In this interview, Professor Alessio Fasano, a distinguished expert in gastroenterology and microbiome science, delves into his groundbreaking research on the physiology of hunger, as explored in his recent article published in The New England Journal of Medicine. 

The discussion highlights the complex interplay between homeostatic, hedonic, and microbiota-driven mechanisms in regulating hunger. Professor Fasano explains the evolutionary roots of hunger, distinguishing between the ancestral homeostatic hunger that ensures survival and the more recent hedonic hunger, driven by pleasure and environmental influences, which can lead to obesity and eating disorders. 

He also introduces microbiota-driven hunger, a concept that explores the influence of gut bacteria on hunger regulation through metabolic, neuroendocrine, and nervous system pathways.

The interview addresses the role of key hormones like ghrelin and leptin, as well as short-chain fatty acids, in controlling hunger. Professor Fasano emphasizes the growing importance of microbiome-based interventions in treating obesity and eating disorders, suggesting that understanding how the microbiota influences hunger could offer a promising avenue for developing personalized treatments. 

The discussion also touches on the impact of the Western diet, which favors hedonic hunger, and offers guidance for healthcare professionals on dietary modifications that promote a balance between the two forms of hunger. 

Ultimately, the interview envisions a future where microbiome-targeted therapies, combined with precision nutrition, could reshape the management of hunger-related disorders and improve public health outcomes.