Akkermansia for Weight Loss: Truth or Trend? - Dr. Michael Ruscio, DC (2024)


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Written by Dr. Ruscio onMay 2, 2024

Why Tried and True Weight Loss Strategies May Be a Better Place to Start

  • What is Akkermansia?|
  • What’s the Mechanism Behind Akkermansia for Weight Loss?|
  • Research-Backed Weight Loss Strategies|
  • Is It Worth It to Try Akkermansia?|
  • Stick with the Foundations for Weight Loss|

If you’ve been on social media, you’ve likely seen advertisem*nts promoting the health and weight loss benefits of the probiotic, Akkermansia muciniphila. As a clinician and researcher, I’m always up for exploring any therapeutic that can help my patients improve their health, including losing weight (if that’s their goal). But after years and years of digging into research, I’ve learned that, more often than not, I’m disappointed when I fact-check claims that are made about new supplements, tests, and products.

We have a mountain of evidence on the vast array of benefits that probiotics have on our health. While I’m optimistic about what future, more rigorous research trials will find about Akkermansia specifically, the data just aren’t there yet to support its use as a stand-alone tool for managing body weight. So, let’s get into the details on Akkermansia for weight loss and, more importantly, the tried and true weight loss strategies you may want to investigate before investing in it.

What is Akkermansia?

Akkermansia for Weight Loss: Truth or Trend? - Dr. Michael Ruscio, DC (1)

Before I get into the mechanism of why Akkermansia may work for weight loss, let me share some background on this potentially novel probiotic.

Akkermansia muciniphila, often abbreviated as A. muciniphila, is a commensal bacteria found in both the small and large intestines of about 90% of healthy people [1]. As its name implies, it loves mucus—mucin proteins are what make up the mucosal layer in the gut. A. muciniphilia uniquely resides within the lining of your gut’s protective mucus layer, where it engages in cross-talk with the cells that line your intestines.

Akkermansia typically shows up within the gut microbiome in the first year of life. An abundance of Akkermansia may be associated with better health (partly because it helps increase the production of short-chain fatty acids), and its numbers tend to decline as we get older [2].

Akkermansia’s prevalence in the total gut microbe population is about 1–5%. Just for reference, let’s consider the concentrations of some other common probiotic strains in the gut—Lactobacillus constitutes about 6% of the small intestine and 0.3% of the large intestine. And Bifidobacteria account for 2–14% of adult gut microorganisms [1].

Advertisem*nts make Akkermansia seem like the only probiotic you need to support your overall gut health, strengthen your small intestine barrier, and help you maintain a healthy weight. So, let’s get into the details on how Akkermansia might work and if the hype about its potential weight loss benefits withstands the scrutiny.

Key Takeaway: Akkermansia is a commensal bacteria found in the human gut. It lives in the mucin layer of the GI tract and communicates with your intestinal cells.

What’s the Mechanism Behind Akkermansia for Weight Loss?

Akkermansia for Weight Loss: Truth or Trend? - Dr. Michael Ruscio, DC (2)

Let me preface this by saying that much of the research on Akkermansia has been completed on animals (namely murine models). This doesn’t necessarily mean Akkermansia isn’t worth taking a closer look at, it just means the research isn’t there yet to make solid claims about its benefits for humans.

When it comes to weight management, Akkermansia muciniphila may provide its benefits in several ways [2, 3]:

  • Appetite suppression
  • Increasing insulin sensitivity and glucose tolerance
  • Lowering insulin resistance
  • Improved gut barrier integrity

Let me break the research down on each of these.

Appetite Suppression

Akkermansia muciniphila may help your body get better at controlling how much you eat.

Research suggests that Akkermansia can influence your levels of hormones like PYY and GLP-1, which are known to suppress appetite and control the amount of food you eat. Having higher levels of these hormones may lead to healthy appetite control—essentially, you feel fuller more quickly and for a longer period of time after you eat, which can add up to eating less. Less food eaten hypothetically translates into weight loss [2].

Insulin Sensitivity and Glucose Tolerance

Akkermansia may improve how your body handles sugar since it can increase GLP-1.

GLP-1 helps glucose homeostasis by encouraging the secretion of insulin (lowers blood sugar) and slowing the release of glucagon (raises blood sugar) [2]. One recent study in 76 people with type 2 diabetes (some participants were on the medication metformin) found diet, exercise, and supplementing with a 5-strain probiotic that included Akkermansia for 3 months led to a 15 mg/dL drop in blood glucose after eating. The group receiving a 3-strain probiotic with Bifidobacterium/Clostridium strains had a postprandial drop in blood glucose of 11 mg/dL. However, neither of the groups had changes in their fasting glucose or HbA1c levels [3].

Akkermansia has also been shown to improve glucose tolerance and insulin sensitivity in obese mice (where researchers fed mice a high-fat diet) [2].

