Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Clinical Research

Association between gastrointestinal phenotypes and weight gain in younger adults: a prospective 4-year cohort study

International Journal of Obesity volume 44, pages 2472–2478 (2020)Cite this article

Subjects

Abstract

Background/objectives

Gastrointestinal phenotypes have previously been associated with obesity, however it is unknown if these phenotypes are a cause or a consequence of obesity and weight gain. Our aim was to assess whether these gastrointestinal phenotypes are associated with future weight gain in younger adults.

Subjects/methods

At baseline, 126 adult participants under the age of 35 were weighed and underwent measurement of gastrointestinal phenotypes including gastric emptying (GE), gastric volume, satiation, satiety, and gastrointestinal hormones. Patients were reappraised after median 4.4 years unless, during the period of follow-up, they participated in a formal weight loss program, received obesity-weight loss interventions, or developed a health condition likely to affect weight. Participants were dichotomized into two groups for each phenotype at the median of each phenotype.

Results

In total, 60 participants met criteria for inclusion and were evaluated after a median of 4.4 years [IQR: 3.5–5], 36 participants were excluded due to conditions that would abnormally affect weight during study period including pregnancy and weight loss treatment, and 30 participants were lost to prospective follow-up. Faster GE was significantly associated with weight gain. Those with faster GE at baseline (n = 30) gained a median of 9.6 kg [3.1–14.9] compared with those with slower GE at baseline (n = 30) who gained a median of 2.8 kg [−4.6 to 9.2] (p = 0.03), over the follow-up period. There was no association between the other phenotypes and weight gain.

Conclusions

In adults ≤35 years old, faster gastric emptying is associated with significantly increased weight gain over the medium term. This provides supportive evidence for the role of gastric emptying in weight gain and development of obesity.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2: Baseline gastric emptying is associated with weight gain in young adults.

References

  1. Acosta A, Streett S, Kroh MD, Cheskin LJ, Saunders KH, Kurian M, et al. White Paper AGA: POWER—practice guide on obesity and weight management, education, and resources. Clin Gastroenterol Hepatol. 2017;15:631–49.e10.

    Article  Google Scholar 

  2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.

    Article  Google Scholar 

  3. Acosta A, Abu Dayyeh BK, Port JD, Camilleri M. Recent advances in clinical practice challenges and opportunities in the management of obesity. Gut. 2014;63:687–95.

    Article  CAS  Google Scholar 

  4. Heymsfield SB, Wadden TA. Mechanisms, pathophysiology, and management of obesity. N Engl J Med. 2017;376:254–66.

    Article  CAS  Google Scholar 

  5. Acosta A, Camilleri M, Shin A, Vazquez-Roque MI, Iturrino J, Burton D, et al. Quantitative gastrointestinal and psychological traits associated with obesity and response to weight-loss therapy. Gastroenterology. 2015;148:537–46.e4.

    Article  Google Scholar 

  6. Halawi H, Khemani D, Eckert D, O’Neill J, Kadouh H, Grothe K, et al. Effects of liraglutide on weight, satiation, and gastric functions in obesity: a randomised, placebo-controlled pilot trial. Lancet Gastroenterol Hepatol. 2017;2:890–9.

    Article  Google Scholar 

  7. Acosta A, Camilleri M, Burton D, O’Neill J, Eckert D, Carlson P, et al. Exenatide in obesity with accelerated gastric emptying: a randomized, pharmacodynamics study. Physiol Rep. 2015;3:e12610.

  8. Gomez V, Woodman G, Abu Dayyeh BK. Delayed gastric emptying as a proposed mechanism of action during intragastric balloon therapy: results of a prospective study. Obesity. 2016;24:1849–53.

    Article  Google Scholar 

  9. Williamson DF, Kahn HS, Remington PL, Anda RF. The 10-year incidence of overweight and major weight gain in US adults. Arch Intern Med. 1990;150:665–72.

    Article  CAS  Google Scholar 

  10. Lloyd-Jones DM, Dyer AR, Wang R, Daviglus ML, Greenland P. Risk factor burden in middle age and lifetime risks for cardiovascular and non-cardiovascular death (Chicago Heart Association Detection Project in Industry). Am J Cardiol. 2007;99:535–40.

    Article  Google Scholar 

  11. Lloyd-Jones DM, Liu K, Colangelo LA, Yan LL, Klein L, Loria CM, et al. Consistently stable or decreased body mass index in young adulthood and longitudinal changes in metabolic syndrome components: the Coronary Artery Risk Development in Young Adults Study. Circulation. 2007;115:1004–11.

    Article  Google Scholar 

  12. Nelson MC, Story M, Larson NI, Neumark-Sztainer D, Lytle LA. Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change. Obesity. 2008;16:2205–11.

    Article  Google Scholar 

  13. Lytle LA, Svetkey LP, Patrick K, Belle SH, Fernandez ID, Jakicic JM, et al. The EARLY trials: a consortium of studies targeting weight control in young adults. Transl Behav Med. 2014;4:304–13.

    Article  Google Scholar 

  14. Lytle LA, Moe SG, Nanney MS, Laska MN, Linde JA. Designing a weight gain prevention trial for young adults: the CHOICES Study. Am J Health Educ. 2014;45:67–75.

    Article  Google Scholar 

  15. Bouras EP, Delgado-Aros S, Camilleri M, Castillo EJ, Burton DD, Thomforde GM, et al. SPECT imaging of the stomach: comparison with barostat, and effects of sex, age, body mass index, and fundoplication. Single photon emission computed tomography. Gut. 2002;51:781–6.

