Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 28 CMW4.3

SFEBES2012 Clinical Management Workshops How do I approach... (6 abstracts)

Neuroendocrine assessment in morbid obesity

John Wilding


Department of Obesity and Endocrinology, University Hospital Aintree, Liverpool, United Kingdom.


Severe or morbid obesity is becoming more common and now affects about 2% of the UK population. Neuroendocrine disturbances are a common feature of morbid obesity and include male and female hypogonadism, deficiencies of the GH-IGF-1 axis and features suggestive of Cushing’s syndrome in some patients. Patients with neuroendocrine disturbance can broadly be considered in three main categories: 1. Those with genetic syndromes (eg Prader-Willi syndrome, leptin deficiency, MC4 receptor mutations), that are the underlying aetiology for both the obesity and the neuroendocrine abnormalities 2. Those with significant structural hypothalamic-pituitary disorders (e.g. craniopharyngiomas, large pituitary tumours) that are both the cause of the neuroendocrine abnormalities and contribute to the aetiology of obesity. 3. Those with no structural hypothalamic / pituitary abnormality, but with functional abnormalities which are apparent on dynamic testing. As severe obesity is so common, the decision as to whether to test has to be made on clinical grounds - most severely obese patients will not require treatment, and the evidence base for treating asymptomatic patients with isolated deficiencies (eg low testosterone in men) in this patient group is very weak. In general those patients in the first two groups above will require careful evaluation, although MRI scanning can be problematic in the heaviest patients; the other groups require a reasonable level of clinical suspicion - features of hypopituitarism / hypogonadism, being the most common symptoms that justify investigation.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.

Article tools

My recent searches

No recent searches.

My recently viewed abstracts