Interview with Professor De Cristofaro and Dr. Mattioli
Introduction
GLP-1 agonists like liraglutide have become a powerful tool for weight management, but they often come with digestive side effects and concerns about long-term use. A recent study, published in the Journal of Pharmacy and Pharmacology Research, suggests that pairing these medications with Omni-Biotic Hetox (in the study the product is referred to as “Omni-Biotic MetaTox”, which is a European version equivalent to half the dose of Omni-Biotic Hetox) —may help enhance results while reducing side effects and preserving lean muscle mass.
In this interview, Dr. Mattioli and Professor De Cristofaro share insights from their research highlighting how probiotics can support gut health, improve the effectiveness of GLP-1 therapy, and minimize common side effects. Join me, Hannah, as we explore this exciting new approach to sustainable weight management.
Here's a sneak preview into what we cover in the interview:
- Probiotics Enhance GLP-1 Therapy – The study found that pairing a lower dose of liraglutide with Omni-Biotic Hetox (equivalent to half the dose of Omni-Biotic Hetox in the U.S.) led to similar weight loss results as a higher dose alone—while reducing side effects and preserving lean muscle mass.
- GLP-1 Agonists Can Disrupt Gut Health – These medications slow down digestion, increasing food exposure to gut bacteria. This can lead to secondary dysbiosis, worsening inflammation and digestive side effects like nausea, constipation, and diarrhea.
- Probiotics Reduce Side Effects – Taking Omni-Biotic Hetox before starting GLP-1 therapy helps strengthen the gut barrier and minimize gastrointestinal side effects. Gradual medication dose increase and fiber-rich diet further improve tolerance.
- Similar Results & Better Adherence – Patients on a lower-dose GLP-1 plus probiotics achieved similar weight loss in 3 months vs. 12 months on a higher dose. They also experienced fewer side effects, leading to better treatment adherence and lower costs.
- Probiotics Support Long-Term Weight Maintenance – After stopping GLP-1 therapy, continuing probiotics and prebiotics (like Omni-Logic Plus) helps maintain gut health, reduce inflammation, and support sustained metabolic benefits to prevent weight regain.
About the researchers
The Italian endocrinologist and nutritionist Professor Paolo De Cristofaro has over 30 years of experience in treating eating disorders and obesity. NUBEN S.R.L., a specialized center that focuses on clinical nutrition and multidisciplinary approaches to managing health conditions related to diet and lifestyle. It is also involved in advancing nutritional science through research. As a co-founder of Nubentech S.R.L., he developed the "Morphogram" project, an innovative tool for assessing body composition and health risks. Prof. De Cristofaro has been involved in various scientific societies, contributing to numerous publications and conferences in the field.
Dr. Marco Mattioli is a doctor in clinical nutrition with extensive expertise in managing obesity, eating disorders, and nutrition-related conditions across all ages. In his current practice, he applies a personalized, multidisciplinary approach to enhance patient health and well-being. Dr. Mattioli has a strong research background, including studies on immune responses and metabolic diseases during his time at the University of Modena and Reggio Emilia. Passionate about advancing health through nutrition, he actively contributes to scientific research and patient-centered care.
Hannah: Hello, and thank you for joining me today. I have with me Professor De Cristofaro and Dr. Mattioli to discuss their recent study on the combination of probiotics with GLP-1 agonists for weight management. Before we dive in, let me introduce our guests.
Professor De Cristofaro, Dr. Mattioli—thank you for being here today.
Dr. Mattioli: Thank you, Hannah, and thanks to the Omni-Biotic USA team for this opportunity to discuss our research.
The Study’s Key Findings
Hannah: Your recent study, published in the Journal of Pharmacy and Pharmacology Research, examined how probiotics impact GLP-1 agonist treatment. Specifically, you compared outcomes from a lower dose of liraglutide paired with Omni-Biotic Hetox versus a higher dose of liraglutide alone.
Remarkably, you found that using a lower dose of liraglutide with Omni-Biotic Hetox for three months yielded similar results to using a higher dose for 12 months. This is a promising finding, especially considering the side effects associated with GLP-1 medications. Can you elaborate on what these results mean for the field?
Dr. Mattioli: Absolutely. Our study highlighted two major findings. First, the combination of Omni-Biotic Hetox with liraglutide led to an improvement in gut microbiota, which plays a crucial role in metabolism. This was achieved alongside dietary adjustments—ensuring personalized meal distribution with adequate fiber intake.
Second, the probiotic amplified the effects of GLP-1 agonists by enhancing neurophysiological mechanisms and insulin sensitivity while reducing inflammation. This allowed for effective weight management at a lower dosage, minimizing side effects.
Comparison between study data and published data available from literature demonstrates that our patients have a reduction in weight, BMI and waist circumference comparable to the 1-year randomized study by Pi-Sunyer et al (DOI: 10.26502/fjppr.0102)
GLP-1 Agonists and the Gut Microbiome
Hannah: That’s fascinating. It aligns with what we know about how obesity is linked to gut dysbiosis—where the gut microbiome in obese individuals differs significantly from that of healthy individuals. What did your study reveal about the relationship between GLP-1 agonists and gut health?