Gut Barrier Integrity

Akkermansia may help you maintain the integrity of your gut barrier.

The small intestine barrier is likely the most important structure in the gastrointestinal tract. It helps us regulate what should stay in our gut (or exit our body in the stool) and what should be absorbed into our circulation (i.e., nutrients). When the intestinal barrier is disrupted (often by microbial dysbiosis), also known as leaky gut, harmful gut bacteria, toxins (like lipopolysaccharide), and undigested food particles can enter our circulation. This increased intestinal permeability stimulates the immune system to get involved and unleashes a whole cascade of events that can increase inflammation. Leaky gut and higher levels of inflammation can impact how our body manages fat making it tough to lose weight or even encourage weight gain [2].

Mice on a high-fat diet (HFD) who receive Akkermansia supplements tend to have reduced fat mass (adipose tissue) and higher levels of anti-inflammatory cytokines, indicating it may help to lower inflammation and promote homeostasis [2].

To sum this up, there’s some mechanistic data to show Akkermansia may be helpful for weight loss. But, it’s certainly not a stand-alone option, and this is what the totality of probiotic research shows as well. Overall, the evidence is mixed; some previous studies support the use of probiotics for improving metabolic diseases and weight, while others find minimal benefits when it comes to weight [4, 5]. This doesn’t mean we throw the baby out with the bathwater. It just means probiotics aren’t a great option for significant weight loss on their own—but they may be helpful as part of a comprehensive weight loss plan.

Key Takeaway: It’s possible that Akkermansia may have beneficial effects on weight loss related to its impact on appetite regulation, glucose metabolism, insulin sensitivity, and gut barrier function. The majority of the research is in mice, so we can’t really draw any firm conclusions yet.

Research-Backed Weight Loss Strategies

Akkermansia for Weight Loss: Truth or Trend? - Dr. Michael Ruscio, DC (3)

We don’t have solid research that says taking the probiotic Akkermansia leads to weight loss. That being said, if you’ve been taking Akkermansia and it’s working well for you, that’s great, and there’s no need to stop.

If you’re just starting on your weight loss journey, I want to reassure you that we have many effective, natural therapies that can help you achieve your goals.

When it comes to weight loss strategies, a comprehensive plan that addresses diet, exercise, and lifestyle is probably the most effective option. I know it’s not exciting or flashy, and for some people it means a complete lifestyle change, but we have massive amounts of research showing the benefits of these therapeutics for weight loss.

Diet for Weight Loss

There’s no one-size-fits-all dietary pattern—the key is to find what works best for your body. Some people do better with less carbs and more protein and fat, others do well with more moderate carbohydrate consumption. Higher protein diets (15–25% of calories) may help with fat and weight loss by increasing your resting metabolic rate and promoting muscle mass [6, 7, 8, 9], but this is not true for low-protein diets (5% of calories) [10, 11].

While we can’t say there’s one perfect diet for weight loss, there is one caveat that applies to us all—we really need to avoid ultra-processed foods and excessive amounts of added sugars as both of these are linked with not only weight and metabolic health concerns but other serious chronic diseases as well.

If you need more incentive to go for whole foods, research suggests that eating whole foods, as opposed to processed ones, significantly increases the calories you burn during digestion [12].

When you’re trying to determine which long-term dietary pattern is right for you, high-quality research trials have shown these whole-foods options to induce significant weight loss, especially if you pair them with regular exercise:

Interestingly, both a ketogenic diet [19] and a diet rich in polyphenols and prebiotics [20] can naturally increase your levels of Akkermansia.

If you’re interested in a more tailored meal plan, you can always work with a registered dietitian or certified nutrition specialist.

In addition to your dietary pattern, you may want to avoid eating small, frequent meals or grazing. This habit may encourage weight gain and more fat around your belly and in your liver when compared to eating fewer, larger meals [10]. Whereas eating 2–3 larger meals each day may increase the calories you burn during digestion [12]. Additionally, layering in some intermittent fasting may aid in your weight loss efforts [21, 22, 23, 24, 25, 26, 27, 28, 29].

Exercise for Weight Loss

No surprise here, but exercise should be a foundational component of your weight loss plan. Resistance training (about 3 days per week) especially promotes building and maintaining muscle mass, which can increase your resting metabolic rate—this means you’ll burn more calories overall [30, 31]. Moderate-to-high intensity exercise (cardiovascular or a combination of cardio and strength) may improve the health of your gut microbiome, which can positively impact your metabolism [32, 33, 34].

If you’re new to exercise, I encourage you to start off by walking as much and as often as you can [35]. Once you get that foundation set, you may want to experiment with resistance training and other forms of cardiovascular exercise that can support your weight loss efforts. And working with an exercise professional is a great way to learn what works best for your body.

Additional Weight Loss Strategies

Diet and exercise are foundational for weight loss, but lifestyle changes are equally important. Let’s talk about some other simple foundations you can focus on outside of food and movement.

