Effectiveness of bariatric surgery on acquired hypothalamic obesity: a systematic review and meta-analysis

Acquired hypothalamic obesity (HO) is a rare type of obesity caused by acquired disease-related and/or treatment-related damage to the hypothalamus, most commonly craniopharyngiomas. Effective management of HO is critical due to its significant impact on quality of life and resistance to conventional treatments. This systematic review and meta-analysis aims to evaluate the 12-month, 24-month and 60-month outcomes of bariatric surgery for HO caused by CPs compared with patients with common obesity (CO). Relevant studies were identified in MEDLINE and EMBASE databases until May 2024. A total of four matched case-control studies were included. The results indicated that bariatric surgery significantly reduced weight in patients with HO (22.98 ± 14.22/21.47 ± 9.61/19.07 ± 16.12% total weight loss, 12/24/60 months after surgery), but the effect was significantly less than that in CO controls (-6.17/-6.41/-7.72% total weight loss 12/24/60 months after surgery). Bariatric surgery can significantly reduce body weight in craniopharyngiomas-related HO, but the effect is less than that in matched patients with common obesity. Further studies are necessary to determine the best surgical or multidisciplinary approach to the treatment of acquired HO.