Dr. Mattioli: One of our core findings is that obesity is associated with primary dysbiosis—reduced microbiota diversity and an increased presence of bacteria that extract more energy from food, leading to visceral fat accumulation and chronic inflammation.
GLP-1 agonists, while effective for weight loss, slow gastrointestinal motility. This prolongs food exposure to gut bacteria, increasing the risk of secondary dysbiosis and exacerbating gastrointestinal side effects like nausea, constipation, and diarrhea.
Hannah: So, essentially, these medications can disrupt the gut microbiome, potentially worsening metabolic health over time?
Dr. Mattioli: Exactly. Slower motility means food and waste sit longer in the gut, allowing for the overgrowth of certain bacteria while also increasing inflammation. This is referred to as “secondary dysbiosis” and can contribute to long-term metabolic imbalances.
Managing Side Effects of GLP-1 Agonists
Hannah: GLP-1 medications are known for digestive side effects. Did your study provide insights on how to mitigate them?
Dr. Mattioli: The majority of our patients show gastrointestinal side effects like nausea, vomiting, constipation, and diarrhea. What we’ve seen and also demonstrated in this study is that introducing a high-quality probiotic like Omni-Biotic Hetox prior to starting the GLP-1 therapy helps the patient to reduce or even avoid these side effects.
Hannah: Do you have any insights or advice from a clinical perspective on how one might be able to mitigate these GI side effects?
Yes, we recommend three key strategies:
- Start probiotics before beginning GLP-1 therapy. Taking Omni-Biotic Hetox 7–10 days beforehand strengthens the gut barrier and reduces inflammation, helping to prevent side effects.
- Gradual dose adjustments. Patients with a predisposition to digestive issues should start with half the recommended dose of GLP-1 agonists and increase gradually over several weeks.
- Dietary modifications. Eating smaller, fiber-rich meals (25–35g of fiber per day) reduces digestive strain and supports microbiota balance.
Hannah: That’s great advice. These steps seem practical and easy to implement while significantly improving patient experience.
Earlier you mentioned that one of the side effects of GLP-1 agonists can also be a secondary dysbiosis. Can you explain this a little more?
Dr. Mattioli: Yes. As mentioned before, the GLP-1 agonist reduces gastric motility. This means that the food (and waste) in the large intestine sits there for longer than usual, increasing exposure to our bacterial flora. This can change the balance of good vs bad bacteria and eventually lead to dysbiosis. The second effect is that our waste products move more slowly through the gastrointestinal tract. This means that there is a higher exposure to pathological bacteria which can increase intestinal inflammation. And with the inflammation come all the other consequences, including GI side effects, including diarrhea.
Comparing High-Dose vs. Low-Dose GLP-1 Treatment
Hannah: Your study compared lower-dose liraglutide plus probiotics to existing data on higher-dose liraglutide without probiotic support. What were the most striking differences?
Dr. Mattioli: We found that the lower-dose protocol yielded comparable weight loss and waist circumference reductions in just three months, whereas the higher-dose protocol required a full year. Additionally, the lower dose had fewer side effects and helped preserve lean mass.
Many previous studies have overlooked lean mass trends, focusing solely on weight loss. However, maintaining lean mass is crucial for metabolic health. Losing muscle during weight loss increases the risk of regaining weight after stopping GLP-1 therapy. Our approach helps preserve muscle while reducing body fat.
Hannah: That’s a major advantage. It’s impressive that you achieved similar weight loss results in a shorter time with fewer side effects.
Dr. Mattioli: Exactly. And since GLP-1 side effects are dose-dependent, using a lower dose significantly improves treatment adherence and patient experience, and reduces the overall cost of the treatment.
Long-Term Considerations and Discontinuing GLP-1 Agonists
Hannah: One common concern with GLP-1 agonists is maintaining weight loss after stopping the medication. What strategies do you recommend?
Dr. Mattioli: We’ve observed that patients who discontinue GLP-1 therapy often feel much better when continuing probiotic supplementation. Our approach includes:
- Continuing Omni-Biotic Hetox for at least one month after stopping GLP-1 therapy.
- Adding Omni-Logic Plus, a prebiotic fiber blend, to support beneficial bacteria like Akkermansia and Faecalibacterium prausnitzii, which are essential for metabolic health.
- Encouraging long-term lifestyle changes, including balanced nutrition and regular physical activity.
Hannah: That makes sense. So probiotics help maintain gut health and metabolic stability even after stopping GLP-1s?
Dr. Mattioli: Precisely. By reinforcing the gut microbiota, we reduce the risk of weight regain and support insulin sensitivity.
Final Thoughts
Hannah: This research is very encouraging. Your findings show that a lower-dose GLP-1 protocol, combined with Omni-Biotic probiotics, offers similar weight loss benefits in a shorter time with fewer side effects. This could reshape the way we approach obesity treatment.
Dr. Mattioli: Thank you. We believe this approach improves not only weight loss outcomes but also patient well-being. By addressing gut health, we can make GLP-1 therapy more sustainable and effective.
Hannah: Thank you both for sharing your insights.
Dr. Mattioli: Thank you for having us!
