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Effects of a lipase inhibitor (Orlistat) on cholecystokinin and appetite in response to a high-fat meal

Abstract

OBJECTIVE: To examine the short-term effects of a lipase inhibitor (Orlistat) on physiological and behavioural measures of appetite in response to a high-fat meal.

DESIGN: Randomised, single blind, placebo-controlled, crossover trial.

SUBJECTS: A total of 19 healthy nonobese male subjects.

PROCEDURES: After an overnight fast, subjects ingested a test meal of 2940 kJ (60% fat, 30% CHO, 10% protein) with Orlistat (120 mg) or a placebo, separated by 2 weeks. Appetite, as assessed by a standard line scale, and plasma cholecystokinin (CCK) concentrations were measured prior to and every hour after the test meal for 4 h. Thereafter, subjects ingested a quantified, but self-selected portion of a standardised lunch (15% protein, 37% fat and 45% CHO), before completing a final line scale questionnaire.

RESULTS: The CCK response to the test meal was negatively correlated with BMI in both the Orlistat and placebo trials (R=−0.69 and −0.65, P<0.01). Orlistat administration did not significantly alter the CCK response to the test meal (6.30±3.27 vs 7.36±3.94 pM min, for Orlistat and placebo, P=0.193). Similarly, the line scale measures of appetite and subsequent intake (520±205 vs 554±197 g, P=0.48) were not different between the trials.

CONCLUSION: Orlistat administration did not alter short-term physiological or behavioural measures of satiety in response to a high-fat meal in healthy, nonobese subjects. The CCK response to a test meal may be partly determined by BMI.

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Acknowledgements

We are grateful to Roche South Africa for partial sponsorship of this research and to Pick and Pay, Clover and Nestle for their generous donations of food. We are also grateful to Judy Belonje and Maglona Paul for their expert technical assistance in performing the glucose and insulin assays, respectively. This study was also partly funded by the Medical Research Council of South Africa, the Nellie Atkinson and Harry Crossley Research Funds of the University of Cape Town.

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Correspondence to J H Goedecke.

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Goedecke, J., Barsdorf, M., Beglinger, C. et al. Effects of a lipase inhibitor (Orlistat) on cholecystokinin and appetite in response to a high-fat meal. Int J Obes 27, 1479–1485 (2003). https://doi.org/10.1038/sj.ijo.0802436

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