Appetite Suppression by GLP-1 Receptor Agonists: Role of Delayed Gastric Emptying

Delayed gastric emptying appears to play only a minor role in liraglutide-induced appetite suppression. In a secondary analysis of a 16-week randomized placebo-controlled trial in people with obesity, gastric emptying correlated with energy intake but explained only 4%-6% of the variance in appetite-related measures. The authors conclude that other gastrointestinal or central effects likely drive the appetite suppression.

Randomized controlled trial — Secondary analysis of a randomized, placebo-controlled trial. Population: Patients with obesity. Follow-up: 16 weeks. Interventions: Liraglutide.

In the entire cohort, gastric emptying correlated significantly with energy intake at baseline and at end of treatment, and with one satiation parameter at baseline. Gastric emptying explained only 4%-6% of the variance in these appetitive measures. No such correlations were seen within the placebo- or liraglutide-treated groups alone. Appetitive measures did not differ among liraglutide-treated participants with normal, persistently delayed, or transiently delayed gastric emptying. The authors concluded that delayed gastric emptying appears to play little direct role in liraglutide-induced appetite suppression.

This paper is directly relevant to researchers studying liraglutide because it separates gastric emptying from appetite suppression, suggesting that delayed emptying is not the main mechanism by which liraglutide reduces appetite. It does not identify the actual mechanism of appetite suppression, nor does it establish whether other GLP-1 receptor agonists behave similarly. It also does not provide clinical guidance on using liraglutide.

Key findings

• Gastric emptying accounted for only 4%-6% of the variance in appetitive measures in the full cohort.
• Gastric emptying correlated significantly with energy intake at both baseline and end of treatment in the entire cohort.
• At baseline, gastric emptying correlated significantly with one parameter of satiation.
• No correlations between gastric emptying and appetitive measures were found in the placebo- or liraglutide-treated groups alone.
• No differences in appetitive measures emerged among liraglutide-treated participants with normal, persistently delayed, or transiently delayed emptying.

Limitations

• Secondary analysis of a trial not designed to test these correlations.
• No causal inference possible from correlational analysis.
• Single 16-week trial; longer-term effects unknown.
• Findings may not generalize to other GLP-1 receptor agonists.

The record

• Journal: Obesity (Silver Spring, Md.) 34(8): 1535-1540
• Published: 2026-07-02
• PMID: 42392577 — DOI: 10.1002/oby.70255
• MeSH terms: Humans, Obesity, Appetite Depressants, Appetite, Satiation, Energy Intake, Gastric Emptying, Adult, Middle Aged, Female, Male, Glucagon-Like Peptide-1 Receptor, Liraglutide, Glucagon-Like Peptide-1 Receptor Agonists
• Funding: NIH HHS; National Institutes of Health; NIH HHS; National Institutes of Health
• Author countries: USA

Peptide profiles: Liraglutide.

All indexed evidence: Liraglutide trials & papers.

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