and lifestyle habits. Dietary habits were assessed using a food frequency questionnaire (English: Food Frequency Questionnaire, FFQ). The gut microbiome was analyzed before and after the intervention by 16S rRNA gene sequencing using an Illumina MiSeq instrument. Before the intervention, the participants' gut microbiome health, considered as the overall condition of the microbiome, was reduced in all participants. After the intervention, which included liraglutide administration, the prebiotic inulin as a dietary supplement, and increased physical activity, all three participants show improved microbiome health and increased bacterial α-diversity in fecal samples. A positive correlation between improvement in microbiome health and intervention duration is evident, best described by the exponential function obtained. Regarding gut microbiome functionality, liraglutide most likely affects mucin production by modulating the proportions of bacteria in the mucosal microbiome, primarily the genus Akkermansia. Obesity is associated with dysbiosis in the form of reduced gut microbiome diversity.