Footnotes

• Twitter @wingyanjoyce, @thetunlab

• Contributors ZX performed the experiments and data analyses and drafted the manuscript. YL assisted in data analysis. KY, QL and FZ assisted in sample preparation and experiments. JWYM and LL conducted faecal microbiota transplantation in the clinic. WT and JYLC assisted in clinical data and specimen management. HMT, PC, FKLC and SCN designed and supervised the clinical study, revised the manuscript and provided critical intellectual contribution.

• Funding This study received funding support from InnoHK, The Government of Hong Kong, Special Administrative Region of the People’s Republic of China (grant number not available (NA)).

• Competing interests FKLC is the co-founder, non-executive Board Chairman and shareholder of GenieBiome Ltd. FKLC is Board Member of CUHK Medical Centre. FKLC has received fees as an advisor and honoraria as a speaker for Eisai Co. Ltd., AstraZeneca, Pfizer Inc., Takeda Pharmaceutical Co., and Takeda (China) Holdings Co. Ltd. FKLC receives patent royalties through his affiliated institutions in the applications of microbiome. SCN is a scientific co-founder and shareholder of GenieBiome Ltd. SCN has served as an advisory board member for Pfizer, Ferring, Janssen, and Abbvie and received honoraria as a speaker for Ferring, Tillotts, Menarini, Janssen, Abbvie, and Takeda. SCN has received research grants through her affiliated institutions from Olympus, Ferring, and Abbvie. SCN receives patent royalties through her affiliated institutions in the applications of microbiome. ZX, and WT are part-time employee of GenieBiome Ltd. JYLC received personal fees from GenieBiome Ltd. SCN, FKLC, ZX, QL are named inventors of patent applications held by the CUHK and MagIC that covers the therapeutic and diagnostic use of microbiome related to FMT or obesity.All other co-authors declare no competing interests.

• Provenance and peer review Not commissioned; internally peer reviewed.

• © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

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