Stepwise treatment strategy for hypothalamic obesity (HyOb)—including nutritional, pharmacological, and surgical therapies in an experienced center—may be most valuable, according to a recent study. The International Registry of Hypothalamic Obesity Disorders (IRHOD) identified a large cohort with self-reported HyOb, a rare cause of rapid weight gain and early metabolic comorbidities. 87 participants were included for analysis (median age: 27 years, range: 3‐71 years). Researchers found:
- A total of 96.5% had obesity, and 3.5% had overweight at maximal weight.
- 75 had brain tumors (86%)—the majority were craniopharyngiomas (72% of those with tumors).
- Non-tumor etiologies included congenital brain malformation (4.6%), traumatic brain injury (3.4%), and genetic anomaly (2.3%).
- 90% received obesity treatments including nutritional counseling (82%), pharmacotherapy (59%), bariatric surgery (8%), and vagal nerve stimulation (1%).
- 46% reported follow‐up BMI results after obesity treatment.
- Surgery was most effective with lifestyle intervention and pharmacological therapy being less effective.
- 80% of participants reporting follow‐up weight remained in the obesity range.
Rose SR, Horne VE, Bingham N, Jenkins T, Black J, Inge T. Hypothalamic obesity: 4 years of the International Registry of Hypothalamic Obesity Disorders. [Published online ahead of print October 8, 2018]. Obesity. doi:10.1002/oby.22315.