People With Spinal Cord Injury Feel Fuller Faster Despite Similar GLP-1 and PYY Levels
Spinal cord injury patients showed enhanced early postprandial satiety and ate 37% less at ad libitum meals than able-bodied controls, despite no significant differences in GLP-1, PYY, or ghrelin levels.
Quick Facts
What This Study Found
SCI patients showed higher early postprandial fullness (d=0.83) and satisfaction (d=0.87), ate less at ad libitum meals (1,086 vs 1,713 kJ, d=1.00, p=0.020), but had no significant differences in GLP-1, PYY, or acylated ghrelin responses.
Key Numbers
12+12; fullness d=0.83; satisfaction d=0.87 (0-60 min); ad lib intake 1,086 vs 1,713 kJ (p=0.020); no hormone differences (PYY, GLP-1, ghrelin)
How They Did This
Counterbalanced crossover study. 12 men with high-level SCI (≥T6) and 12 able-bodied controls consumed covert high-energy (2,513 kJ) and low-energy (1,008 kJ) preloads. Subjective appetite and ad libitum intake measured. Appetite hormones measured in high-energy trial.
Why This Research Matters
Obesity in SCI patients was assumed to partly involve impaired appetite regulation. This study shows appetite is actually enhanced, meaning obesity in SCI is driven primarily by reduced energy expenditure, not overeating — which changes how weight management should be approached.
The Bigger Picture
This study adds to our understanding of how GLP-1 and other satiety hormones interact with the nervous system. The dissociation between normal hormone levels and enhanced satiety in SCI suggests that gut-brain signaling pathways beyond these peptides are important for appetite regulation.
What This Study Doesn't Tell Us
Small study (24 participants). Only men studied. High-level SCI (≥T6) only — results may differ for lower-level injuries. Single center. Appetite hormone measurements may not capture all relevant signals.
Questions This Raises
- ?What mechanisms drive the enhanced satiety in SCI if GLP-1, PYY, and ghrelin are unchanged?
- ?Does the enhanced satiety persist long-term or does it diminish over time?
- ?Should weight management in SCI focus entirely on energy expenditure rather than appetite control?
Trust & Context
- Key Stat:
- 37% less intake SCI patients voluntarily ate 37% less at ad libitum meals despite normal levels of appetite-regulating peptides GLP-1, PYY, and ghrelin
- Evidence Grade:
- Moderate evidence: well-designed counterbalanced crossover study with large effect sizes, but small sample (24 total, men only).
- Study Age:
- Published 2021. Research on appetite regulation in SCI populations remains limited.
- Original Title:
- Accentuated early postprandial satiety in people with spinal cord injury versus able-bodied controls.
- Published In:
- Appetite, 167, 105628 (2021)
- Authors:
- Fenton, Jordan M, King, James A(3), Hoekstra, Sven P, Willis, Scott A, Ogawa, Takahiro, Goosey-Tolfrey, Victoria L
- Database ID:
- RPEP-05376
Evidence Hierarchy
Frequently Asked Questions
Why do people with spinal cord injuries gain weight if they feel fuller?
SCI patients gain weight primarily because they burn far fewer calories due to reduced muscle mass and inability to exercise — not because they eat too much. This study shows they actually eat less than able-bodied people after identical meals.
Are appetite hormones like GLP-1 affected by spinal cord injury?
This study found GLP-1, PYY, and ghrelin levels were similar between SCI patients and controls. The enhanced satiety appears to come from other mechanisms, possibly altered gut signaling or autonomic changes from the injury itself.
Read More on RethinkPeptides
Cite This Study
https://rethinkpeptides.com/research/RPEP-05376APA
Fenton, Jordan M; King, James A; Hoekstra, Sven P; Willis, Scott A; Ogawa, Takahiro; Goosey-Tolfrey, Victoria L. (2021). Accentuated early postprandial satiety in people with spinal cord injury versus able-bodied controls.. Appetite, 167, 105628. https://doi.org/10.1016/j.appet.2021.105628
MLA
Fenton, Jordan M, et al. "Accentuated early postprandial satiety in people with spinal cord injury versus able-bodied controls.." Appetite, 2021. https://doi.org/10.1016/j.appet.2021.105628
RethinkPeptides
RethinkPeptides Research Database. "Accentuated early postprandial satiety in people with spinal..." RPEP-05376. Retrieved from https://rethinkpeptides.com/research/fenton-2021-accentuated-early-postprandial-satiety
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.