The obesity epidemic has proven to have a significant burden on the current of state of healthcare. At an individual level, obesity and its sequelae have numerous effects on the state of health and quality of life. On a global perspective, treatment of obesity and its sequelae come at a high cost. Obesity, in terms of intestinal dysbiosis, is a complicated disequilibrium that offers many unclear complications. Thus, restoration of the commensal microflora serves a potential therapeutic option in combatting the obesity epidemic be it via antibiotic therapy, probiotics, prebiotics, symbiotics (combination of prebiotic and probiotic therapy), or fecal microbiota transplant. This manuscript will review the role of intestinal dysbiosis in the pathogenesis of obesity and the potential role for microflora manipulation as therapy.