38 Effect of the GLP-1 Analogue Exenatide on Functional Connectivity Within Hedonic and Homeostatic Brain Networks in Lean and Obese Women

Abstract

G A A b st ra ct s developed pulmonary embolism. Percentage total body weight loss (TBWL) was 14.2 ± 3.3%, 15.4 ± 6%, 17 ± 8%, and 14 ± 12% at 3, 6, 9, 12 months, respectively (p=0.002). Fifty percent of subjects had a good response to ESG at 12 months with an average weight loss of 22 ± 5 kg representing 80 ± 12% excess weight loss (%EWL). Forty percent of the cohort had minimal response to ESG at 12 months with and average weight loss of only 3.2 ± 2.8 kg, and one subject was lost to follow-up. Patients reported improvement in all domains of eating behavior (cognitive restraint [p=0.02], emotional eating [p=0.006], and uncontrolled eating [p=0.06] assessed by TFEQ21. Repeat upper endoscopy at 3 months showed intact sleeve gastroplasty with formation of fibrotic bridges. ESG significantly alters satiation with lower caloric intake to reach maximum fullness leading to termination of the meal from 1086±302 kcal pre-ESG to 446±198 kcal post-ESG (p= 0.003). Furthermore, ESG significantly delays gastric emptying of solids with an 82 minute (79%) increase in time to empty 50% of the ingested meal (p=0.03). ESG improves insulin sensitivity (p= 0.05). Serum leptin significantly decreases after ESG (p <0.001); however, ghrelin levels fail to increase despite significant weight loss. Conclusions: ESG appear to produce significant weight loss and perturbations in gastric function and eating behavior in a significant portion of subjects.