Short‐term intestinal lipase inhibition in normal‐weight individuals does not affect postprandial peptide YY_3‐36 and glucagon‐like peptide‐1 levels, hunger or satiety

Abstract

Fat malabsorption associated with Roux-en-Y gastric bypass (RYGB) may contribute to elevated postprandial glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) after the procedure, leading to sustained weight loss and appetite reduction. This study investigated whether fat malabsorption via orlistat increases GLP-1 and PYY and if these increases would be proportional to changes in hunger and satiety. Five healthy participants received standardized meals with 120 mg orlistat or placebo in a randomized, double-blinded, crossover design for 3 days. On the final day, glucose, insulin, GLP-1, PYY 3-36 and visual analogue scores for hunger and satiety were measured over a 14-hour period that included three meals. Fasting, 14-hour area under the curve (AUC) and meal-related AUC for glucose and insulin were similar, although postprandial increases in peak insulin and glucose were greater with orlistat. PYY 3-36 , GLP-1, hunger and satiety were not different. In conclusion, short-term orlistat administration does not enhance postprandial GLP-1 or PYY 3-36 or affect hunger or satiety in normal-weight individuals. Furthermore, fat malabsorption from RYGB is unlikely to mediate subsequent postprandial increases in GLP-1 and PYY.

Hypothalamic control of body fat mass by food intake: The key to understanding why obesity should be treated as a disease

“…Under normal circumstances when a person has a stable weight, stable fat mass and meal composition is constant, evidence indicates that both the appearance and disappearance patterns as well as peak or nadir levels of these gut hormones are proportional to the number of calories in the meal. 24,25 However, the relationships between meal calories and gut hormone secretion are altered depending on macronutrient content and following weight change achieved through either underfeeding or overfeeding. 22 An important lesson from these data is that what ultimately governs the brain's regulation of the calories consumed during an individual meal and over 24 h is a confluence of multiple gut-derived signals (e.g.…”

Atualizações sobre os medicamentos da Diretriz Brasileira de Obesidade: uma revisão de literatura

“…Estudos demonstraram que o orlistate não afeta a secreção de peptídeo pós-prandial (PYY) ou de peptídeo semelhante ao glucagon-1 (GLP-1), estes que são responsáveis pelo controle do apetite e saciedade. Esse achado foi confirmado através de escala de fome e saciedade preenchidas pelos participantes do estudo, evidenciando que a inibição da lipase intestinal com auxílio do orlistate não altera os padrões de fome e saciedade e que a perda de peso ocorre por outros meios (Nguyen et al, 2020).…”