Orlistat Mouth Rinse: Using the Tongue to Deliver Antiobesity Medication in a Double-blind Randomized Crossover Pilot Trial

Overview

Journal Diabetes Obes Metab

Specialty Endocrinology

Date 2023 May 3

PMID 37132340

Authors

Stefany D Primeaux

Robert Dubin

Frank L Greenway

Affiliations

Soon will be listed here.

Abstract

Aim: To investigate the effects of an orlistat mouth rinse on the intake of a high-fat meal.

Methods: A double-blind, balanced order, crossover study was conducted in participants (n = 10, body mass index 25-30 kg/m ) assigned to receive placebo or orlistat (24 mg/mL) prior to a high-fat meal. Participants were divided into low- or high-fat consumers based on calories consumed from fat following placebo administration.

Results: The orlistat mouth rinse decreased total and fat calories consumed during the high-fat meal in high-fat consumers, and did not alter calories consumed in low-fat consumers (P < 0.05).

Conclusions: Orlistat decreases long-chain fatty acid (LCFA) absorption by inhibiting lipases that breakdown triglycerides. Orlistat mouth rinse decreased fat intake in high-fat consumers, suggesting that orlistat inhibited the detection of LCFAs from the high-fat test meal. Lingual delivery of orlistat is predicted to eliminate the risk of oil incontinence and promote weight loss in individuals who prefer fat.

Citing Articles

Protective and Therapeutic Effects of Orlistat in Combination with "Cardamom" Extract on Learning, Memory, Anxiety, and Neuroinflammation in Obese Mice.

Al-Dalaeen A, Batarseh N, Abdelhadi N, Atawneh S, AbuKashef R, Al-Yasari A Medicina (Kaunas). 2025; 61(2).

PMID: 40005380 PMC: 11857227. DOI: 10.3390/medicina61020263.

References

Ulven T, Christiansen E . Dietary Fatty Acids and Their Potential for Controlling Metabolic Diseases Through Activation of FFA4/GPR120. Annu Rev Nutr. 2015; 35:239-63. DOI: 10.1146/annurev-nutr-071714-034410. View

Mattes R . Fat taste and lipid metabolism in humans. Physiol Behav. 2005; 86(5):691-7. DOI: 10.1016/j.physbeh.2005.08.058. View

Schreiber A, Braymer H, Primeaux S . Transection of Gustatory Nerves Differentially Affects Dietary Fat Intake in Obesity-Prone and Obesity-Resistant Rats. Chem Senses. 2020; 45(7):541-548. PMC: 7545249. DOI: 10.1093/chemse/bjaa053. View

Ahmad F, Mahmud S . Acute pancreatitis following orlistat therapy: report of two cases. JOP. 2010; 11(1):61-3. View

Doyle M, Premathilake H, Yao Q, Mazucanti C, Egan J . Physiology of the tongue with emphasis on taste transduction. Physiol Rev. 2022; 103(2):1193-1246. PMC: 9942923. DOI: 10.1152/physrev.00012.2022. View

Kamphuis M, Saris W, Westerterp-Plantenga M . The effect of addition of linoleic acid on food intake regulation in linoleic acid tasters and linoleic acid non-tasters. Br J Nutr. 2003; 90(1):199-206. DOI: 10.1079/bjn2003858. View

Brondel L, Quilliot D, Mouillot T, Khan N, Bastable P, Boggio V . Taste of Fat and Obesity: Different Hypotheses and Our Point of View. Nutrients. 2022; 14(3). PMC: 8838004. DOI: 10.3390/nu14030555. View

Li Z, Maglione M, Tu W, Mojica W, Arterburn D, Shugarman L . Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005; 142(7):532-46. DOI: 10.7326/0003-4819-142-7-200504050-00012. View

Flint A, Raben A, Blundell J, Astrup A . Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies. Int J Obes Relat Metab Disord. 2000; 24(1):38-48. DOI: 10.1038/sj.ijo.0801083. View

10.

Stewart J, Seimon R, Otto B, Keast R, Clifton P, Feinle-Bisset C . Marked differences in gustatory and gastrointestinal sensitivity to oleic acid between lean and obese men. Am J Clin Nutr. 2011; 93(4):703-11. DOI: 10.3945/ajcn.110.007583. View

11.

Cvijanovic N, Feinle-Bisset C, Young R, Little T . Oral and intestinal sweet and fat tasting: impact of receptor polymorphisms and dietary modulation for metabolic disease. Nutr Rev. 2015; 73(5):318-34. DOI: 10.1093/nutrit/nuu026. View

12.

Stunkard A, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985; 29(1):71-83. DOI: 10.1016/0022-3999(85)90010-8. View

13.

Mancini M, Halpern A . Orlistat in the prevention of diabetes in the obese patient. Vasc Health Risk Manag. 2008; 4(2):325-36. PMC: 2496972. DOI: 10.2147/vhrm.s6808. View

14.

OMeara S, Riemsma R, Shirran L, Mather L, Riet G . A systematic review of the clinical effectiveness of orlistat used for the management of obesity. Obes Rev. 2004; 5(1):51-68. DOI: 10.1111/j.1467-789x.2004.00125.x. View

15.

Gaudet D, El-Desoky D, Poret J, Braymer H, Primeaux S . Expression of neural markers of gustatory signaling are differentially altered by continuous and intermittent feeding patterns. Physiol Behav. 2019; 212:112719. PMC: 6897321. DOI: 10.1016/j.physbeh.2019.112719. View

16.

Besnard P, Passilly-Degrace P, Khan N . Taste of Fat: A Sixth Taste Modality?. Physiol Rev. 2015; 96(1):151-76. DOI: 10.1152/physrev.00002.2015. View

17.

Gilbertson T, Khan N . Cell signaling mechanisms of oro-gustatory detection of dietary fat: advances and challenges. Prog Lipid Res. 2013; 53:82-92. DOI: 10.1016/j.plipres.2013.11.001. View

18.

Seabrook L, Borgland S . The orbitofrontal cortex, food intake and obesity. J Psychiatry Neurosci. 2020; 45(5):304-312. PMC: 7850155. DOI: 10.1503/jpn.190163. View

19.

Chen C, Bench E, Allerton T, Schreiber A, Arceneaux 3rd K, Primeaux S . Preference for linoleic acid in obesity-prone and obesity-resistant rats is attenuated by the reduction of CD36 on the tongue. Am J Physiol Regul Integr Comp Physiol. 2013; 305(11):R1346-55. PMC: 3882564. DOI: 10.1152/ajpregu.00582.2012. View

20.

Jaime-Lara R, Brooks B, Vizioli C, Chiles M, Nawal N, Ortiz-Figueroa R . A systematic review of the biological mediators of fat taste and smell. Physiol Rev. 2022; 103(1):855-918. PMC: 9678415. DOI: 10.1152/physrev.00061.2021. View