Secondary analysis of a 16-week randomized, placebo-controlled trial (NCT02647944) examining whether delayed solid-food gastric emptying mediates appetite suppression (satiation, energy intake) in adults with obesity treated with liraglutide vs. placebo.
Gastric emptying correlated significantly with energy intake across the entire cohort at baseline and end of treatment, but explained only 4–6% of variance in appetitive measures. No correlations were found within the placebo or liraglutide groups alone, and no differences in appetite were seen across subgroups with normal, persistently delayed, or transiently delayed gastric emptying on liraglutide.
- Secondary (post-hoc) analysis limits causal inference. - Findings are specific to liraglutide and may not generalize to other GLP-1RAs (e.g., semaglutide, tirzepatide). - Gastric emptying subgroup sizes not reported, raising power concerns.
Delayed gastric emptying appears to contribute minimally to liraglutide's appetite-suppressing effects, so GI side effects like slow emptying should not be viewed as a marker of efficacy. Clinicians need not equate gastroparesis-like symptoms with better weight-loss outcomes on GLP-1RAs.
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