Abstract
BackgroundWhether gastrointestinal motor and sensory function is primary cause or secondary effect of abnormal body weight is uncertain. Moreover, studies relating continuous postprandial sensations of satiation to measurable pathology are scarce. This work assessed postprandial gastrointestinal function and concurrent sensations of satiation across a wide range of body weight and after weight change.MethodsPatients with anorexia nervosa (AN) and obesity (OB) were investigated in reference to normal weight controls (HC). AN were additionally investigated longitudinally. Gastric emptying, antral contractions and oro-cecal transit after ingestion of a solid meal were investigated by MRI and 13C-lactose-ureide breath test. The dependency of self-reported sensations of satiation on the varying degree of stomach filling during gastric emptying was compared between groups.Results24 AN (BMI 14.4 (11.9–16.0) kg/m2), 16 OB (34.9 (29.6–41.5) kg/m2) and 20 HC (21.9 (18.9–24.9) kg/m2) were studied. Gastric half-emptying time (t50) was slower in AN than HC (p = 0.016) and OB (p = 0.007), and a negative association between t50 and BMI was observed between BMI 12 and 25 kg/m2 (p = 0.007). Antral contractions and oro-cecal transit were not different. For any given gastric content volume, self-reported postprandial fullness was greater in AN than in HC or OB (p < 0.001). After weight rehabilitation, t50 in AN tended to become shorter (p = 0.09) and postprandial fullness was less marked (p < 0.01).ConclusionsA relationship between body weight and gastric emptying as well as self-reported feelings of satiation is present. AN have slower gastric emptying and heightened visceral perception compared to HC and OB. Longitudinal follow-up after weight rehabilitation in AN suggests these abnormalities are not a primary feature, but secondary to other factors that determine abnormal body weight.Trial registrationRegistered July 20, 2009 at ClinicalTrials.gov (NCT00946816).
Highlights
Whether gastrointestinal motor and sensory function is primary cause or secondary effect of abnormal body weight is uncertain
Exclusion criteria were age 60 years; history of gastrointestinal, cardiorespiratory, hematologic, renal or atopic disorders, diabetes, drug or alcohol abuse; abdominal surgery; regular intake of medication altering gut function; presence of metallic foreign bodies interacting with magnetic resonance imaging (MRI); claustrophobia; body dimensions too large to fit into MRI scanner; pregnancy and lactation
A relationship was detected between body weight and gastric emptying such that anorexic patients (AN) had slower gastric emptying than healthy controls (HC) or obese participants (OB)
Summary
Whether gastrointestinal motor and sensory function is primary cause or secondary effect of abnormal body weight is uncertain. Studies relating continuous postprandial sensations of satiation to measurable pathology are scarce. This work assessed postprandial gastrointestinal function and concurrent sensations of satiation across a wide range of body weight and after weight change. The central perception of satiation and satiety regulates food intake and is modulated by biophysical and neurohormonal feedback mechanisms originating from the gastrointestinal (GI) tract [5,6,7,8]. Observational and interventional trials studying the interrelation between GI motor and postprandial sensory function with body weight have not provided definitive findings. The relation of self-reported postprandial sensations of satiation and stomach volumes with body weight has not been demonstrated without invasive methods
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