What Is the Link Between Food Intake and Gastrointestinal Symptoms in Obesity?

Obesity, unhealthy weight. Nutritionist inspecting a woman’s waist using a meter tape to prescribe a weight loss diet
Researchers analyzed whether food intake parameters, such as hunger and hedonic eating, were associated with gastrointestinal symptoms in obesity.

Changes to food intake parameters, such as hunger, satiation, postprandial satiety, and hedonic eating, are associated with gastrointestinal (GI) symptoms in patients with obesity, according to a study published in Gastro Hep Advances.

Researchers conducted a cross-sectional study of 274 patients (mean age, 41±10 years; women, 75%; body mass index (BMI), 39±8 kg/m2) with obesity. All patients were enrolled in the Individualized Obesity Pharmacotherapy clinical trial (ClinicalTrials.gov Identifier: NCT03374956). After fasting for 8 hours, researchers assessed patient hunger, satiation, postprandial satiety via gastric emptying, and hedonic eating. Study participants also completed the abridged Bowel Disease Questionnaire to assess functional GI symptoms. Patients with known chronic GI disorders, alcohol use disorder, eating disorders, active psychiatric symptoms, or using medications that could alter the measured intake parameters were excluded.

Researchers discovered several statistically significant associations. Increased hunger was associated with fewer lumpy stools (odds ratio [OR], 0.18; 95% CI, 0.04-0.76; P =.02). Abnormal satiation, indicated by a larger consumption of calories before feeling full, was associated with altered stool consistency (OR, 2.92; 95% CI, 1.34-6.34; P <.01), bloating (OR, 2.49; 95% CI, 1.33-4.66; P <.01), bloating after meals (OR, 2.09; 95% CI, 1.14-3.83; P =.02), loose or watery stools (OR, 2.09; 95% CI, 1.14-3.84; P =.02), and more frequent abdominal pain or discomfort relieved by defecation (OR, 2.4; 95% CI, 1.15-5.01; P =.02).

Abnormal postprandial satiety was associated with loose or watery stools (OR, 1.84; 95% CI, 1.02-3.34; P =.04), more bloating (OR, 2.26; 95% CI, 1.23-4.2; P <.01), and bloating after meals (OR, 1.83; 95% CI, 1.02-3.29; P =.04).

Hedonic eating was associated with more frequent abdominal pain or discomfort linked to a change in stool frequency (OR, 2.4; 95% CI, 1.15-5.01; P =.02), bloating (OR, 2.49; 95% CI, 1.24-5; P =.01), bloating after meals (OR, 2.1; 95% CI, 1.1-4.04; P =.03), more than 3 bowel movements per day (OR, 1.93; 95% CI, 1.005-3.692; P =.048) upper abdominal pain after meals more frequent than once a month (OR, 4.24; 95% CI, 1.82-9.85; P <.01), and nausea more frequent than once a week (OR, 4.51; 95% CI, 1.79-11.37; P <.01).

Study limitations include the possibility of recall bias, as participants were asked to complete questionnaires; a lack of generalizability, as most patients were White American and women; and the cross-sectional design, which prevents causal inference of the results.

“In patients with obesity, homeostatic (hunger, satiation, and postprandial satiety) and hedonic components of food intake are associated with various chronic GI symptoms,” the study authors wrote. “These symptoms are known to be observed with a significantly higher prevalence in patients with obesity. Our study further shows an association between food intake and functional GI symptoms.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Pleases see the original reference for a full list of authors’ disclosures.

Reference

Ghusn W, Cifuentes L, Campos A, et al. Association between food intake and gastrointestinal symptoms in patients with obesity. Gastro Hep Advances. August 7, 2022. doi:10.1016/j.gastha.2022.07.019