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Treatment of Hypothalamic Obesity With GLP-1 Analogs

Paul Dimitri1,2, Christian L Roth3,4

  • 1The Department of Paediatric Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK.

Journal of the Endocrine Society
|December 20, 2024
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) show promise for treating hypothalamic obesity (HO). While results vary, some studies indicate weight loss and improved metabolic function, warranting further research.

Area of Science:

  • Endocrinology
  • Neuroscience
  • Pharmacology

Background:

  • Hypothalamic obesity (HO) results from damage to hypothalamic nuclei affecting satiety and energy expenditure.
  • Current treatments for HO have limited success in promoting weight loss and satiety.
  • Glucagon-like peptide-1 (GLP-1) pathways, independent of the hypothalamus, regulate satiety.

Purpose of the Study:

  • To review the current literature on the efficacy of GLP-1 receptor agonists (GLP-1RAs) in treating hypothalamic obesity (HO).

Main Methods:

  • A nonsystematic literature review was conducted.
  • Searched Medline, Google Scholar, and clinical trials registries (ClinicalTrials.gov; clinicaltrialsregister.eur).
  • Included papers published from January 2005 to February 2024 using Pubmed and Embase databases with keywords: GLP-1, GLP-1RA, hypothalamic obesity, suprasellar tumor, and craniopharyngioma.

Main Results:

  • Identified 7 case studies, 5 case series, and 2 clinical trials on GLP-1RA use in HO.
  • Case studies consistently showed weight loss and improved metabolic function.
  • Case series and the ECHO trial yielded variable results, with some patients experiencing significant weight loss and BMI reduction, even with extensive hypothalamic damage.

Conclusions:

  • GLP-1RAs represent a potential novel therapeutic strategy for HO.
  • Patient stratification is needed to identify individuals most likely to respond to GLP-1RA treatment.
  • Further randomized controlled trials are essential to confirm efficacy, alone or in combination therapies.
Keywords:
GLP-1GLP-1 receptor agonistand craniopharyngiomahypothalamic obesitysuprasellar tumor

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