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According to the World Health Organization (WHO), the widespread problem of overweight and obesity is the fifth most important risk factor for deaths in the world. The most frequently mentioned are the genetic and environmental factors that lead to the absorption of excess energy from food and to accumulate it in the form of spare adipose tissue. Another important fact is that even the use of a low-energy diet does not support the effective reduction of excessive body weight. It turns out that the cause may be intestinal microbiota, the composition of which changes in people with overweight and obesity. The intestinal microbiota dysbiosis is additionally perceived by many researchers as the cause of the development of metabolic diseases, including obesity or type 2 diabetes. On the other hand, Gram-negative bacteria constituting a component of the intestinal ecosystem are the source of lipopolysaccharide (LPS), responsible for the development of systemic inflammation and endotoxemia. Based on a literature review related to the subject, it can be concluded that intestinal microbiota disorders, intestinal barrier damage and increased LPS levels in patients adversely affect the obesity and components of the metabolic syndrome and hinder the treatment of these diseases.