Background: Hypothalamic obesity (HyOb) is a disease characterized by weight gain resistant to lifestyle changes and dietary restriction. The main clinical findings are hyperfagia and decline of satiety, high levels of insulin and an increase of adipogenesis. The major problem for these patients is that conventional treatments, either medical or surgical are not succesful and have variable results.
Objective and hypotheses: We aim to describe the natural history of the disease in patients who have attended our centre from early in their childhood until adolescence and to find new uses for psychiatric drugs that might shed new light in the treatment of this disease.
Method: We recollected data from 10 patients (seven women and three men) diagnosed of HyOb by a multidisciplinary team. The data included anthropometrics, clinical data and treatment received to stop gain weight and comorbiditiesd in periods of 6 months. We used the Tanofsky-Kraff et al (EAHQ) questionnaire to asses the alimentary behaviour of the subjects.
Results: The main causes of excessive gain weight that we found were of tumoral origin: two pilocytic astrocytoma, one hypothalamic neurocytoma, one anaplastic astrocytoma and one craniopharyngioma. We recollected four patients with Prader-Willy syndrome and one late onset meningitis by group B streptococcal infection. We found that the psychiatric drugs we used (methylphenidate, dextroamphetamine, fluoxetine and topiramate) associated to eating habits modifications managed to lower the weight (P<0.05) in our patients.
Conclusion: Treatment of HyOb should be assesed early in the diagnosis. There is limited evidence about the effect of psychiatric drugs on HyOB. Some of these drugs might be useful and improved quality of life.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology