Endocrine Abstracts

JOINT1176

Introduction: Craniopharyngiomas are low-grade suprasellar intracranial tumours commonly associated with obesity. This scoping review explored the potential impact of hyperphagic eating behaviour on the development of obesity in craniopharyngioma patients and to help identify areas for future intervention.

Methods: PRISMA-ScR and JBI methodology was followed. Five databases and two trial registries were searched. All published studies with all study designs were included for both adult onset and childhood craniopharyngioma, including those with or without obesity. The following categories were also included if they demonstrated their impact on eating behaviours: neuroimaging, endocrine response, energy expenditure, sleep, and neuropsychology.

Results: Evidence surrounding eating behaviours in craniopharyngioma patients was sparse with only 18 of the 54 included papers using validated eating behaviour assessments. Eating behaviour was included as a primary outcome (n = 7), secondary outcome (n = 12), or commented on without formal measurement (n = 35). Few studies included patients with adult-onset craniopharyngioma (n = 8), or compared patients with craniopharyngioma with and without obesity (n = 2), and no papers were identified assessing eating behaviours as an intervention for craniopharyngioma-related obesity. Six papers identified more pathological eating behaviour in the craniopharyngioma population whilst two papers found evidence to the contrary. Twelve papers commented on the impact of GLP1 analogues on eating behaviour, demonstrating limited impact on eating behaviours but long-term data on this is lacking. Four case-control studies examined endocrine response and eating behaviours, demonstrating a possible connection between salvia oxytocin levels, fasting ghrelin and adverse eating behaviours in those with craniopharyngioma associated obesity, albeit not consistently. Four studies identified a decrease in resting energy expenditure or basal metabolic rate in those with craniopharyngioma, whilst two further papers reported no difference. Structural imaging studies have correlated increased adverse eating behaviours with extensive intracranial lesions. A variable neural response was noted in craniopharyngioma such as an increase in the activation of the insula and cerebellum when viewing high calorific food. No studies commented on sleep.

Discussion: The quality of evidence on eating behaviours in those with craniopharyngioma and their impact on obesity is poor with mixed findings. Further understanding of eating behaviour following craniopharyngioma is needed, through longer-term research using validated measures. Clinical practice may benefit from exploration of eating behaviour to enhance patient-centred care by informing treatments tailored to patient needs.