Appetite Suppression by GLP ‐1 Receptor Agonists: Role of Delayed Gastric Emptying

OBJECTIVE: This study aimed to evaluate relationships between delayed gastric emptying and appetite suppression during treatment with liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA). METHODS: We conducted a secondary data analysis from a 16-week randomized, placebo-controlled liraglutide trial in patients with obesity. We examined correlations between solid food gastric emptying and measurements of satiation and energy intake in the entire cohorts at baseline and end of treatment and separately in placebo- and liraglutide-treated patients who completed the trial. We also compared appetitive measures among liraglutide-treated participants who displayed either normal, persistently delayed, or transiently delayed emptying during treatment. RESULTS: In the entire cohorts at baseline and completion, gastric emptying correlated significantly with energy intake and, at baseline, with one parameter of satiation. Gastric emptying accounted for only 4%-6% of the variance in these appetitive measures. No such correlations were found in the placebo- or liraglutide-treated groups alone. There were no differences in appetitive measures among the subgroups that displayed different gastric emptying patterns during liraglutide treatment. CONCLUSIONS: Delayed gastric emptying appears to play little direct role in appetite suppression induced by liraglutide. Further research should explore whether delayed emptying or other gastrointestinal effects of other GLP-1RAs affect appetite directly or indirectly. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02647944.