Endocrine Abstracts

JOINT3798

Purpose: Patients with hypothalamic pathology often develop hypothalamic obesity, causing severe metabolic alterations resulting in increased morbidity and mortality. Treatments for hypothalamic obesity have not proven very effective, although the glucagon-like peptide-1 receptor agonist semaglutide has been shown to have positive effects. We examined semaglutide’s effect on weight loss in a sample of patients with hypothalamic obesity.

Methods: Four female patients with hypothalamic obesity resulting from treatment of craniopharyngiomas were treated with semaglutide for twelve months. Whole Body Dual-energy x-ray absorptiometry scans were performed, and blood samples drawn at baseline, after six and twelve months. Semaglutide dosages were increased monthly along with tracking of body weight and eating behavior (Three Factor Eating Questionnaire, TFEQ-R18). Semi-structured interviews were conducted with the four patients to explore their quality-of-life following weight loss.

Results: BMI was reduced in all cases, with an average of 9. 8 kg/m² (range: 5. 8-13. 6 g/m²) corresponding to a weight loss of 20. 9% (range: 10. 5-26. 2%) or 25. 7 kg (range: 15. 5-42. 0 kg). We found a comparable reduction in total fat mass (20. 8%, P = 0. 02) and lean mass (17. 8%, P = 0. 04). The patients all experienced an improved quality-of-life, including greater ease in physical activity, reduced pain and finding it easier to purchase clothing in their size. Unfavorable eating eating behaviors were reduced after 1 month of treatment (emotional eating –41 points, P = 0. 02, uncontrolled eatin –23 points, P = 0. 11). HbA1c and total cholesterol were significantly reduced (P = 0. 014 for both), with stable values from 6 months on.

Conclusion: Semaglutide is a promising and safe treatment option for hypothalamic obesity, that improves eating behavior, reduces weight and improves metabolic markers.