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The primary outcome was weight regain after cessation of weight management drugs, and secondary outcomes were changes in cardiometabolic markers (HbA 1c , blood pressure, total cholesterol and triglycerides)

The coverages of nifH and 16S rRNA genes in each metagenomic sample were calculated using Coverm v0.6.1 in contig mode ( (parameters: -min-read-percent-identity 80 (70 for the 16S rRNA gene) -min-read-aligned-percent 75 -methods reads_per_base) based on the customized nifH and 16S database described above