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Gastric emptying is the process by which (the bolus of) food is sent from the stomach to the small intestine. Depending on the type of food and the individual, the speed at which this occurs can vary considerably over time. The speed of gastric emptying affects weight in various ways.
Gastric Emptying and Weight
A delayed gastric emptying leads to lower weight. It takes longer for the stomach to empty, resulting in prolonged satiety and reduced food intake. Additionally, nutrients are released more gradually, contributing to a more stable blood sugar level and thus a more stable release of insulin and IGF-1 (both of which promote fat storage).
For example, people with delayed gastric emptying may struggle to eat enough because an average meal may take 7 hours instead of 3 hours to be processed by the stomach. Conversely, accelerated gastric emptying can lead to overweight due to increased hunger and greater fluctuations in blood sugar levels.
These are just two examples; there are other well-known and lesser-known factors that influence the speed of gastric emptying, which in turn affects weight. Controlling gastric emptying can therefore be a means of controlling weight.
Type of Food
I have never had the speed of my personal gastric emptying tested, but I suspect it is relatively slow. Without filling my diet largely with liquid food, I do not get the necessary amount of calories for my goals. A week without my trusted cold milk with oatmeal and shakes of cottage cheese with banana quickly costs me several kilos. If I had to eat that oatmeal as thicker porridge, or whole bananas and pots of cottage cheese, I would not get a quarter of the same amount.
This could of course be due to ease and habit, but the speed of gastric emptying can also play a major role here. The speed of gastric emptying is higher with liquid food and slower with solid food [1]. The more watery, the faster.
So, my shakes of 250 ml of cottage cheese, 200 ml of water or milk, and a whole banana provide a shorter feeling of satiety than in solid form. The blender has already done part of the stomach’s work. Convenient in my case, less convenient if you use shakes to replace a meal for weight loss.
So, if you want to lose weight, it is advisable to avoid sweet drinks. You already knew that, of course, but now you have an extra reason. Meals in a more solid form provide a longer feeling of satiety and thus a more gradual release of nutrients.
Medication
There are also more drastic methods to slow down gastric emptying. This week, the results of a study on the effects of Liraglutide were published in
The Lancet Gastroenterology & Hepatology [2]. Liraglutide is a medication aimed at treating type 2 diabetes. In the randomized double-blind study, it was found to be more successful than a placebo in slowing gastric emptying and reducing weight in a test group.
Forty adults between the ages of 18 and 65 were injected with Liraglutide or a placebo for 16 weeks. The participants were healthy except for being overweight (minimum BMI of 30). The groups were divided into a test group and a placebo group. Both groups were placed on a standardized diet. They also received help focused on behavior change for weight loss.
The dose of Liraglutide was increased every week for 5 weeks and then continued until week 16. After 5 and 16 weeks, the speed of gastric emptying was measured compared to the baseline. Weight of the participants was also looked at as a secondary outcome. After 5 weeks, the placebo group had lost an average of 0.6 kg and the test group 3.7 kg. After 16 weeks, the test group had lost an average of 5.3 kg and the placebo group 2.5 kg.
Gastric emptying had caused a significant delay, and this delay was related to weight loss. In the test group, gastric emptying was delayed by an average of 71 minutes after 5 weeks. Nearly an hour longer to process nutrients and induce hunger again. In the placebo group, gastric emptying was delayed by an average of 4 minutes, although there were also individuals whose gastric emptying had accelerated. However, in the test group, gastric emptying was delayed in everyone after 5 weeks. After 16 weeks, gastric emptying in the test group was delayed by half an hour and hardly changed in the placebo group.
If this medication could be used for weight loss, according to the researchers, gastric emptying after 5 weeks would be a good indication of whether this medication works for the individual. If there is a significant enough effect on the speed of gastric emptying, then the medication should be successful in contributing to weight loss.
References
- Bonner JJ, Vajjah P, Abduljalil K, Jamei M, Rostami-Hodjegan A, Tucker GT, Johnson TN. Does age affect gastric emptying time? A model-based meta-analysis of data from premature neonates through to adults. Biopharm Drug Dispos. 2015 May;36(4):245-57. doi: 10.1002/bdd.1937. Epub 2015 Feb 12. PubMed PMID: 25600493; PubMed Central PMCID: PMC5023994.
- Houssam Halawi, MD et al. Effects of liraglutide on weight, satiation, and gastric functions in obesity: a randomised, placebo-controlled pilot trial. The Lancet Gastroenterology & Hepatology, September 2017 DOI: 10.1016/S2468-1253(17)30285-6
