Weight gain from omeprazole
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Weight Gain from Omeprazole: A Comprehensive Review
Introduction to Omeprazole and Weight Gain
Omeprazole, a widely used proton pump inhibitor (PPI), is primarily prescribed to treat conditions like gastroesophageal reflux disease (GERD) by reducing stomach acid production. However, its impact on body weight has garnered attention, with studies indicating varying effects based on factors such as sex, genetic background, and duration of treatment.
Omeprazole and Weight Gain in Animal Models
Sex and Genetic Background Influence
Research on mice has shown that the impact of omeprazole on weight gain can be influenced by sex and genetic background. In a study involving different strains of mice on high caloric diets, male mice on a high-energy diet with omeprazole (HiE + O) gained more weight compared to those on standard diets. Interestingly, female mice exhibited reduced energy expenditure across all diet treatments, while male mice only showed this reduction on the HiE + O diet. Additionally, gut microbiota composition changes were observed in female but not male mice, suggesting a sex-specific response to omeprazole .
Suppression of Weight Gain in Rats and Chickens
Contrary to the findings in mice, long-term omeprazole treatment in young male rats resulted in suppressed body weight gain and reduced bone mineralization. This suppression was linked to hypergastrinemia, which caused growth in the oxyntic mucosa and hyperplasia of enterochromaffin-like (ECL) cells . Similarly, in chickens, omeprazole treatment led to reduced body weight gain and bone density, alongside increased weight of the parathyroid glands due to hypertrophy and hyperplasia 34. These findings suggest that omeprazole's effects on weight can vary significantly across different animal models.
Omeprazole and Weight Gain in Humans
Long-term PPI Therapy and Weight Gain
In humans, long-term PPI therapy, including omeprazole, has been associated with undesired weight gain. A study involving GERD patients treated with PPIs for an average of 2.2 years found significant increases in both body weight and body mass index (BMI). Specifically, 71% of the patients experienced weight gain, with an average increase of 3.5 kg (6.2% of baseline weight) . This suggests that prolonged use of omeprazole can contribute to weight gain in patients, highlighting the need for weight management strategies during treatment.
Weight Gain in Crohn’s Disease Patients
Interestingly, in patients with gastroduodenal Crohn’s disease, omeprazole treatment led to symptomatic improvement and weight gain. Over an eight-week period, patients experienced a mean weight gain of 6 kg, indicating that omeprazole may have beneficial effects on weight in specific patient populations .
Mechanisms Behind Omeprazole-Induced Weight Changes
Hypergastrinemia and Appetite Regulation
One proposed mechanism for omeprazole-induced weight changes is hypergastrinemia, which can affect appetite and metabolism. In chickens, elevated plasma gastrin levels due to omeprazole treatment were associated with decreased food intake, suggesting a satiety effect . This mechanism may also play a role in the weight gain observed in other studies, as changes in gastrin levels can influence overall energy balance and body weight.
Conclusion
The impact of omeprazole on weight gain is complex and influenced by various factors, including sex, genetic background, and duration of treatment. While animal studies provide insights into potential mechanisms, human studies highlight the need for careful weight management during long-term PPI therapy. Further research is necessary to fully understand the underlying mechanisms and to develop strategies to mitigate undesired weight changes in patients undergoing omeprazole treatment.
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