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In this review, we discuss a broad range of clinical approaches that warrant attention to provide comprehensive and patient\u2010centred medical care to liver transplant recipients, and to be prepared to confront the rapidly changing clinical challenges and ensuing dilemmas.\u00a0Adipose tissue is a complex and metabolically active organ. Visceral fat deposition is a key predictor of overall obesity\u2010related morbidity and mortality. Limited pharmacological options are available for the treatment of obesity in the liver transplant population. Bariatric surgery may be an alternative in eligible patients. The rapidly increasing prevalence of nonalcoholic fatty liver disease (NAFLD) is a global concern; NAFLD affects both pre\u2010 and posttransplantation outcomes. Numerous studies have investigated pharmacological and nonpharmacological management of NAFLD and some of these have shown promising results. Liver transplant recipients are constantly exposed to numerous factors that result in intestinal microbiota alterations, which were linked to the development of obesity, diabetes type 2, metabolic syndrome (MS), NAFLD, and hepatocellular cancer. Microbiota modifications with probiotics and prebiotics bring gratifying results in the management of metabolic complications. Fecal microbiota transplantation (FMT) is successfully performed in many medical indications. However, the safety and efficacy profiles of FMT in immunocompromised patients remain unclear. Obesity together with immunosuppressive treatment, may affect the pharmacokinetic and\/or pharmacodynamic properties of coadministered medications. Individualized immunosuppressive regimens are recommended following liver transplantation to address possible metabolic concerns.\u00a0Effective and comprehensive management of metabolic complications is shown to yield multiple beneficial results in the liver transplant population and may bring gratifying results in improving long\u2010term survival rates.<\/jats:p>","DOI":"10.1002\/iid3.538","type":"journal-article","created":{"date-parts":[[2021,10,2]],"date-time":"2021-10-02T14:11:10Z","timestamp":1633183870000},"page":"3-21","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5820-0548","authenticated-orcid":false,"given":"Kinga","family":"Czarnecka","sequence":"first","affiliation":[{"name":"Department of Transplant 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