Stool samples will be collected at pre-baseline and 2 weeks before the end of the weight loss and weight maintenance phases using OMNIgene GUT DNA Stabilization Kits (DNA Genotek). DNA extraction will be performed using MoBio Powerlyzer Powersoil DNA Isolation Kit (MoBio Laboratories, Carlsbad, California, USA) as described previously.96 (link) DNA concentration will be quantified fluorometrically with a Qubit dsDNA HS Assay kit (Life Technologies). Faecal microbial composition will be assessed by 16S rRNA amplicon sequencing.97 (link) This analysis will include determination of Firmicutes:Bacteroidetes ratios and quantification of Akkermansia muciniphila abundance. A subsample of highest responders (n=10) and lowest responders (n=10) (based on weight regain) will also undergo more detailed analysis of samples from pre-baseline, end of weight loss and end of weight maintenance. Samples will be assessed for identification of responder/non-responder phylogenetic and functional traits using shotgun metagenomic sequencing.98 (link)