P1160 - Effect of Changes in Gastric Emptying and Low-calorie Phenotype Tailored Diet on Weight Loss: Results From a 12-week Clinical Trial

Lizeth Cifuentes, MD¹, Wissam Ghusn, MD², Alejandro Campos, MD², Fauzi Feris, MD², Daniel Sacoto, MD², Alan De la Rosa, MD², Maria Daniela. Hurtado, MD, PhD³, Andres Acosta, MD, PhD^2
1University of Pittsburgh Medical Center, Pittsburgh, PA; ²Mayo Clinic, Rochester, MN; ³Mayo Clinic, Jacksonville, FL

Introduction: Rapid gastric emptying and large fasting gastric volume in obesity can cause increased food intake and appetite, leading to energy imbalance and obesity. To address this, interventions like anti-obesity medications, bariatric endoscopy, and surgery alter gastric functions and motility. A lifestyle intervention based on obesity phenotypes has been shown to result in greater weight loss. We aim to investigate the link between gastric emptying time and 12-week weight loss, with a focus on patients with rapid gastric emptying.

Methods: Patients with obesity (BMI ≥30kg/m2) were invited to join a 12-week lifestyle weight-loss program involving a low-calorie diet (500kcal deficit from measured total energy expenditure by indirect calorimetry). Participants were assigned to either the standard lifestyle intervention (SLI [low-calorie diet, moderate physical activity, weekly behavioral therapy]) or the phenotype-tailored lifestyle intervention (PLI), which was determined based on their phenotype (abnormal satiation, abnormal postprandial satiety [APS], emotional eating, or abnormal resting energy expenditure). We measured gastric emptying (GE) using scintigraphy for a 320kcal, 30% fat solid meal at baseline and after 12 weeks. We calculated GE T1/2 in minutes and defined abnormal postprandial satiety as a patient with rapid gastric emptying. Linear models were used to analyze the association between weight loss at 12 weeks, adjusted for age, sex, baseline weight, and treatment arm, and GE T1/2 at baseline and after 12 weeks, as well as their interaction.

Results: Between July 2020 and August 2021, 211 participants were screened and 165 were assigned to one of the two treatments in the two phases: 81 SLI and 84 PLI. From this, 145 had a normal

postprandial satiety (GE T1/2 135.7 min [31.1]) compared with patients with APS (GE T1/2

85.7 min [13.6]). Patients in the PLI with APS were able to lose more than patients with SLI and APS (-4.12 kg ]95% CI-5.28, -2.97]; p< 0.001). And more importantly, the change in GE T1/2 was strongly associated with this weight loss difference (p< 0.005).

Discussion: In patients with abnormal postprandial satiety, delaying gastric emptying with a tailored lifestyle intervention, results in successful weight loss.




Disclosures:


Lizeth Cifuentes, MD¹, Wissam Ghusn, MD², Alejandro Campos, MD², Fauzi Feris, MD², Daniel Sacoto, MD², Alan De la Rosa, MD², Maria Daniela. Hurtado, MD, PhD³, Andres Acosta, MD, PhD². P1160 - Effect of Changes in Gastric Emptying and Low-calorie Phenotype Tailored Diet on Weight Loss: Results From a 12-week Clinical Trial, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.