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The gut microbiota plays a pivotal role in regulating host energy metabolism, and dysbiosis, an imbalance in its composition and function, is strongly linked to obesity development and progression, Traditional Chinese medicine (TCM) has long been utilized for weight management, yet \u201cefficiency limitations\u201d and \u201cresource waste\u201d remain significant concerns. This comprehensive review explores the emerging approach of using probiotic-fermented herbal residues for obesity management. We examine how fermentation technologies transform herbal byproducts into high-value anti-obesity preparations through biological processes that enhance bioactive compounds, improve bioavailability, and modulate the gut-liver axis. 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