    Article  CAS  Google Scholar 

  16. Chial HJ, Camilleri C, Delgado-Aros S, Burton D, Thomforde G, Ferber I, et al. A nutrient drink test to assess maximum tolerated volume and postprandial symptoms: effects of gender, body mass index and age in health. Neurogastroenterol Motil. 2002;14:249–53.

    Article  CAS  Google Scholar 

  17. Vazquez Roque M, Camilleri M, Stephens D, Jensen M, Burton D, Baxter K, et al. Gastric sensorimotor functions and hormone profile in normal weight, overweight, and obese people. Gastroenterology. 2006;131:1717–24.

    Article  CAS  Google Scholar 

  18. Camilleri M, Iturrino J, Bharucha AE, Burton D, Shin A, Jeong ID, et al. Performance characteristics of scintigraphic measurement of gastric emptying of solids in healthy participants. Neurogastroenterol Motil. 2012;24:1076–e562.

    Article  CAS  Google Scholar 

  19. Loos RJF, Janssens A. Predicting polygenic obesity using genetic information. Cell Metab. 2017;25:535–43.

    Article  CAS  Google Scholar 

  20. Duffey KJ, Gordon-Larsen P, Jacobs DR Jr., Williams OD, Popkin BM. Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the Coronary Artery Risk Development in Young Adults Study. Am J Clin Nutr. 2007;85:201–8.

    Article  CAS  Google Scholar 

  21. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011;364:2392–404.

    Article  CAS  Google Scholar 

  22. van Can J, Sloth B, Jensen CB, Flint A, Blaak EE, Saris WH. Effects of the once-daily GLP-1 analog liraglutide on gastric emptying, glycemic parameters, appetite and energy metabolism in obese, non-diabetic adults. Int J Obes. 2014;38:784–93.

    Article  Google Scholar 

  23. Vella A, Lee JS, Camilleri M, Szarka LA, Burton DD, Zinsmeister AR, et al. Effects of pramlintide, an amylin analogue, on gastric emptying in type 1 and 2 diabetes mellitus. Neurogastroenterology Motil. 2002;14:123–31.

    Article  CAS  Google Scholar 

  24. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999;282:1523–9.

    Article  CAS  Google Scholar 

  25. Vella A, Camilleri M. The gastrointestinal tract as an integrator of mechanical and hormonal response to nutrient ingestion. Diabetes. 2017;66:2729–37.

    Article  CAS  Google Scholar 

  26. Halawi H, Camilleri M, Acosta A, Vazquez-Roque M, Oduyebo I, Burton D, et al. Relationship of gastric emptying or accommodation with satiation, satiety, and postprandial symptoms in health. Am J Physiol Gastrointest Liver Physiol. 2017;313:G442–7.

    Article  Google Scholar 

  27. Meyre D, Delplanque J, Chèvre J-C, Lecoeur C, Lobbens S, Gallina S, et al. Genome-wide association study for early-onset and morbid adult obesity identifies three new risk loci in European populations. Nat Genet. 2009;41:157.

    Article  CAS  Google Scholar 

  28. Ramachandrappa S, Farooqi IS. Genetic approaches to understanding human obesity. J Clin Investig. 2011;121:2080–6.

    Article  CAS  Google Scholar 

  29. Acosta A, Camilleri M, Shin A, Carlson P, Burton D, O’Neill J, et al. Association of melanocortin 4 receptor gene variation with satiation and gastric emptying in overweight and obese adults. Genes Nutr. 2014;9:384.

    Article  Google Scholar 

  30. Vazquez-Roque MI, Camilleri M, Vella A, Carlson P, Laugen J, Zinsmeister AR. Association of TCF7L2 allelic variations with gastric function, satiation, and GLP-1 levels. Clin Transl Sci. 2011;4:183–7.

    Article  CAS  Google Scholar 

Download references

Funding

MC is supported by NIH RO1-DK67071. AA is supported by NIH (C-Sig P30DK84567, K23-DK114460) and ANMS Career Development Award.

Author information

Authors and Affiliations

  1. Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Rochester, MN, 55905, USA

    Gregory Pajot, Michael Camilleri, Gerardo Calderon, Judith Davis, Deborah Eckert, Duane Burton & Andres Acosta

  2. Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, 55905, USA

    Gregory Pajot, Michael Camilleri, Gerardo Calderon, Judith Davis, Deborah Eckert, Duane Burton & Andres Acosta

Authors
  1. Gregory Pajot
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Camilleri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gerardo Calderon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Judith Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Deborah Eckert
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Duane Burton
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andres Acosta
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AA conceived the idea of the study, GP and AA designed the study protocol. DE and DB assisted with baseline laboratory measurements. GC and JD mailed questionnaires to participants. GP and GC conducted review of electronic medical records and review of questionnaires. Statistical analysis was performed by GP, AA, GC, and MC. The paper was drafted and revised by GP, AA, and MC. The final paper was approved by all authors.

Corresponding author

Correspondence to Andres Acosta.

Ethics declarations

Conflict of interest

AA is a stockholder in Gila Therapeutics, Phenomix Sciences and Lipiquester; he serves as a consultant for Rhythm Pharmaceuticals, General Mills, Gila Therapeutics. MC is a stockholder in Phenomix Sciences and serves as a consultant to Takeda, Allergan, Rhythm, Salix, Arena, Enterin.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pajot, G., Camilleri, M., Calderon, G. et al. Association between gastrointestinal phenotypes and weight gain in younger adults: a prospective 4-year cohort study. Int J Obes 44, 2472–2478 (2020). https://doi.org/10.1038/s41366-020-0593-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-020-0593-8

Search

Advanced search

Quick links