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Influences of fat restriction and lipase inhibition on gastric emptying in obesity

International Journal of Obesity volume 30, pages 1203–1210 (2006)Cite this article

Abstract

Objective:

Accelerated gastric emptying of solids may play a role in the pathogenesis of obesity. Orlistat, a potent lipase inhibitor, induces fat malabsorption and body weight loss but might accelerate gastric emptying as a result of suppressed CCK release. The aim was to investigate the role of fat restriction and lipase inhibition in CCK release and gastric emptying.

Subjects:

A total of 28 patients (three male (M)/25 female (F); mean (s.d.) BMI 37.4(3.9) kg/m2) entering a randomized, double-blind, placebo-controlled study.

Measurements:

CCK release and gastric emptying by scintigraphy at the start (T0), after 1 month of an energy- and fat-restricted diet and placebo (T1), and after 1 month (T2) and 1 year (T3) of randomization to placebo or 120 mg orlistat three times a day.

Results:

One month of dieting and a weight loss of 2.3 kg (2.1% of initial weight) did not affect gastric emptying of liquids and solids. Basal and meal-stimulated CCK levels remained unaltered. Placebo-treated subjects who continued the diet for 1 month demonstrated a borderline significant suppressed CCK secretion and a weight loss of 1.2 kg (1.0%) without an effect on gastric emptying. After 1 year, the CCK secretion recovered to or beyond values at the start. A significantly slower emptying of solids (17.6 (T3) versus 25.9 (T1)%/h) and a weight loss of 10.4 kg (9.9%) was observed. Subjects on 120 mg orlistat lost 2.5 kg (2.5%) after 1 month, and 9.8 kg (9.9%) after 1 year. Basal and postprandial CCK release decreased significantly after the first month of orlistat treatment but normalized after 1 year. Diet and lipase inhibition did not have any influence on gastric emptying.

Conclusion:

Energy and fat restriction of 1 month did not alter gastric emptying in the whole group. Continuation of the diet for 1 year resulted in a delayed gastric emptying of solids. Lipase inhibition did not result in a sustained depressed CCK release and the anticipated acceleration of gastric emptying did not occur.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    E M H Mathus-Vliegen

  2. Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

    M L van Ierland-van Leeuwen

  3. Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    R J Bennink

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  1. E M H Mathus-Vliegen
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  2. M L van Ierland-van Leeuwen
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  3. R J Bennink
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Correspondence to E M H Mathus-Vliegen.

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Mathus-Vliegen, E., van Ierland-van Leeuwen, M. & Bennink, R. Influences of fat restriction and lipase inhibition on gastric emptying in obesity. Int J Obes 30, 1203–1210 (2006). https://doi.org/10.1038/sj.ijo.0803255

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