Restful Sleep

A lack of quality sleep contributes to many health conditions, including heart disease [36], obesity [36, 37, 38, 39] metabolic disorders like metabolic syndrome [36], poor brain function [36], and of course, fatigue [36].

Resetting your sleep schedule is a vitally important kind of self-care. Here’s a quick summary of research-backed options for improving your sleep:

  • Set a bedtime routine and a consistent bedtime and waking time. Avoid all-nighters and shift work if possible. Try to eat dinner at least two hours before bedtime.
  • Avoid bright lights and screen use for at least two hours before bed [40].
  • Modify your bedroom environment (temperature, lights, sounds) to support good sleep [41].
  • Address breathing problems, like mouth breathing, snoring, sleep apnea, or allergies, by consulting with a medical professional [42, 43, 44]
  • Exercise regularly, but avoid vigorous exercise close to bedtime [45].
  • Try taking melatonin to help you fall asleep quickly, and take probiotics for general sleep support [46, 47, 48, 49, 50, 51, 52].

Stress Management

Stress impacts your energy by affecting memory and learning, digestion, heart health, sleep, immune function, and hormones [53]. If you have unmanaged stress, you’re at risk of leaky gut and increased inflammation, which can lead to weight gain [54, 55]. Practicing mindfulness meditation, yoga, deep breathing exercises, and time in nature can help to normalize your stress response, reduce inflammation, and keep your gut healthy [56].

Red Light Therapy and Cold Exposure

While not foundational therapies for weight loss, red light therapy and cold exposure may be helpful when added to a comprehensive weight loss plan.

Red light therapy promises to boost our metabolism using low-level red light to enact the modulation of key metabolites, promoting fat breakdown and enhancing overall metabolic function. While red light therapy may help to reduce body fat and change your body composition, it may only contribute minimally to weight loss [57, 58, 59].

Cold exposure is similar in that it may increase your metabolism at rest and after exercise. Cold exposure may also activate brown fat, which can break down sugar and fat molecules [60, 61, 62].

Key Takeaways: We have the most research to support the use of a whole-food diet and exercise for weight loss. But optimizing sleep, managing stress levels, and trying red light therapy and cold exposure may enhance your results.

Is It Worth It to Try Akkermansia?

Akkermansia for Weight Loss: Truth or Trend? - Dr. Michael Ruscio, DC (4)

With the research we currently have, it’s too early for us to draw any firm conclusions about the effects of Akkermansia on human health. But whether or not you try Akkermansia for weight loss is totally up to you. It does seem to be safe in the short term, but we don’t have any long-term safety studies yet, and we don’t have any firm direction on the amount you need to take for a clinical benefit.

It’s important to remember that the intestinal microbiota can’t be micromanaged or simplified to the actions of a single microbial strain. The truth is, your gut microbiota composition is unique to you, and it’s extremely complex. While Akkermansia is an interesting focus of research, we must consider the broader context. It’s new and intriguing but the claims that have been made about it thus far just aren’t supported by the research we have.

That being said, if you’ve tried diet, exercise, and other lifestyle strategies for weight loss and you want to give probiotics a try, I’d recommend supplementing with other options since we have a ton of high-quality research. In the clinic, we use the triple therapy probiotic approach—this just means we use three different categories of probiotics together (Lactobacillus/Bifidobacteria blend, Saccharomyces boulardii, and soil-based). Monitor your progress and give it 2–3 months to see maximum benefit.

Key Takeaways: Once you have your healthy foundation set with diet, exercise, and lifestyle, if you’d like to try probiotics, consider forgoing Akkermansia and instead go for probiotic options that have much more research.

Stick with the Foundations for Weight Loss

When it comes to new products and supplements, I’m as hopeful as the next person. But I’ve learned, sometimes the hard way, that I need to remove the rose-colored glasses and really investigate the evidence. I’m not saying we always need to have tons of research before we try a novel therapeutic. But in the case of Akkermansia for weight loss, the evidence so far is quite underwhelming, at least as a stand-alone therapy.

Fortunately, we have many tried and true weight loss solutions if that’s your goal. A wholesome dietary pattern (that limits grazing and incorporates intermittent fasting) and exercise are very effective foundational strategies. Lifestyle measures that optimize sleep and stress, and possibly adding in red light therapy, cold exposure, and triple therapy probiotics may help enhance your results.

Whatever you decide, it’s crucial to tune into your body’s responses and choose the path that feels most aligned with your wellness goals. We’d love to support you in your health journey, so contact us for an appointment at the Ruscio Institute for Functional Health.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

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➕ Links & Resources

Further Reading:

  • Improve Your Body Composition in 3 Steps
  • What is Resistance Training: Your Guide to Build Muscle Safely and Sustainably
  • Weekend Warrior: Does Exercising Weekends Only Work?

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