The aim of this review was to examine: (1) the ability of cholecystokinin (CCK) or analogues of CCK to influence satiation and changes in body weight generally and (2) the efficacy of CCK in influencing satiation and eating behaviour specifically at physiological levels of dosing. A systematic review of the literature was performed following the PRISMA 2020 guidelines in five electronic databases investigating the effect of exogenous CCK or analogues on satiation and body weight. A meta-analysis of studies that infused CCK and measured satiation via changes in food/energy intake was also conducted. A total of 1054 studies were found using the search terms which were reduced to fifteen studies suitable for inclusion. Of the twelve studies measuring the effect on the weight of food ingested or energy intake, eleven showed a decrease. An analogue of CCK which can be administered orally failed to produce any weight loss at 24 weeks. The meta-analysis found the effect of CCK on satiation dosed at physiological levels was significant with a standardised mean difference of 0·57 (95 % CI 0·30, 0·85, P < 0·0001). By comparison, CCK dosed at higher, pharmacological levels also had a significant effect with a standardised mean difference of 0·91 (95 % CI 0·46, 1·36, P < 0·0001). Eight of the ten studies in the meta-analysis combined CCK infusion with some means to facilitate stomach distension. The present review found evidence that at both physiological and pharmacological levels of dosing CCK has a significant effect on satiation but no evidence for weight loss over the long term.

The objective was to determine the effects of dietary fibre with bulking, viscous and gel-forming properties on satiation, and to identify the underlying mechanisms. We conducted a randomised crossover study with 121 men and women. Subjects were healthy, non-restrained eaters, aged 18–50 years and with normal BMI (18·5–25 kg/m2). Test products were cookies containing either: no added fibre (control), cellulose (bulking, 5 g/100 g), guar gum (viscous, 1·25 g/100 g and 2·5 g/100 g) or alginate (gel forming, 2·5 g/100 g and 5 g/100 g). Physico-chemical properties of the test products were confirmed in simulated upper gastrointestinal conditions. In a cinema setting, ad libitum intake of the test products was measured concurrently with oral exposure time per cookie by video recording. In a separate study with ten subjects, 4 h gastric emptying rate of a fixed amount of test products was assessed by 13C breath tests. Ad libitum energy intake was 22 % lower for the product with 5 g/100 g alginate (3·1 (sd 1·6) MJ) compared to control (4·0 (sd 2·2) MJ, P< 0·001). Intake of the other four products did not differ from control. Oral exposure time for the product with 5 g/100 g alginate (2·3 (sd 1·9) min) was 48 % longer than for control (1·6 (sd 0·9) min, P= 0·01). Gastric emptying of the 5 g/100 g alginate product was faster compared to control (P< 0·05). We concluded that the addition of 5 g/100 g alginate (i.e. gel-forming fibre) to a low-fibre cookie results in earlier satiation. This effect might be due to an increased oral exposure time.