Obesity: Treating Short-Lived Satiety

Patients who are obese may have a genetic makeup that causes their stomachs to empty faster than those of normal-weight people. Investigators say there is a drug that can help.

Some patients who are obese have accelerated gastric emptying compared to normal weight patients. That is a matter of genetics, a Mayo Clinic team reported at the 2015 Digestive Disease Week conference in Washington, DC. But drug treatment appears to help slow that process.

Andres Acosta, MD, PhD, and colleagues at the Rochester, MN institution reported on research with exanatide (Byetta/AstraZeneca), a glucagon-like peptide-1 agonist used for the treatment of type 2 diabetes.

The team assessed the drug’s effects on gastric emptying in patients who did not have diabetes.

“Our overall hypothesis was that anti-obesity therapy is more efficacious when the pharmacological effects of the agents are matched with the disturbance of function and with genetic variations that control the receptor targeted by the drug,” they wrote in their study abstract.

Patients in the study got the drug twice daily for 30 days.

Researchers evaluated subjects’ rates of gastric emptying, satiety, satiation and weight loss in the participants, 20 obese people with accelerate gastric emptying defined as emptying half of the solids ingested within 90 minutes. The normal rate is 121 minutes, the team said. (Satiation is defined as the point at which a person feels full and stops eating. Satiety is the length of time before that person gets hungry again).

They measured gastric emptying of solids by having participants consume Ensure, and satiety by how much they ate at an ad libitum buffet, that is, an offering of food that was set out and available whenever a participant wanted to eat.

The results were that “exenatide had a very significant effect” delaying gastric emptying by and reducing caloric intake at the buffet by an average of 130 calories.

During the study, participants lost an average of 1.3 kg. Patients who were genetically programmed to have faster gastric emptying showed the greatest weight loss, an average of 1.66 kg.

There were no reported side effects, the researchers reported.

They concluded “Exenatide reduces body weight and food intake and delays gastric emptying of solids.” Those whose genetic makeup includes TCF7L@res7903146 T allele showed the greatest weight loss. Such patients would be the ideal candidates for future studies, they wrote.