The Role of Akkermansia muciniphila in Obesity: Benefit or Harm?

The global prevalence of obesity continues to increase, and several studies have demonstrated that modulating the composition and function of gut microbiota can significantly impact on people with overweight and obesity. Akkermansia muciniphila is a commensal gut bacterium associated with beneficial effects on human metabolism. Its abundance is linked to health, whereas a reduction is commonly observed in obesity. A. muciniphila constitutes approximately 3-5% of the gut microbiota in healthy adults and has attracted attention as a potential next-generation probiotic. This bacterium produces metabolites, proteins, and outer membrane compounds that influence gut barrier function, glucose metabolism, and immune response. Despite promising findings, several controversies and knowledge gaps persist. Its precise mechanism of action remains incompletely understood, and some studies raise concerns about potential pro-inflammatory effects under certain conditions or at high concentrations. As a microbial therapeutic, supplementation with A. muciniphila represents an emerging strategy. Overall, current evidence suggests that diet is key determinant of gut microbiota composition and function, modulating the abundance of A. muciniphila. Targeted dietary interventions may offer a potential and accessible strategy to ameliorate obesity related metabolic alterations and metabolic syndrome. This narrative review critically examines the current evidence on its metabolic effects, addresses safety concerns, and controversies, highlights the limitations of current research, and aims to evaluate the potential benefits and risks of this microbial therapy.